First aid

Employers are obliged by law to provide first aid facilities under the Health and Safety (First Aid) Regulations 1981 (First Aid Regulations).

New first aid training and approval arrangements came into force on 1 October 2009. The mandatory four-day training course was reduced to three days and there is also now a one-day option for small businesses. All qualified first aiders still have to attend a two-day requalification course every three years. The guidance also suggests that refresher training taken annually would be beneficial to first aiders and their employers (www.hse.gov.uk/firstaid).

The regulations require employers to provide:

• adequate and appropriate first aid equipment and facilities;

• an adequate number of trained and qualified first aiders. These are people who have been trained and received certificates to show they are capable of administering first aid;

• an “appointed person” if the first aider is absent; and

• an appointed person instead of a first aider in some smaller, low-risk workplaces. This person will provide information to all workers about the provision of first aid, location of equipment, facilities and personnel.

Employers must determine their own first aid needs. Assessments need not be recorded, but employers may have to justify decisions about the level of provision. The HSE guidance says that employers should consider:

• workplace hazards and risks;

• the size of the organisation;

• the organisation’s accident history;

• the nature and distribution of the workforce;

• the site’s remoteness from emergency medical services;

• the needs of travelling, remote and lone workers;

• employees working on shared or multi-occupied sites; and

• annual leave and other absences of first aiders and appointed persons.

If the assessment identifies a comparatively low risk to health and safety, employers may only need to provide a “clearly identified and suitably stocked” first aid container and an appointed person to look after first aid arrangements and take charge in emergencies.

If the risks are greater, employers may need to provide a sufficient number of first aiders to ensure someone is always available to give first aid immediately, train first aiders in specific procedures, inform local emergency services, in writing, of the sites where hazardous substances or processes are in use and provide first aid rooms.

The Approved Code of Practice (ACOP) to the First Aid Regulations states that employers have to provide suitable first aid materials, equipment and facilities. Every workplace must have at least one first aid box, and the box should be accessible at all times when employees are present.

The guidance lists a minimum stock of first aid items. The list is not mandatory, and “equivalent but different” items will be considered acceptable.

An HSE leaflet, Basic advice on first aid at work, should be included in the first aid container. It is available in both leaflet and poster formats, in line with the latest recommendations on first aid practice from the Resuscitation Council (UK).

A first aid room is usually necessary in high-risk establishments such as those in shipbuilding, the chemicals industry and large construction sites. It should contain essential first aid equipment. A designated person should have responsibility for the room. Employers are required to make a first aid room easily accessible to stretchers and to any other equipment needed to convey patients to and from the room. The first-aid room should be sign-posted and the signs should comply with the Health and Safety (Safety Signs and Signals) Regulations 1996 (SI 1996 No. 341).

Employers must provide information to employees about the provision of first aid, location of equipment, facilities and personnel. This should take into account people with language or reading difficulties. Employers should give new employees this information as part of their induction training and provide at least one notice in each workplace giving locations of facilities and equipment, and names and locations of first aiders.

The ACOP to the First Aid Regulations states that, if the assessment identifies a need for first aiders, employers should ensure that they are provided in “sufficient numbers at appropriate locations”. Where there are 50 or more employees, at least one such person should be provided “unless the assessment justifies otherwise”.

The HSE guidance suggests the following numbers of first aiders:

• lower-risk workplaces (i.e. shops, offices, libraries): at least one appointed person where fewer than 50 people are employed; at least one first aider where there are between 50 and 100 people; and, over this, one additional first aider for every 100 employees;

• medium-risk workplaces (i.e. light engineering, food processing, warehousing and assembly work): at least one appointed person where fewer than 20 people are employed; at least one first aider for every 50 where the workforce is between 20 and 100; and over this, there should be one additional first aider for every 100 employees; and

• higher-risk workplaces (i.e. construction, slaughter houses, chemical manufacturing or where much of the work involves dangerous machinery or sharp instruments): at least one appointed person where fewer than five people are employed; at least one first aider for between five and 50 employees, one additional first aider for every 50 people employed above this and at least one first aider trained in specific emergency action where there are hazards for which additional first aid skills are required.