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Corporate

First Aid: Standard Operating Procedure

Document Control Summary

Status: Replacement. Replaces: First Aid Policy

Version: v1.0 Date: January 2016

Author/Title: Owner/Title:

Nick Hulme - Health, Safety and Security Advisor Liz Lockett - Associate Director or Quality and Risk

Approved by: Policy and Procedures Committee Date: 21/01/2016

Ratified: Policy and Procedures Committee Date: 21/01/2016

Related Trust Strategy and/or Strategic Aims

Risk Management Strategy

Implementation Date: February 2016

Review Date: February 2019

Key Words: First; Aid; Kit

Associated Policy or Standard Operating Procedures

Health and Safety Policy

Contents

1. Introduction .............................................................................................................. 2

2. Purpose ..................................................................................................................... 3

3. Scope ........................................................................................................................ 3

4. Responsibilities ........................................................................................................ 3

5. First Aid Guidance.................................................................................................... 4

6. New Employees ........................................................................................................ 5

7. Determining the First Aid Needs – the Risk Assessment ...................................... 6

8. Fulfilling the First Aid Needs as Indicated by the Assessment ............................. 8

9. First Aid Materials, Equipment and Facilities ......................................................... 9

10. Process For Monitoring Compliance And Effectiveness ..................................... 12

11. References and Further Guidance ........................................................................ 12

First Aid SOP/February 2016

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Appendix 1 - Checklist for Assessment of First Aid Needs ........................................... 13

Appendix 2 - First Aid Needs Risk Assessment ............................................................. 15

Appendix 3 - Detail on Factors to Consider When Making the Assessment ................ 19

Appendix 4 - First Aid Training Information .................................................................... 23

Appendix 5 - Suggesed Number of First Aiders to be Available During Work ............. 26

Change Control – Amendment History

Version Dates Amendments

1. Introduction

The Health and Safety (First Aid) Regulations 1981 set out the essential aspects of first aid

that employers have to address. This SOP sets out the essential information to help

managers and supervisors to understand and comply with the Regulations so as to ensure

the Trust meets its legal duties on compliance. It offers practical advice on what managers

need to do. Managers may also find it useful to look at HSE’s ‘First aid at work’ website (see

‘further guidance’). These Regulations apply to all workplaces, including those with less than

five employees, and to the self-employed.

Employers have a legal duty to make arrangements to ensure their employees receive

immediate attention if they are injured or taken ill at work. It doesn’t matter whether the injury

or illness is caused by the work they do. What is important is that they receive immediate

attention and that an ambulance is called in serious cases. First aid can save lives and

prevent minor injuries becoming major ones. First aid at work covers the arrangements that

need to be made to manage injuries or illness suffered at work. The Regulations do not

prevent staff, who are specially trained, from taking action beyond the initial management

stage.

First Aid means:

a case where a person will need help from a medical practitioner or nurse, treatment for the

purpose of preserving life and minimising the consequences of injury and illness until such

help is obtained and treatment of minor injuries which would otherwise receive no treatment

or which do not need treatment by a medical practitioner or nurse (HSE 1997).


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2. Purpose

The purpose of the First Aid SOP is to ensure that any employee of The Trust has adequate

and appropriate access to First Aid provision and the needs for identifying this.

3. Scope

This SOP describes the procedures which should be followed by all Trust employees when

dealing with occasions when they may need emergency attention. It continues to describe

the procedure to follow to identify the first aid needs of a department/team. All employees

should have an awareness of this SOP and a number of employees will use the procedures

for action.

4. Responsibilities

4.1 The Trust Board

The Trust Board has overall responsibility for Health and Safety and ensuring that effective

management systems are in place to achieve high standards of Health, Safety and Welfare

and will call for periodic reports on the effectiveness and implementation of the First Aid

SOP.

4.2 Chief Executive

The Chief Executive has specific responsibility for giving effect to Health and Safety matters

on behalf of the Board and will ensure that this SOP is implemented and that the

effectiveness of the SOP is periodically reviewed.

4.3 Managers and Supervisors

Managers and Supervisors have the responsibility to implement the First Aid SOP in that

they shall carry out the necessary risk assessments to determine the first aid needs and

thereafter provide adequate first aid personnel to meet the identified needs and ensure

access to First Aid facilities and equipment is maintained and that an appropriate person is

identified to maintain the First Aid facilities and equipment. Managers may consult with the

Health and Safety Advisor and/or the Occupational Health Service in determining whether

adequate first aid facilities for employees are specified and provided.

Managers will ensure all employees are aware of this SOP and the first aid arrangements

i.e. the location of first aid boxes and first aiders. This will extend to informing new and

temporary staff at their induction training.

Managers will also ensure that an adequate number of staff are identified for and released

for First Aid training. Managers will also enable staff to receive subsequent refresher training

prior to certificate expiry to ensure the ongoing re-training costs to the Trust are kept to a

minimum.

Managers will also ensure that staff are released for additional training between re-

certification training where this is provided – in line with the HSE recommendation to provide

annual refresher training for first-aiders to help maintain their skills.


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Managers engaging personnel who work on a self employed basis will need to clarify and

confirm the first aid arrangements in place for them - see paragraph 4.8 below.

4.4 First Aiders

First Aiders must ensure that they have been recognised as First Aiders by The Trust and

that they receive regular training updates to maintain this recognition.

4.5 Occupational Health Service

In addition the Occupational Health Service may be available to support employees who

have been involved in a first aid incident – depending upon local arrangements pertaining to

the site.

4.6 Employees

All employees have a responsibility to abide by the First Aid SOP and any decisions arising

from its implementation. Should any employee become aware of any issues relating to this

SOP, they should report to their manager accordingly. All staff have a responsibility to make

themselves aware who their First Aiders are and where they and first aid boxes are located.

4.7 Health and Safety Lead

The Health and Safety Advisor is responsible for auditing and reviewing this SOP and in

conjunction with Occupational Health and managers to monitor the effectiveness of First Aid

provision throughout the Trust’s premises.

4.8 Duties of self-employed persons

Where the self-employed work on premises under the control of an employer or with other

self-employed workers, they are each responsible for making their own first-aid provision.

However, joint arrangements can be made with other occupiers to provide common cover.

Managers engaging personnel who work on a self employed basis will need to clarify and

confirm the first aid arrangements in place.

Anyone carrying out activities involving low hazards (such as clerical work) in their own

homes would not be expected to provide first-aid equipment beyond their normal domestic

needs.

5. First Aid Guidance

General

All staff who suffer an injury at work or who require assistance having become unwell at

work should be assisted by the nearest available first aid provider. If required, further

emergency assistance support is available from the medical emergency team or external

emergency services dependent on the severity of the incident.


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Sharps Injuries

Employees should be familiar with, and follow, the needle-stick / sharps / bites / scratch /

splash type injury procedure in the Infection Control Manual. Any member of staff receiving

such an injury should notify Occupational Health as soon as possible. If Occupational Health

personnel are not available they should contact the Infection Control Nurse or Accident and

Emergency Department by phone, where the individual will be advised of any necessary

action.

Transport

In the event of transport being required, taxis or the normal ambulance service may be

employed to transport staff from Trust premises to the appropriate point of treatment.

Reporting of Incidents

However minor the injury, an incident form must be completed in accordance with The Trust

incident reporting procedures. Reports should include details of the injured person and the

attending first aider.

RIDDOR

The Trust has a duty to report some accidents and incidents at work under RIDDOR

(Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013). Further

details are available in the Reporting and Managing of Adverse Events SOP along with

guidance on the means of reporting. See also www.hse.gov.uk/riddor/index.htm

Information for Employees

First-aid arrangements operate efficiently in an emergency only where everyone in the

workplace is aware of them, and understands and accepts them. One way to achieve this is

to develop procedures for informing staff in consultation with employees or safety

representatives. They should detail first-aid provision and explain how employees will be

informed of the location of first-aid equipment, facilities and personnel. The procedures

should also identify who will provide relevant first-aid information to new and transferred

employees.

A simple method of keeping employees informed is to display first-aid notices. The

information needs to be clear and easily understood by all employees. Employers should

also take steps to cater for those with reading or language difficulties. At least one notice in a

prominent position at each site, including the base for travelling employees, should give

enough opportunity for employees to see them. The inclusion of first-aid information during

induction training will help ensure new employees are made aware of first-aid arrangements.

6. New Employees

Before being allowed to work unsupervised in the department, a new employee or existing

member of staff who has transferred from another work location should be required to

http://www.hse.gov.uk/riddor/index.htm


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demonstrate to their immediate supervisor their understanding of the First Aid arrangements

by:

a) showing the location of the First Aid box

b) stating what to do in the event of a serious injury or sudden illness to themselves

or another member of staff

c) stating what to do in the event of an injury involving sharps

7. Determining the First Aid Needs – the Risk Assessment

Introduction

In October 2009 HSE introduced revised guidance on First Aid. An employer can send

prospective first aiders on a course in either a First Aid at Work (FAW) or emergency first aid

at work (EFAW). The employer should use the findings of their first aid needs assessment to

ensure the type of training course chosen is appropriate for the circumstances of the

workplace.

The FAW course is 3 days, whereas the EFAW option is a 1-day course for smaller low

hazard work places. Both the FAW and EFAW courses provide certification for 3 years.

Towards the end of the three year certification period, first aiders need to undertake an FAW

2-day requalification course or a 1-day EFAW course, as appropriate, to obtain another three

year certificate.

Within any certification period, HSE strongly recommends that first aiders undertake annual

refresher training. Although not mandatory, this will help qualified first aiders maintain their

basic skills and keep up to date with any changes to first aid procedures. Existing certificates

will continue to be valid until their due expiry date and irrespective of any annual refresher

training completed. First aiders do not have to provide evidence of having completed annual

refresher training in order to undertake an FAW requalification

The Law

The Health and Safety (First Aid) Regulations 1981 require employers to provide suitable

first aid equipment, facilities and personnel to enable first aid to be given to employees if

they are injured or become ill at work. Regulation 3(2) states that in order to provide first aid

to injured or ill employees, ‘…a person shall not be suitable unless he has undergone

(a) such training and has such qualifications as the Health and Safety Executive

may approve for the time being in respect of that case or class of case, and

(b) such additional training, if any, as may be appropriate in the circumstances of

that case’.

For employers to comply with this Regulation, their first aiders must have a valid certificate of

competence in FAW or EFAW, issued by a suitable training provider.


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General and Risk Assessment

An employer should make an assessment of first-aid needs appropriate to the circumstances

of each workplace. A risk assessment form (see Appendix 3) has been provided to identify

the need for training, specialist training for particular hazards, the need for a first aid box and

information to staff regarding provision.

The aim of first aid is to reduce the effects of injury or illness suffered at work, whether

caused by the work itself or not. First-aid provision must be ‘adequate and appropriate in the

circumstances’. This means that sufficient first-aid equipment, facilities and personnel should

be available:

(a) to give immediate assistance to casualties with both common injuries or illness

and those likely to arise from specific hazards at work;

(b) to summon an ambulance or other professional help.

Level of First Aid Provision

How much first-aid provision an employer has to make depends on the circumstances of

each workplace. There is no fixed level but each employer needs to assess what equipment,

facilities and personnel are appropriate.

Where the first-aid assessment identifies a need for people to be available for rendering first

aid, the employer should ensure that they are provided in sufficient numbers and at

appropriate locations to enable first aid to be administered without delay should the occasion

arise. Where 50 or more people are employed, at least one such person should be provided

unless the assessment justifies otherwise.

Factors to Consider When Making the Assessment

When assessing first aid needs, managers should consider:

1. the nature of the work and workplace hazards and risks;

2. the size of the organisation;

3. the nature of the workforce;

4. the organisation’s history of accidents;

5. the needs of travelling, remote and lone workers;

6. work patterns;

7. the distribution of the workforce;

8. the remoteness of the site from emergency medical services;

9. employees working on shared or multi-occupied sites;

10. annual leave and other absences of first-aiders and appointed persons;

11. first-aid provision for non-employees.

Appendix 1 is a ‘Checklist for Assessment of First Aid Needs’

Appendix 2 is the ‘First Aid Needs Risk Assessment Form’

Appendix 3 is ‘Detail on Factors to Consider When Making the Assessment’


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8. Fulfilling the First Aid Needs as Indicated by the Assessment

Levels of First Aid Personnel

There are 3 levels of personnel:

1. Appointed Person (AP) 2. Certificated Emergency First Aid at Work (EFAW) person 3. Certificated First Aider

Appointed Persons (AP)

It is important that someone is always available to take charge of the first-aid arrangements.

If an employer’s assessment of first-aid needs identifies that a first-aider is not required in

the workplace, the minimum requirement on any employer is that a person should be

appointed to take charge of the first-aid arrangements. The role of this appointed person

includes looking after the first-aid equipment and facilities and calling the emergency

services when required.

Arrangements should be made for an appointed person to be available to undertake these

duties at all times when people are at work. They can also provide emergency cover where a

first-aider is absent due to exceptional, unforeseen and temporary circumstances but not for

foreseeable absence such as annual leave. If the first-aid needs assessment indicates that

first-aiders are required, they should be available whenever the need arises.

To fulfil their role, appointed persons do not need first-aid training, although emergency first-

aid training courses are available. Therefore, it is important to remember that appointed

persons are not first-aiders and should not attempt to give first aid for which they have not

been trained. Given this and the remaining possibility of an accident or sudden illness, rather

than providing appointed persons, employers may wish to consider providing qualified first-

aiders.

Certified First Aiders

Where an employer provides first aiders in the workplace, they should have a valid

certificate of competence in either:

First Aid at Work (FAW) or

Emergency First Aid at Work (EFAW)

FAW training includes EFAW and also equips the first-aider to apply first aid to a range of

specific injuries and illness

EFAW training enables a first-aider to give emergency first aid to someone who is injured or

becomes ill while at work


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Validity of Certificates and Retaining Requirements

FAW and EFAW certificates are valid for three years. Employers need to arrange retraining

before certificates expire. Where first-aiders attend the relevant course within three months

prior to certificate expiry, the new certificate will take effect from that date of expiry for a

further period of three years. Retraining can be undertaken earlier than this three-month

period, in which case the new certificate will take effect from the date the course is

completed, however managers should realise that this would have the effect of losing over 3

months of validity.

Where retraining has not been undertaken before certificate expiry, it should be completed

no more than 28 days beyond the expiry date. The new certificate will be dated from the

expiry date of the previous certificate. If retraining is not completed by the end of this 28-day

period, the individual will need to undertake a full FAW course or EFAW course, as

appropriate, to be re-established as a first-aider.

Maintaining an Adequate Number of Qualified Fire Aid Personnel

Managers need to be aware that the First Aid at Work Regulations require a constant

availability of first aid personnel (in line with their assessment) whilst workers are present.

They need to ensure such cover is provided for annual leave, varying working hours/patterns

including weekend working, nights and public holidays.

In addition managers need to ensure that refresher training takes place to ensure

certification remains valid as previously described.

Managers also need to ensure that where existing personnel are no longer able to fulfil their

first aid role for example change of role, change of work-base, personal reasons or having

left the organisation or retirement that replacement personnel are identified and trained. In

cases of retirement, succession planning for their replacement ought to be possible.

9. First Aid Materials, Equipment and Facilities

When the assessment of first-aid requirements has been completed, the employer should

provide the materials, equipment and facilities needed to ensure that the level of cover

identified as necessary will be available to employees at all relevant times. This will include

ensuring that first-aid equipment, suitably marked and easily accessible, is available in all

places where working conditions require it.

Purpose of First Aid Box

to provide dressings etc. for the treatment of minor injuries, e.g. plaster for minor cuts

to provide an interim dressing for a more serious injury e.g. a pad to staunch more serious bleeding whilst in the injured person travels to the Accident and Emergency Department.


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First Aid Containers, Contents and Restocking

The minimum level of first-aid equipment is a suitably stocked and properly identified first-aid

container. Every employer should provide for each work site at least one first-aid container

supplied with a sufficient quantity of first-aid materials suitable for the particular

circumstances.

Depending on the findings of the first-aid needs assessment, more than one first-aid

container might be required on large sites. First-aid containers should be easily accessible

and preferably placed near to hand washing facilities. They should only be stocked with

items useful for giving first aid and should protect them from dust and damp. All first-aid

containers should be identified by a white cross on a green background.

There is no mandatory list of items to be included in a first-aid container. The decision on

what to provide will be influenced by the findings of the first-aid needs assessment. As a

guide, where work activities involve low hazards, a minimum stock of first-aid items might be:

a leaflet giving general guidance on first aid (for example, HSE’s leaflet Basic advice

on first aid at work);

20 individually wrapped sterile plasters (assorted sizes), appropriate to the type of

work (hypoallergenic plasters can be provided, if necessary);

two sterile eye pads;

four individually wrapped triangular bandages, preferably sterile;

six safety pins;

two large sterile individually wrapped un-medicated wound dressings;

six medium-sized individually wrapped un-medicated wound dressings;

a pair of disposable gloves - preferably non-latex (see HSE’s leaflet Latex and you).

This is a suggested contents list only.

The contents of first-aid containers should be examined frequently and restocked soon after

use. They should be re-stocked by the trained first aider or a suitable representative.

Sufficient supplies should be held in stock on site. Care should be taken to dispose of items

safely once they reach their expiry date.

Additional First Aid Materials and Equipment

The needs assessment may indicate that additional materials and equipment are required,

for example scissors, adhesive tape, disposable aprons and individually wrapped moist

wipes. They may be kept in the first-aid container if there is room or stored separately.

If mains tap water is not readily available for eye irrigation, at least a litre of sterile water or

sterile normal saline (0.9%) in sealed, disposable containers should be provided. Once the

seal has been broken, containers should not be kept for reuse. Containers should not be

used beyond their expiry date.

There may be a need for items such as protective equipment in case first-aiders have to

enter dangerous atmospheres, or blankets to protect casualties from the elements. Such

items should be stored securely near the first-aid container, in the first-aid room or in the


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hazard area, as appropriate. Access to them should be restricted to people trained in their

use.

Tablets and Medication

First aid at work does not include giving tablets or medicines to treat illness. The only

exception to this is where aspirin is used when giving first aid to a casualty with a suspected

heart attack in accordance with currently accepted first-aid practice. It is recommended that

tablets and medicines should not be kept in the first-aid container.

Some workers carry their own medication that has been prescribed by their doctor (e.g. an

inhaler for asthma). If an individual needs to take their own prescribed medication, the first-

aider’s role is generally limited to helping them do so and contacting the emergency services

as appropriate.

Automated External Defibrillators

Where an employer decides to provide a defibrillator in the workplace, it is important that

those who may use it are appropriately trained (see ‘further guidance’). HSE does not

specify the content of this training and organisations providing it do not need HSE approval.

Travelling First Aid Kits

Travelling First Aid kits should be provided for staff working away from hospital or clinic

premises e.g. who work alone and where travel forms a significant part of their work routine.

All Trust vehicles such as Ward cars and those used by Facilities and Estates should also

carry a minimum of a travelling first aid kit.

There is no mandatory list of items to be included in first-aid kits for travelling workers. They

might typically contain:

a leaflet giving general guidance on first aid (for example HSE’s leaflet Basic advice

on first aid at work);

6 individually wrapped sterile plasters (hypoallergenic plasters can be provided, if

necessary);

2 triangular bandages;

2 safety pins;

1 large sterile un-medicated dressing;

individually wrapped moist cleansing wipes;

a pair of disposable gloves – preferably non-latex (see HSE’s leaflet Latex and you).

This is a suggested contents list only and suitable arrangements should be in place

for restocking kits.

First Aid Rooms

Employers should provide a suitable first-aid room or rooms where the assessment of first-

aid needs identifies this as necessary. The first-aid room(s) should contain essential first-aid

facilities and equipment, be easily accessible to stretchers and be clearly signposted and

identified. If possible, the room(s) should be reserved exclusively for giving first aid.


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A first-aid room will usually be necessary where there are higher hazards such as in

chemical industries or on large construction sites, and in larger premises at a distance from

medical services. A designated person should be given responsibility for supervising it. The

room(s) should be clearly signposted and identified by white lettering or symbols on a green

background.

10. Process for Monitoring Compliance and Effectiveness

In order to ensure compliance, managers should undertake a first aid needs risk assessment

of their area to confirm there is an adequate number of first aid personnel, equipment and

facilities. Once this has been completed, training and subsequent refresher training should

be arranged as appropriate.

Further compliance will be monitored through annual audits and any reported incidents that

are highlighted through Risk Management and the Health and Safety Advisor.

11. References and Further Guidance

Information on first aid at work is available on HSE’s ‘First aid at work’ website at:

http://www.hse.gov.uk/firstaid/

Health and Safety at Work Act 1974

The Health and Safety (First Aid) Regulations 1981 and the Approved Code of Practice

Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 1995

http://www.hse.gov.uk/firstaid/


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Appendix 1

Checklist for Assessment of First Aid Needs

Factor to consider Impact on first-aid provision Space for notes

Hazards (use the findings of your risk assessment and take account of any parts of your workplace that have different work activities/hazards which may require different levels of first-aid provision)

Does your workplace have low-level hazards such as those that might be found in offices and shops?

The minimum provision is: - an appointed person to take charge of first-aid arrangements; - a suitably stocked first-aid box.

Does your workplace have higher level hazards such as chemicals or dangerous machinery? Do your work activities involve special hazards such as hydrofluoric acid or confined spaces?

You should consider: - providing first-aiders; - additional training for first-aiders to deal with injuries resulting from special hazards; - additional first-aid equipment; - precise siting of first-aid equipment; - providing a first-aid room; - informing the emergency services.

Employees

How many people are employed on site?

Where there are small numbers of employees, the minimum provision is: - an appointed person to take charge of first-aid arrangements; - a suitably stocked first-aid box. Where there are large numbers of employees you should consider providing: - first-aiders; - additional first-aid equipment; - a first-aid room.

Are there inexperienced workers on site, or employees with disabilities or particular health problems?

You should consider: - additional training for first-aiders; - additional first-aid equipment; - local siting of first-aid equipment. Your first-aid provision should cover any work experience trainees.

Accidents and ill health record

What is your record of accidents and ill health? What injuries and illness have occurred and where did they happen?

Ensure your first-aid provision will cater for the type of injuries and illness that might occur in your workplace. Monitor accidents and ill health and review your first-aid provision as appropriate.

Working arrangements

Do you have employees who travel a lot, work remotely or work alone?

You should consider: - issuing personal first-aid kits; - issuing personal communicators/mobile phones to employees.

Do any of your employees work shifts or work out of hours?

You should ensure there is adequate first-aid provision at all times people are at work.

Are the premises spread out, e.g. are there several buildings on the site or multi-floor buildings?

You should consider provision in each building or on each floor.

Is your workplace remote from emergency medical services?

You should: - inform the emergency services of your location; - consider special arrangements with the emergency services.


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Do any of your employees work at sites occupied by other employers?

You should make arrangements with other site occupiers to ensure adequate provision of first aid. A written agreement between employers is strongly recommended.

Do you have sufficient provision to cover absences of first-aiders or appointed persons?

You should consider: - what cover is needed for annual leave and other planned absences; - what cover is needed for unplanned and exceptional absences.

Non-employees

Do members of the public visit your premises?

Under the Regulations, you have no legal duty to provide first aid for non-employees but HSE strongly recommends that you include them in your first-aid provision.


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Appendix 2

First Aid Needs Risk Assessment Form

Determine Which Ward/Team/Department Or Combination You Are Assessing

Workplace Address*

Assessor Date

Ward(s)/Team(s)/Dept(s) being reviewed *

(alone or combination of)

* Please use the full name(s) for clarity and include address so as to avoid any confusion

There are 5 steps to determining the first aid personnel you require: Step 1 - Determine the hazard level and other risks applying to your ward/team/dept. Step 2 - Determine how many staff are typically present on a shift by shift basis. Step 3 - Determine the number and skill level of first aid persons required shift by shift. Step 4 - Determine the annual needs for first aid persons (to provide cover at all times staff are

working) Step 5 - Determine how your identified needs are to be met and ensure first aid facilities are provided

Step 1 – Determine The Hazard Level And Other Risks Applying To Your Ward/Team/Department

A. Taking account of SOP guidance what is the assessment of the hazard level associated with your work activities

Low

Hazard

High

Hazard

High

Hazard

And

Added

Risks

B. Does the work/work environment involve any particular risks/ hazardous substances etc. which require an increase in first aider nos. or skills – these and similar may suggest high or ‘added risks’

If so give details;-

C. Are any employees at greater risk e.g. young workers, trainees or people with disabilities?

If so give details;-

Step 2 – Determine How Many Staff Are Typically Present On A Shift By Shift Basis

A1. The working arrangements are typically standard office hours – for example Monday to Friday, 9-5 or thereabouts - If Yes go to A2, if No consider using option ‘B’

Yes / No

A2. How many staff are typically present each shift **. If wide variation it may worth using option B

B. For all other shift patterns you will need to take account of the days worked and the shift patterns in place and determine the typical maximum number of staff present for any shift ** see below

If you are combining more than 1 ward/team/dept into this assessment include their staffing nos. in this calculation to give total number for each shift.

Note - This is NOT the staffing establishment figure which is higher.

Shift Total no. staff typically present (all roles – see**)

Note any significant variation from this number e.g. at weekends

Early/ Day

Late

Night

**Include other staff such as housekeeping, doctors, OT’s etc. who may typically be present)


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Step 3 – Determine The Number And Skill Level Of First Aid Persons Required Shift By Shift

Now determine the appropriate First Aid persons skill level required and how many first aid persons you need for each shift

(see SOP and appendix 4)

Note that the requirements shown in App.4 are the minimum legal requirements

Number and skill level of First Aid persons required on shift to cover the number of staff working on shift

Appointed Persons

Emergency FAW

First Aid at Work

***FAW and added risk

Early/Day

Late

Night

***First-aider with additional training to respond to issues arising from hazards identified in step 1 above e.g. hazardous substances (specify), work at height etc.

Step 4 – Determine The Annual Needs For First Aid Personnel (So As To Provide Cover Shift By Shift For The Identified Hazard Level For All Shifts /Days Staff Are Present

Having decided upon the First Aid cover required ‘on shift’ you now need to calculate the total number of first aid personnel you require (the pool) so as to be able to provide this level of cover across all shifts when staff are present at work as several individuals will be required to cover each other for annual leave etc. so as to ensure a FA presence on shift at all times. If there is wide variation between shift requirements it may be necessary to calculate the annual requirements separately for each shift Explanation: If you operate 3 shifts per day over 365 days you will need to cover 1095 shifts. As 1 person typically works circa 210 shifts per year (i.e. 52x5 = 260 - 32A/L- 8 B/H - 4.5% [10 days] Sickness) then to provide for 1 FA person / shift requires a pool of 6 FA persons (i.e.1095 divided by 210 = 5.2 rounded up to 6), similarly to provide 2 FA persons / shift requires 2x 5.2, rounded =11 over the year and so on. There may be some variations if staff numbers vary significantly and consistently between shifts. Note;- These calculations are based on minimum levels of cover allowing for planned days off, annual leave, bank holidays , 4.5% sickness absence (Trust average), however other non-emergency absence will also need covering e.g. Jury Service.

