Guide to carrying out a First Aid Needs Assessment 

This is a guide to carrying out a first aid needs assessment, please contact us if you would like further advice or assistance. 
 
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 
The nature of the workforce 
The organisation’s history of accidents and illness 
The needs of travelling, remote and lone workers 
Work patterns such as shift work 
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 
First‐aid provision for non‐employees 
The size of the organisation 
 
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: 
 
Hazard 
Cause of accidents 
Example of injury requiring first aid 
Chemicals 
Exposure during handling, spillages, splashing, leaks 
Poisoning, loss of consciousness, burns, eye injuries, respiratory problems 
Electricity 
Failure to securely isolate electrical systems and equipment during work on them, poorly maintained electrical equipment, contact with overhead power lines, underground power cables or mains electricity supplies, using unsuitable electrical equipment in explosive atmospheres 
Electric shock, burns, heart attack 
Machinery 
Loose hair or clothing becoming tangled in machinery, being hit by moving parts or material thrown from machinery, contact with sharp edges 
Crush injuries, amputations, fractures, lacerations, eye injuries 
Slips, trips and falls 
Uneven floors, staircases, trailing cables, obstructions, slippery surfaces due to spillages, worn carpets and mats 
Fractures, lacerations, sprains and strains 
Manual Handling 
Repetitive and/or heavy lifting, bending and twisting, exerting too much force, handling bulky or unstable loads, handling in uncomfortable working positions 
Fractures, lacerations, sprains and strains 
Work at height 
Overreaching or overbalancing when using ladders, falling off or through a roof 
Head injury, loss of consciousness, spinal injury, fractures, sprains and strains, lacerations 
Workplace Transport 
Hit by, against or falling from a vehicle, being hit by part of a load falling from a vehicle, being injured as a result of a vehicle collapse or overturn 
Crush injuries, head injury, fractures, sprains and strains 
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: 
 
Emergency First Aider at Work (EFAW) – 6 hour course (3 days) 
First Aider at Work (FAW) – 18 hour course (3 days) 
 
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) 
 
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 Nature of the Workforce You should also consider the possible illnesses that could occur in the workplace and ensure you have adequate provision.Extra, specialised training and provision may be needed for hazards such as chemicals, dangerous machinery, working in confined spaces etc. 
 
The Young 
The Elderly 
Specific health problems (such as heart conditions, asthma, diabetes etc.) 
Disabilities 
 
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: 
That ‘non-manual’, low risk workplaces (such as shops, offices, libraries) have a minimum of one first aider on duty at all times per 100 people (or part thereof). 
That ‘manual’ workplaces (light assembly work, warehousing, food processing or higher risks), have a minimum of one first aider on duty at all times per 50 people (or part thereof). 
 
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: 
100 or more people are employed in a ‘non‐manual’, low risk workplace; or 
50 or more people are employed in a ‘manual’ or higher risk workplace. 
 
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 sequence of training is shown below: