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Guide to Carrying out a First Aid Needs Assessment

The new First Aid at Work Guidelines for Employers from the Health and Safety Executive are effective from 1st October 2009. The new type of first aid needs assessment will identify what type of first aid training your first aiders will need, how many first aiders you need and where they should be located.

A First Aid Needs Assessment should consider the following topics:

The nature of the work, the hazards and the risks

One of the more complicated areas of the new first aid needs assessment is considering 'the nature of the work, the hazards and the risks'. You should consider the risks and identify what possible injuries could occur in order to ensure sufficient first aid provision is available.

The following table, compiled using information from the Health & Safety Executive, identifies some common workplace risks and the possible injuries that could occur:

Risk Possible Injuries Requiring First Aid
Manual Handling Fractures, lacerations, sprains and strains.
Slip and trip hazards Fractures, sprains and strains, lacerations.
Machinery Crush injuries, amputations, fractures, lacerations, eye injuries.
Work at height Head injury, loss of consciousness, spinal injury, fractures, sprains and strains.
Workplace transport Crush injuries, fractures, sprains and strains, spinal injuries.
Electricity Electric shock, burns.
Chemicals Poisoning, loss of consciousness, burns, eye injuries.

The table is not comprehensive and does not cover all the risks that could occur in a workplace, so you should look at each area of the workplace and document the risks and the possible injuries.

One reason for this exercise is to ensure that you provide the correct type of first aider(s). There are now two levels of workplace first aider:

You should ensure that your first aiders are trained to deal with the injuries and illness that could occur. The table below will help you match your requirements to the most appropriate course:

What Emergencies are First Aiders Trained to Deal With?
EFAW = Emergency First Aid at Work (6 hour course)
FAW = First Aid at Work (18 hour course)
6 Hours
18 hours
Acting safely, promptly and effectively in an emergency
Cardio Pulmonary Resuscitation (CPR)
Treating an unconscious casualty (including seizure)
Wounds and bleeding
Minor injuries
Preventing cross infection, recording incidents and actions and the use of available equipment
Sprains and strains  
Spinal injuries  
Chest injuries  
Severe burns and scalds  
Eye injuries  
Heart attack  

Extra, specialised training and provision may be needed for hazards such as chemicals, dangerous machinery, working in confined spaces etc.

You should also consider the possible illnesses that could occur in the workplace and ensure you have adequate provision.

The Nature of the Workforce

You should consider the needs and health of all workers and ensure that first aiders are available and trained to deal with specific health needs. You should consider things such as:

The Organisation's History of Accidents and Illness

You should look at the organisations history of accidents and illness to try and identify any needs or trends that may influence the location or type of first aider. Different levels of provision may be required in different areas of the workplace.

The Needs of Travelling, Remote and Lone Workers

First Aid should be available wherever people work so you may need to consider providing personal first aid kits or training to travelling, remote or lone workers.

Work Patterns Such as Shift Work

Adequate first aid cover should be available whenever people are at work. There may be circumstances when a higher level of cover is needed when less people are at work, such as overnight maintenance work in a normally low risk environment.

The Distribution of the Workforce

First Aiders should be able to reach the scene of an incident quickly. Consider extra first aiders on large sites, sites with multiple buildings or buildings with multiple floors.

Remoteness to the site from Emergency Medical Services

If the workplace is remote from emergency medical services you may need to make special transport arrangements should an incident occur. Consider how employees will summon help - do they have access to a phone?

Even in urban areas you should be aware that it often takes more than 10 minutes for an ambulance crew to reach a casualty, so the correct provision of first aid is a vital link in reducing the effects of illness or injury.

Employees Working on Shared or Multi-Occupied Sites

On shared work sites it may be possible to share first aid provision, such as the security team providing first aid cover at a large shopping centre. It is important to fully exchange details of the hazards and risks so that adequate first aid cover is provided. Make agreements in writing to avoid misunderstandings.

Annual leave and other foreseeable absences

You should ensure that adequate first aid cover is available at all times, including when a first aider is on annual leave, a training course, a lunch break or other foreseeable absences. This generally means that workplaces need more than one first aider to ensure that cover is maintained.

If your first aid needs assessment identifies the need for a 'First Aider at Work' (18 hour course), it is not acceptable to provide an 'Emergency First Aider at Work' (6 hour course) to cover foreseeable absences. You should also consider what cover is needed for non-planned absences such as sick leave.

First Aid Provision for Non-Employees

The HSE recommend that you include non-employees in your first aid needs assessment. You should consider the duty of care that you assume when a non-employee visits your site. This is particularly relevant if you provide a service for others such as schools, places of entertainment, shops etc. Consider both the injuries and illnesses that could occur.

For large events such as concerts, organisers have a duty of care to ensure that adequate medical, ambulance and first aid cover is available. Organisers of such events should refer to The Event Safety Guide, published by HSE books, for further information.

The Size of the Organisation

The number of people on a site should no longer be the primary basis for determining first aid needs; all the areas of the new first aid needs assessment should be carefully considered. However, in general terms the larger your organisation is, the more first aiders you will need.

After identifying the locations / times that first aid cover is needed, the HSE recommend:

It is likely that if your workplace is large you will have already identified the need for full FAW (18 hour) training for your first aiders, but in any case, due to the increased probability of illness and injury occurring in larger workplaces, the HSE recommend that full FAW (18 hour) training is provided if:

Reviewing the First Aid Needs Assessment

You should review your first aid needs from time to time, particularly if you have operational changes in your workplace. It is recommended that a record is kept of incidents dealt with by first aiders to assist in this process.

Annual Refresher Training

Due to the wealth of evidence on the severity of 'first aid skill fade', the HSE now recommend that all First Aiders attend annual refresher training. The flow chart below shows the new sequence of training: