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January 24, 2023

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Legislation and guidance

The (slow) evolution of The Health and Safety (First-Aid) Regulations

Adam Clarke from Praxis42 discusses what the regs don’t tell you about first aid…

Adam Clarke

Adam Clarke, Managing Director (Consulting) Praxis42.

Having trained first aiders and ‘appointed persons’ in an organisation is something we’re all familiar with. The Health and Safety (First-Aid) Regulations 1981 may seem timeless, but with the way we work evolving thanks to influences like developing technology and the pandemic, there are also some additional things to consider when we think about First-Aid Regulations, even if they’re not explicitly mentioned.

First aid has always been with us. It’s one of those basic human triggers: if someone is injured, it’s in most people’s nature to want to help. Actually pinpointing when a formal kind of first aid started to take shape is more of a problem however. We have references to basic first aid as early as the Roman army, which had designated combat medics amongst its ranks.

As you’d imagine, the battlefield continued to be the place where first-aid knowledge and expertise continued to be developed through the centuries, until German Friedrich Esmarch used his experience as a military surgeon to publish a series of works based on what he saw as best practice in the middle of the 19th Century. Many point to these as the beginning of modern first aid, with the formation of St John Ambulance and St Andrew’s Ambulance Association following not long after in England and Scotland.

But it wasn’t until the Health and Safety (First-Aid) Regulations 1981 were created, that there was a mandatory set of rules that applied to all employers, including those with fewer than five employees. Over 40 years later, and with just a few revisions, these regulations are still guiding the way employers ensure first aid provision for their employees.

Your responsibilities as an employer

Credit: Alamy Stock

At their heart, the regulations are very simple, requiring that each workplace assess the potential for injury/illness based on the activities carried out there, then ensure that skills and equipment are in place to deal with those situations if they occur.

They stipulate that employers must be in a position to provide immediate medical attention to employees who are injured or taken ill in the workplace, by

  • Conducting a first-aid assessment of the workplace
  • Providing first-aid training to employees
  • Providing first-aid facilities, equipment and personnel

These points apply to all organisations, but how you meet the requirements depends very much on the size of your organisation. The HSE advises that as a minimum, a small office, identified through assessment as having low health and safety risks, needs a first-aid box and an appointed person to take responsibility for first-aid arrangements like calling an ambulance. A larger workplace with bigger health and safety risks is likely to need one or more trained first aiders and better first-aid facilities.

First-aid needs assessments

The first stage of the process is the assessment, which is critical to understanding the level of first-aid provision needed at your workplace – a factory will have very different needs to a library for example. This needs to cover everything from the type of work carried out and previous accidents in the workplace, to considerations like the distance of your workplace to medical services.

The HSE provides some useful case studies that show the assessment process for different types of organisations, as well as a checklist for first-aid needs assessments which will help you cover all bases for your own assessments.

It’s important to note that the regulations apply to all businesses, so even people who are self-employed are required to have ‘adequate and appropriate’ equipment to provide first aid for themselves while at work. Assessments should be carried out in exactly the same way as for a larger organisation, with training and kit sourced in line with the assessment’s results.

Also worth highlighting here is that the regulations apply equally to non-employees in your workplace. So contractors, freelancers, visitors and members of the public should all be considered when assessing first-aid needs and delivery.

The assessment is one part of the process that does need to continually evolve as equipment, technology, the way we work and where we do it continue to see significant changes.

For example, many office environments now provide options for hybrid working. With employees spending a greater portion of their time working from home, the potential for an incident in the workplace itself is reduced. Conversely, this means there’s more likelihood of a first aider being away from the office if there does happen to be an incident, so first-aider absences need to be considered more carefully.

Mental-health first aid

There’s one area of the assessment that I personally feel needs to be explored and defined more thoroughly: mental-health first aid.

Whilst it’s comparatively easy to identify low and high risks when it comes to physical injury, a workplace categorised as ‘low hazard ’may actually pose a significant risk to mental health when factors such as performance expectations, deadlines & targets, and simply dealing with the pressures of our modern, challenging world are considered.

Mental-health first aid can help first aiders identify and support employees who may be struggling, and while this is significantly different to dealing with a physical injury, the principle of helping a person who needs it, is totally in line with the aims of the regulations.

So while carrying out your assessment, please also take some time to consider the mental-health needs of your employees.

First aiders and appointed persons

Not every organisation (or specific locations within it) will need first aiders, often an appointed person is adequate. So let’s just quickly look at the difference between these two equally-important roles.

It will be no surprise to you to learn that first aiders provide first aid, whilst an appointed person is in charge of the first-aid arrangements, taking responsibility for looking after the equipment & facilities and calling the emergency services. Workplaces that only require an appointed person are likely to be smaller, with low health-and-safety risks. If you have multiple first aiders, an appointed person is unnecessary as the first aiders will take over the responsibilities of the role.

Although employees themselves don’t have any responsibilities when it comes to the regulations, they should be encouraged to make the first aiders aware of any health issues they have, or any medication they take, which may be important if the employee becomes ill at work.

First-aid training

If your workplace needs first aiders, then they will need to be trained by a recognised organisation offering courses such as:

  • First Aid At Work (FAW)
  • Emergency First Aid At Work (EFAW)

It’s recommended that every first aider has annual refresher training to keep their skills sharp and their knowledge up to date – ideally they’ll have had no cause to use their skills over the year!

Beyond these essential courses, there are others that should also be considered too, such as Slips, Trips and Falls training, and Mental Health First Aid courses.

Appointed persons will also need training with a specific First Aid Appointed Person course, which can be done remotely and will usually last less than an hour.

How many first aiders do you need?

There are no hard-and-fast rules to determine the number you need. The HSE suggests numbers based on the environment and hazard level, and these, along with the case studies mentioned above are good guides:

Low-hazard workplaces (ie offices, shops, libraries):

  • < 25 employees: at least one appointed person
  • 25 to 50 employees: at least one first aider trained in EFAW
  • > 50 employees: at least one FAW-trained first aider for every 100 employees (or part thereof)

Higher-hazard workplaces (ie engineering, food processing, warehouses, construction):

  • < 5 employees: at least one appointed person
  • 5 to 50 employees: at least one first aider trained in EFAW or FAW (guided by the type of potential injuries)
  • > 50 employees: at least one FAW-trained first aider for every 50 employees (or part thereof)

First-aid equipment and facilities

Bull First AidAs with the number of first aiders, the regulations provide guidelines rather than hard rules here, with your own assessment leading you towards the equipment and facilities your organisation needs to deal with any incidents effectively.

As a minimum, every organisation needs a first-aid kit with suitable contents, along with clear comms that identify the first aiders and where they and the first-aid kits can be found. Often this is simply notices displayed around the workplace.

A higher-risk environment will of course need more equipment and facilities. This may include a dedicated first-aid room that’s large enough for a medical/examination couch, and contains washable surfaces, and hot & cold running water. These rooms should be accessible for transport to hospital, and have notices on the door identifying first aiders, their contact details, and where they can be located.

Looking ahead

From ancient battlefields to high-tech manufacturing environments, the need for expert first aid has remained constant, even if the knowledge and techniques have evolved.

You can’t be too prepared when it comes to first aid training and equipment, particularly in new areas of concern such as mental-health first aid, so feel free to go above and beyond the regulations for the good of your employees. If you have an incident at your workplace, you’ll be pleased you did.

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Diana Kloss
Diana Kloss
1 year ago

The HSE Guidance says that the employer has no legal duty to provide first aid for non-employees, like members of the public, and that appears to be what the regulations say. Have I missed something?

Sophie Bevington
Sophie Bevington
1 year ago

We are having an interesting conversation about first aid in the workplace when we have a highly flexible office work environment as we don’t know who will be in what day to give first aid cover. I would be interested to hear how others are making it work.

Nigel Evelyn-dupree
Nigel Evelyn-dupree
1 year ago

Hi Diane: Elf-an-safety starts with a duty of care for self before anyone else nevertheless, if a member of the public, non-employee is injured, I am not at all sure that “denying attention would not be negligent” for another human being and no less than an expectation of assistance were you injured. What has been expediently missed for three decades has been display screen interface ergonomics regardless of recent Accessibility Regulations or effectively Product Safety never mind the 1974 Act or 93 UK DSE Reg’s, 1995 DDA or 1998 PUWER Act promoting personal custom “reasonable adjustments and/or accommodations” for induced… Read more »