First Aid Needs Assessment

This is an abridged version of the latest HSE guidance (October 2009). It should be read in conjunction with the .pdf that can be downloaded at the bottom of the page.

Assessment of Need
An employer should make an assessment of first-aid needs appropriate to the circumstances of each workplace.

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:
- To give immediate assistance to casualties with both common injuries or illness and those likely to arise from specific hazards at work;
- To summon an ambulance or other professional help.

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 employers have an occupational health service or access to other occupational health advice, they might wish to delegate the responsibility for carrying out the assessment and advising on first-aid provision, to them.

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.
In assessing their needs, employers should consider:
- The nature of the work and workplace hazards and risks;
- The size of the organisation;
- The nature of the workforce;
- The organisation’s history of accidents;
- The needs of travelling, remote and lone workers;
- Work patterns;
- The distribution of the workforce;
- The remoteness of the site from emergency medical services;
- Employees working on shared or multi-occupied sites;
- Annual leave and other absences of first aiders and appointed persons;
- First-aid provision for non-employees

Nature of the work
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 the risk assessment can help the employer 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.

The type of work performed will help determine the identifiable hazards in the workplace and the possible harmful consequences for employees, and therefore the level of first-aid provision. For example, in organisations such as offices or shops, employers may only need to provide an appointed person to take charge of first-aid arrangements, and a clearly identified and suitably stocked first-aid box. However, even in these circumstances it is still possible for an accident or sudden illness to occur and it is recommended that employers consider having a qualified first aider available.

Where the work involves hazards such as chemicals or dangerous machinery, or special hazards such as hydrofluoric acid or confined spaces, first-aid requirements will be greater. Employers may then need to:

- Provide a sufficient number of qualified first aiders so that someone isalways available to give first aid immediately following an incident;
- Provide additional training for first aiders to deal with injuries/ illness resulting from special hazards;
- Consider additional first-aid equipment;
- Provide one or more first-aid rooms;
- Inform the local emergency services, in writing, of the site where hazardous substances or processes are in use.

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, it is likely that because of the variety of work carried out, separate risk assessments will have to be made for individual buildings or departments within a university complex. The results of these separate assessments should be carried over to the assessment of first-aid needs. This will mean that first-aid provision could vary between buildings or departments.

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, it is recommended that employers consider providing a qualified first aider.

Nature of the workforce
The particular needs of young workers, trainees, pregnant workers and employees with disabilities or special 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 future first-aid provision. For large 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. Where employees work alone, other means of summoning help such as a mobile phone may be useful to call for assistance in an emergency.

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 each floor. Consideration should also be given to employees that work in self-contained areas.

Remoteness of the site from emergency medical services
Where a site is remote from emergency medical services, employersmay 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 (the public, children at school, etc
These Regulations do not oblige employers to provide first aid for anyone other than their own employees. However, many organisations such as schools, places of entertainment, fairgrounds and shops provide a service for others and it is strongly recommended that employers include them in their assessment of first-aid needs and make provision for them. (Guidance on first-aid provision in schools is available from the Department for Children, Schools and Families.)

Where first-aid provision is intended to cover both employees and non employees, employers should check their liability insurance covers the activities of first aiders. They should also 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 review their first-aid needs from time to time,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.

First Aid Personnel

First aiders
Where the first-aid assessment identifies a need for people to beavailable 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.

How many first aiders are needed?

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. The following is a guide only to how many first aid trained staff companies may need:

Low Hazard

Less than 25 employees = At Least One Appointed Person

25 - 50 employees = At Least One EFAW (one days training)

More than 50 = At Least One FAW (three days training) per 100 or part thereof

Higher Hazard

Less than 5 employees = At Least One Appointed Person

5 - 50 employees = At Least One EFAW (one days training) or FAW (three days training) depending on the type of injuries that might occur

More than 50 = At Least One FAW (three days training) per 50 or part thereof

What training and qualifications are needed to become a first aider in the workplace?
Before taking up first-aid duties, a first aider should hold a valid certificate of competence in either:
- First aid at work (FAW), issued by a training organisation approved by HSE; or
- Emergency first aid at work (EFAW)

The findings of the needs assessment can be used to help employers decide whether their first aiders should be trained in FAW or EFAW. If the assessment indicates that first aiders should be trained to FAW standard, it is not acceptable to provide first aiders that possess an EFAW certificate instead. As a guide, the flow chart in Appendix 4 suggests the category of first-aid personnel to provide under different circumstances.

Additional training of first aiders may be necessary to cover special hazards so they can deal with particular problems that might arise. For example, more in depth training would be advisable in cases where work activities involve the use of hydrofluoric acid or cyanide, or working in 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. It may be undertaken as an extension to FAW/ EFAW training or as a stand-alone course and a certificate should be issued separately from the FAW/ EFAW certificate.

On successful completion of an FAW or EFAW course, candidates are issued with a certificate for three years. They then need to undertake an FAW requalification course or EFAW course, as appropriate, to obtain another three year certificate. Employers should make every effort to ensure that first aiders attend the relevant course within the three month period prior to certificate expiry date. The new certificate will then take effect from the date of expiry.

However, where it has not been possible to requalify in this three month period, HSE will allow extension of the certificate for 28 days beyond the expiry date, within which an FAW requalification or EFAW course should be completed. There is no need to contact HSE to request the certificate extension. During the extension period, HSE will continue to recognise the FAW/ EFAW qualification and the first aider can still provide first aid to employees.

Annual Refresher Training

HSE strongly recommends that first-aiders undertake annual refresher training during any three year FAW/ EFAW certification period. 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.

Appointed persons
Where an employer’s assessment of first-aid needs identifies that a first aider is not necessary, the minimum requirement on an employer is to appoint a person to take charge of the first-aid arrangements, including looking after 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.

Even in small, low hazard organisations where first aiders areconsidered unnecessary, there is always the possibility of an accident or sudden illness. Therefore, it is important that someone is always available to take charge of the first-aid arrangements, including looking after the equipment and facilities and calling the emergency services when required. In the absence of first aiders, employers should appoint a person for this purpose, though appointed persons are not necessary where there is an adequate number of first aiders.

To fulfil their role, appointed persons do not need first-aid training, though emergency first-aid 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 should consider providing qualified first aiders.

The Regulations allow for a person to be appointed to provide emergency cover in the absence of first aiders but only where the absence is due to exceptional, unforeseen and temporary circumstances. Absences such as annual leave do not count. Remember, if the first-aid needs assessment indicates that first aiders are required, they should be available whenever the need arises.

Roles of Key Personnel

Employer
Under the Health and Safety (First-Aid) Regulations 1981, employers have a duty to provide suitable first-aid equipment, facilities and personnel so that immediate assistance can be given to employees that are injured or taken ill at work. Employers should ensure that employees are aware of the first-aid arrangements in their workplace. These duties apply to all employers including those with fewer than five employees.

Self-Employed Worker
Self-employed workers have a duty under the Health and Safety (First Aid) Regulations 1981 to ensure that where appropriate, they have suitable first-aid equipment to provide first aid to themselves while at work.

First Aider
If an employer decides they need to provide one or more first aiders in their workplace, they should ensure a suitable employee has a valid certificate of competence in either first aid at work or emergency first aid at work. Once qualified, a first aider can provide first aid to employees that are injured or
taken ill while at work.

Appointed Person
If an employer decides that a first aider is not required in their
workplace, they should appoint a person 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. They can also provide emergency cover where a first aider is absent due to unforeseen circumstances (annual leave does not count).
Appointed persons do not need first-aid training and are not necessarywhere there is an adequate number of first aiders.