Review of the First Aid at Work Regulations

1. Review of the First Aid at Work Regulations Feedback on the current HSE position Dr Richard Elliott

2. Why Change? • Modernising the regulatory framework • Changing perceptions of the role of FAW • Changing patterns of employment • Changing market for first aid training

3. The Process • Research - get the background data • Discussion Document - general options • Approval by Health & Safety Commission • Further consultation with stakeholders • Change Regulations / ACoP /guidance

4. The Issues • Legislative (structure, effectiveness, costs, scope) • Training courses(legal requirements, flexibility, skill decay, standards) • Approval and monitoring of training(legal requirements, qualifications, new systems) • Equipment and related issues

5. Legislative Framework • Health and Safety etc. at Work Act 1974 • Health & Safety (First Aid) Regulations 1981 • First aid at work Approved Code of Practice and Guidance • Supplementary guidance

6. Regulatory Structure - Questions • Should FAW be incorporated into other health and safety management regulations?e.g. Management of Health & Safety at Work 1999 or Workplace (Health Safety & Welfare) 1992 NO • What benefit, if any, would this be to employers in assessing and making their first aid provision? NONE

7. Effectiveness - Questions • Does FAW make clear the roles and duties of employers, first aiders and appointed persons? Generally, NO What additional guidance should HSE give on making a first aid needs assessment? A LOT ! • What other areas of first aid at work does HSE need to clarify or provide new guidance on? MANY, not all FAW related

8. Cost - Questions • Should HSE guidance include examples of comparative costs of making first aid provision? NO

9. Scope of FAW - Questions • Should first aid for the public be provided on a voluntary basis as at present or should this be compulsory through new legislation requiring employers to make provision? VOLUNTARY > COMPULSORY

10. Public First Aid - Problems • Outside the scope of HSWA –new legislation • Who are “the public”? What are “public places”? • Who would enforce the law, and how? • Costs for employers – proportional to what? • Potential for increased litigation – duty of care

11. Training – Current Position • FIRST AIDER • 4 days initial training • 2 days refresher every 3 years • Training regulated by HSE • APPOINTED PERSON • No specific training required • No regulation of training • 2 different legal statuses

12. Training - Problems • Indirect cost of releasing trainees for 4 days is a disincentive to employers • Skill decay is a well recognised problem and 3 yearly refresher training is grossly inadequate • There is widespread use of trained, though unregulated, appointed persons

13. Training – Answers? • Shorter first aid courses • More frequent refresher training • More “basic” first aiders trained in emergency first aid

14. Proposed Outline of New Scheme

15. Retain the current system Change to the proposed two-tier system 6 hour course + annual refresher or 16 hour course + annual refresher All workplaces to have at least one qualified first aider Training – Options

16. Retain the current system Change to the proposed two-tier system 6 hour course + annual refresher or 16 hour course + annual refresher All workplaces to have at least one qualified first aider 11.8 % 62.0 % 20.1 % Training – Options

17. Training – New Problems • A 16 hour course lasts more than 2 days • 16 hours may be too short for a full course • One day refreshers may be too short • Annual refreshers may be too frequent (for either employers, trainers or trainees) • Assessment at every course will be expensive and difficult to manage

18. New Version of 2-tier Scheme

19. Assessment – Proposed Scheme

20. Standards – Current PositionHSE Accepts - • Resuscitation Council (UK) guidelines • ERC guidance where that agrees with RC(UK) • Current edition of VAS Tripartite manual • Other publications provided they are based on sound medical / scientific research or are in line with the three above

21. Standards – Options • The current system should continue • Reduce the number of standards accepted by only accepting those of Resuscitation Council & VAS • Accept a wider range of standards including, for example, those of ambulance authorities or Medical Royal Colleges • Encourage the industry to develop its own standard setting body for FAW, perhaps as a collaborative venture between the voluntary and independent sectors

22. The current system should continue Reduce the number of standards accepted by only accepting those of Resuscitation Council & VAS Accept a wider range of standards including, for example, those of ambulance authorities or Medical Royal Colleges Encourage the industry to develop its own standard setting body for FAW, perhaps as a collaborative venture between the voluntary and independent sectors 35.4 % 9.8 % 27.8% 18.3% Standards – Options

23. Approval of TrainingLegal Background The regulations currently require that a first aider shall have: “such training and qualifications as the Health and Safety Executive may approve for the time being in respect of that case or class of case”

24. Approval of TrainingProblems • The current system is under-resourced and no new resources will become available • Monitoring of training organisations is infrequent • Standards for trainers / assessors are poorly defined • The system is outdated with respect to current regulatory practice

25. Approval of TrainingEssential Features • Any new system will need to deliver assurance that appropriate first aid training is being delivered • There should be a nationally agreed qualification for both trainers and assessors, and a register of those qualified • HSE will consult the first aid training industry if a need is identified for more detailed guidance for training providers

26. Approval of TrainingOptions • HSE approves training providersi.e. continue existing system with an external contractor undertaking monitoring • HSE approves structure and content of trainingthe monitoring system would not be administered by HSE but by an independent monitoring body, e.g. from within the industry, with external accreditation, responsible to HSE • No approval system (longer term option)self regulation by the industry

27. HSE approves training providersi.e. continue existing system with an external contractor undertaking monitoring HSE approves structure and content of trainingthe monitoring system would not be administered by HSE but by an independent monitoring body, e.g. from within the industry, with external accreditation, responsible to HSE No approval system (longer term option)self regulation by the industry 58 % 39 % 3 % Approval of TrainingOptions

28. First Aid EquipmentLegal Background The Approved Code of Practice currently requires that an employer shall provide: “at least one first aid container supplied with a sufficient quantity of first aid materials suitable for the particular circumstances”

29. First Aid EquipmentOptions • Retain the present system as it stands • Retain the Regulation and ACoP but replace the suggested contents list with expanded guidance to assist employer to provide the most appropriate materials • Amend the ACoP to specify a mandatory basic contents list, which might not necessarily be appropriate

30. Retain the present system as it stands Retain the Regulation and ACoP but replace the suggested contents list with expanded guidance to assist employer to provide the most appropriate materials Amend the ACoP to specify a mandatory basic contents list, which might not necessarily be appropriate 18.7% 56.3% 18.7% First Aid EquipmentOptions

31. MedicinesQuestions • Are there any circumstances in which first aiders should be responsible for the distribution of over the counter medicines to employees? NO • If medicines were made available for supply by first aiders, should they be kept in the first aid box, in a separate container or somewhere else? NOT First Aid Box

32. Proposals to Commission • No change to Regulations or ACoP • Updated guidance on HSE website • New course structure as proposed • Limit approval process, in future,to content and structure of courses • Explore formation of an industry body

33. Any Questions ?