Calculating the number of people required for the pool (For column ‘B’ – typically 3x365 = 1095 for 24/7 or 5x52-8 = 252 for M-F less BkHols)

A No shifts/ year to be covered

B Shifts worked / person – typically 210 if std. FT hours

C No. FA persons required /shift

D No. required for pool (A divided by B, times C)

E Actual no. needed (D rounded up)

Example 1095 210 2 10.4 11

Appointed Persons (AP)

Emergency First Aid at Work (EFAW)Persons

First Aid at Work (FAW) Persons

First Aid at Work (FAW) Persons - added risks

Step 5a – Providing First Aid Personnel To Meet The Identified Need

How many First Aid persons does your assessment indicate are

required to provide at the least the minimum level of provision at all

times

Appointed

Persons

Emergency

FAW

First Aid

at Work

FAW and

added risk

How many First Aid persons of each type do you already have?

What is the shortfall for each type of First Aid person?

Are there clinical staff available with adequate training in First Aid

who may be counted in addressing your First Aider nos.

If so give numbers and details

If there is a shortfall in provision how is this going to be addressed

and by when.


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Step 5b – Current List Of Staff With First Aid Training Certifications

Name of First Aider/

EFAW/Appointed Person

Date of Initial

Training

Certificate

Expiry Date (X)

Re-certification window

(Max permissible range is 3 mths

before / 28 days after date X)

Dates of any annual

Refresher Courses

undertaken

Step 5c – Lone Working And/Or Mobile Workers

Do employees who work alone have an easy and accessible means of summoning help? Yes/No

Do employees travel long distances or are they continuously mobile as part of their duties? If so, do

they carry a personal first aid kit? (Should be provided – see SOP)

Yes/No

Step 5d – Provision Of Facilities And Equipment

First-aid containers (kits) Travelling first-aid kit

Number

needed

Number in

place

Number needed Number in place

Additional equipment

(specify)

Is a first aid

room needed?

Yes /No Is a first aid room

in place

Yes /No

Are the names of the First Aiders/Appointed Persons posted on the premises/ward/department so as to

inform staff?

Yes/No

Are the locations of First Aid facilities posted on the premises/ward/department, made known and accessible

to every employee?

Yes/No

If eye wash facilities are required are they adequate for the hazards? (taps are acceptable in most

circumstances).

Yes/No

Are first aid boxes adequately stocked and accessible?

Yes/No

Is there a named person responsible for stocking the first aid box? If so please

provide their name(s) – if no answer this taken as a ‘no’ response

Name(s)

Are employees made aware of the incident reporting arrangements?

(All First incidents should be reported via the incident reporting system and

include details of the injured person and the attending first aider)

Yes/No

Implementation / Summary Of Actions Required

Action Lead person Date/Progress

/Completed

1. Establish the arrangements in accordance with the foregoing assessment

2. Ensure First Aid persons are aware of their roles and of the need to

communicate rosters/time off to ensure cover is provided for each and every shift.

3. Make all staff aware of the First Aid arrangements, names of first aid persons,


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how they can be contacted and the location of first aid facilities and equipment,

4. If the assessment covers more than a single ward/team/dept. ensure all the

above is shared and communicated as effective sharing will reduce the total

number of first aid persons required.

5. Ensure the equipment and facilities identified as being required are provided,

kept replenished, remain in date and maintained in good order


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Appendix 3

Detail on Factors to Consider When Making the Assessment

In deciding on their first-aid provision, employers will need to take account of different work

activities in different parts of an establishment. For example, a work site may contain

production and office/administration areas. In such circumstances, it is likely that separate

risk assessments will have to be made for individual departments, and the results of these

should be carried over to the assessment of first-aid needs. This will mean that first-aid

provision could vary between departments or buildings.

Size of the Organisation

Generally, the larger the workforce, the greater the first-aid provision that is required.

However, employee numbers should not be the sole basis for determining first-aid needs. A

greater level of provision may be required when fewer people are at work but are

undertaking tasks such as maintenance work. Employers should provide sufficient cover for

the various circumstances that can occur.

Even in workplaces with a small number of employees there is still the possibility of an

accident or sudden illness. Therefore, employers may wish to consider providing a qualified

first aider.

Nature of the Workforce

The particular needs of young workers, trainees, pregnant workers and employees with

disabilities or particular health problems should be addressed. First-aid provision should also

be extended to work experience trainees.

History of Accidents

Information collected when investigating previous accidents/incidents should be used when

assessing the adequacy of future first-aid provision. For large and/or multi-site organisations

this information could be helpful in determining where first-aiders should be located, what

geographical area they should be required to cover and what first-aid equipment is

necessary.

Needs of Travelling, Remote and Lone Workers

Employers are responsible for meeting the first-aid needs of their employees working away

from the main site, for example those who travel regularly or who work elsewhere. The

assessment should determine whether those who travel long distances or are continuously

mobile should carry a personal first-aid kit. Organisations with employees who work in

remote areas should consider making special arrangements such as issuing personal

communicators and providing additional training. Where employees work alone, other means

of summoning help, such as a mobile phone, may be useful to call for assistance in an

emergency.


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Work Patterns

First-aid requirements may vary where employees work shifts or out of hours. It is important

that sufficient provision is always available when employees are at work, and separate

arrangements may have to be made for each shift.

Distribution of the Workforce

An employer should consider how the size of the premises could affect quick access to first-

aid facilities. For example, whether additional first-aid provision is needed on a site with

more than one building, or whether the distance between buildings is such that additional

provision would be unnecessary. Employers with a multi-floor building should consider how

many first-aiders or appointed persons will be required to give adequate provision to

employees on each floor. Consideration should also be given to employees who work in self-

contained areas, and how their needs are assessed and met.

Remoteness of the Site from Emergency Medical Services

Where a site is remote from emergency medical services, employers may need to make

special arrangements to ensure appropriate transport is available. Employers should inform

the emergency services, in writing, of their location and any particular circumstances,

including specific hazards.

Employees Working On Shared or Multi-Occupied Sites

On a shared or multi-occupied site, employers can arrange for one employer to take

responsibility for providing first-aid cover for all the workers. In these cases, a full exchange

of information about the hazards and risks involved should help ensure that the shared

provision is adequate. All employers should agree the arrangements and employees should

be kept informed. A written agreement between employers is strongly recommended to

avoid any misunderstandings.

Where an employment business contracts out employees to another employer, the

employment business should ensure, by arrangement with the user employer, that these

employees have access to first-aid provision.

Annual Leave and Other Absences of First-Aiders and Appointed Persons

It is essential that adequate provision is made at all times people are at work. Employers

therefore need to ensure there is cover for annual leave and other planned absences of first-

aiders or appointed persons. Employers should also consider what cover is needed for

unplanned and exceptional absences such as sick leave or special leave due to

bereavement.

First Aid Provision for Non-Employees

These Regulations do not require employers to provide first aid for anyone other than their

own employees. However, many organisations such as schools, places of entertainment and


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shops provide a service for others and it is strongly recommended that employers include

non-employees in their assessment of first-aid needs and make provision for them.

Where first-aid provision is intended to cover both employees and non-employees,

employers should ensure that:

the level of provision for employees does not fall below the standard required by

these Regulations;

the level of provision for non-employees complies with any other relevant legislation

and guidance.

Review of First-Aid Provision

Employers should periodically review their first-aid needs, particularly after any operating

changes, to ensure provision remains appropriate. To help with this process, it is

recommended that a record is kept of the incidents dealt with by first-aiders and appointed

persons. This will be met through the completion of an incident report in each instance in line

with Trust policy.

Records

It is good practice for employers to provide first-aiders and appointed persons with a book in

which to record incidents they attend, again this will be met by the completion of an incident

report in each instance in line with Trust policy. The information to be recorded should

include:

date, time and place of the incident;

name and job of the injured or ill person;

details of the injury/illness and what first aid was given;

what happened to the person immediately afterwards (for example went back to

work, went home, went to hospital);

name and signature of the first-aider or person dealing with the incident.

This information can help the employer identify accident trends and possible areas for

improvement in the control of health and safety risks. It can be used for reference in future

first-aid needs assessments. These records may also be helpful for insurance and

investigative purposes.

Linking the First Aid Needs Assessment with Other Risk Assessments

The Management of Health and Safety at Work Regulations 1999 require employers to

make an assessment of the risks to health and safety of their employees at work, to identify

what measures they need to take to prevent or control these risks.

Information gathered from these risk assessments can help managers carry out their

assessment of first-aid needs, if preventive or control measures fail. Identifying the likely

nature of an accident or injury will help the employer work out the type, quantity and location

of first-aid equipment, facilities and personnel to provide.


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Findings of the Risk Assessment

Having completed the assessment the assessor will then be in a position to determine how

the first aid needs will be addressed.

How Many First-Aiders Are Needed?

The findings of the first-aid needs assessment will help the employer decide how many first-

aiders are required. There are no hard and fast rules on exact numbers as employers will

need to take into account all the relevant circumstances of their particular workplace.

After completing the checklist in appendix 1 and completing the assessment appendix 2, the

flow chart in Appendix 5 serves as a general guide on how many first-aiders or appointed

persons might be needed. The employer should take into account all relevant information to

make a valid judgement.

Recording the Assessment

There is no requirement for the assessment of first-aid needs to be formal or written down

although it may be useful for employers to record the results. Employers might need to justify

their level of first-aid provision. Appendix 2 is provided for this purpose.

Summary

Having completed the assessment of First Aid needs taking into account all the foregoing

aspects the manager should now have determined the numbers of ‘First Aid’ personnel

required, the level of expertise/training required (i.e. Appointed Person / Emergency First Aid

at Work Person / First Aider), the facilities and equipment required and where these should

be located.

The next stage is to put in place the necessary arrangements to fulfil those identified needs.


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Appendix 4

First Aid Training Information

First Aid at Work (FAW) Courses – usually run as a 3 day course

Content of a first aid at work (FAW) course

The training should include all these elements but where practicable, you can tailor it to meet

the needs of individuals and/or their employers. On completion of training, successful

candidates should be able to:

(a) provide emergency first aid at work as per EFAW course content (– see C. below)

(b) administer first aid to a casualty with:

(i) injuries to bones, muscles and

joints, including suspected spinal

injuries;

(ii) chest injuries;

(iii) burns and scalds;

(iv) eye injuries;

(v) sudden poisoning;

(vi) anaphylactic shock;

(vii) recognise the presence of major illness

and provide appropriate first aid.

(including heart attack, stroke, epilepsy,

asthma, diabetes).

Duration of a First Aid at Work (FAW) course

FAW courses should contain at least 18 contact hours, which include the final practical

assessment. ‘Contact hours’ refer to teaching and practical time, excluding lunch and breaks.

The course is run over a minimum of three days. However, it is acceptable to run the course

over a longer period, not exceeding ten weeks, where each session lasts at least two hours.

Training courses for FAW should not be combined with FAW requalification courses.

First Aid at Work (FAW) Requalification Course - usually run as a 2 day course

Validation of students prior to commencement

Administrative systems should be in place to ensure students are not accepted for

requalification training unless they have a current and valid FAW certificate. This requirement is

non-negotiable and pre-course information should make this requirement clear. Training

providers should validate a student’s FAW certificate before they start a requalification course.

Content of a First Aid at Work (FAW) requalification course

FAW requalification training should cover the topics of the full FAW course in sufficient detail to

ensure students are competent on completion.

Duration of a First Aid at Work (FAW) requalification course

FAW requalification courses should contain at least 12 contact hours, which include the final

assessment. ‘Contact hours’ refer to teaching and practical time, excluding lunch and breaks.

The course is run over a minimum of two days. However, it is acceptable to run the course over

a longer period, not exceeding six weeks, where each session lasts at least two hours.

Emergency First Aid at Work (EFAW) Course - usually run as a 1 day course

Content of an emergency first aid at work (EFAW) course

On completion of training, successful candidates should be able to: understand the role of the

first aider including reference to:


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the importance of preventing cross infection;

the need for recording incidents and actions;

use of available equipment;

assess the situation and circumstances in order to act safely, promptly and effectively

in an emergency;

administer first aid to a casualty who is unconscious (including seizure);

administer cardiopulmonary resuscitation;

administer first aid to a casualty who is choking;

administer first aid to a casualty who is wounded and bleeding;

administer first aid to a casualty who is suffering from shock;

provide appropriate first aid for minor injuries (including small cuts, grazes, bruises,

minor burns and scalds, small splinters).

The EFAW course is content is the same as the EFAW component of FAW training.

Certificates issued to successful students should contain the title ‘Emergency First Aid at

Work’. There is no final practical assessment. Trainers should use continuous assessment to

evaluate candidates.

Duration of an emergency first aid at work (EFAW) course

EFAW courses should contain at least 6 contact hours. ‘Contact hours’ refer to teaching and

practical time and excludes lunch and breaks etc. The training is run over a minimum of 1

day, but can be run over a longer period not exceeding 4 weeks, each session lasting at

least 2hours.

Emergency First Aid at Work Requalification Course

There is no specific requalification course. Requalification training amounts to the same

content and duration as the initial EFWA course i.e. 1 day, hence it is the same course for

new personnel and for re-qualifiers and there is no specific need for validation of status prior

to the course.

FAW and EFAW Annual Refresher Course - usually run as a 1 day course

HSE strongly recommends that first aiders undertake annual refresher training within any

three year certification period of FAW or EFAW. It is not mandatory and any training provider

offering annual refresher training should not state that it is a legal requirement. Equally, any

certificates issued to students should not state or imply that the training is HSE approved.

Content of an annual refresher course for FAW and EFAW personnel

The training would normally cover the content shown below;-

Candidates should demonstrate their competence to:

(a) assess the situation in an emergency;

(b) administer first aid to a casualty who is unconscious (including seizure);

(c) administer cardiopulmonary resuscitation;

(d) administer first aid to a casualty who is wounded and bleeding;

(e) administer first aid to a casualty who is suffering from shock.


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Duration of an annual refresher course for FAW and EFAW personnel

The training would normally last at least three hours over half a day.

Where available, in-house occupational health professionals (a doctor registered with the

General Medical Council or a nurse registered with the Nursing and Midwifery Council) can

run annual refresher training in the workplace providing they have current experience of first

aid skills, are competent to train and are familiar with the current standards HSE accepts for

the first aid management of injuries and illness in the workplace.

Additional Training to Meet Specific Hazards

Employers may need first aiders with specific training additional to FAW/EFAW. For

example, to provide first aid in relation to incidents arising from work with particular hazards

such as hydrofluoric acid, cyanide or confined spaces. Similarly, further training would be

required for personnel who may need to use a defibrillator.

The content of these additional training courses is not specified by HSE, nor is HSE approval

needed to run them. They should be provided as an extension to FAW/EFAW courses, or as

standalone courses, and a certificate should be issued separately from the FAW / EFAW

certificate. Any certificates issued to students for additional training should not state or imply

that the training is HSE approved.

Training for Appointed Persons

When an employer's first-aid needs assessment identifies that a first-aider is not necessary,

the minimum requirement is to appoint a person to take charge of first-aid arrangements.

The role of this appointed person includes looking after the first-aid equipment and facilities

and calling the emergency services when required. They can also provide emergency cover,

within their role and competence, where a first-aider is absent due to unforeseen

circumstances (annual leave does not count). To fulfil their role, appointed persons do not

need first-aid training. However, emergency first-aid training courses are available.

Appointed persons are not first-aiders and should not attempt to give first aid for which they

have not been trained.


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Appendix 5

Suggested Numbers of First Aid Personnel to be Available at All Times People Are at Work (HSE Guidance)

1. From your risk assessment, what degree of hazard is associated with your work activities?

2. How many

employees do

you have?

3. What first-aid personnel

do you need?

4. What injuries and

illness have

previously occurred

in your workplace?

5. Have you taken

account of the factors

below that may affect

your first-aid

provision?

■Inexperienced workers or

employees with disabilities

or particular health

problems

■Employees who travel a

lot, work remotely or work

alone

■Employees who work

shifts or out of hours

■Premises spread out

across buildings/floors

■Workplace remote from

emergency medical

services

■Employees working at

sites occupied by other

employers

■Planned and unplanned

absences of first-aiders/

appointed persons

■Members of the public

who visit the workplace

Low hazard

e.g. offices, shops,

libraries

Higher hazard

e.g. light engineering

and assembly work,

food processing,

warehousing, extensive

work with dangerous

machinery or sharp

instruments,

construction, chemical

manufacture.

■Ensure any injuries and

illness that might occur

can be dealt with by the

first-aid personnel you

provide

■Where first-aiders are

shown to be

unnecessary, there is still

a possibility of an

accident or sudden

illness, so you may wish

to consider providing

qualified first-aiders

Less than 25

25—50

More than 50

More than 50

At least one appointed person

At least one appointed person

At least one first-aider trained

in FAW for every 100

employed (or part thereof)

At least one first-aider trained in EFAW or FAW depending on the type of injuries that might occur

At least one first-aider

trained in EFAW

At least one first-aider trained in FAW for every 50 employed (or part thereof)

5—50

Less than 5

OR

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