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
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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
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.
First Aid SOP/February 2016
Page 7 of 26
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’
First Aid SOP/February 2016
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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
First Aid SOP/February 2016
Page 9 of 26
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.
First Aid SOP/February 2016
Page 10 of 26
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
First Aid SOP/February 2016
Page 11 of 26
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.
First Aid SOP/February 2016
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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
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.
First Aid SOP/February 2016
Page 14 of 26
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.
First Aid SOP/February 2016
Page 15 of 26
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)
First Aid SOP/February 2016
Page 16 of 26
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.
First Aid SOP/February 2016
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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)