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 gt COMPULSORY

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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

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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

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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

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Training Answers?

• Shorter first aid courses
• More frequent refresher training
• More basic first aiders trained in emergency
  first aid

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Proposed Outline of New Scheme
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Training Options

• 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

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Training Options

• 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

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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

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New Version of 2-tier Scheme
19
Assessment Proposed Scheme
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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

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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

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Standards Options

• 35.4
• 9.8
• 27.8
• 18.3

• 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

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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

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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

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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

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Approval of TrainingOptions

• HSE approves training providers i.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

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Approval of TrainingOptions

• HSE approves training providers i.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

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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

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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

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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

• 18.7
• 56.3
• 18.7

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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

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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

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Any Questions ?
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