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Health and safety concerns

A guide for RCN members who have health and safety concerns at work including staffing levels, violence at work, lone working, manual handling and cigarette smoke

The Health and Safety Executive (HSE) defines stress as “The adverse reaction people have to excessive pressure or other types of demand placed on them”. Stress is a health and safety issue if the stress is work-related. Your employer has a duty to ensure your health and safety at work, including your psychological well-being.

Raise any complaints and concerns regarding stress at work with your manager. Do this as soon as possible and ask for remedial action to be taken. In the interim remember to:

  • keep a record of all dates, events and symptoms suffered
  • keep a personal record of all working hours including those outside the normal place of work 
  • ensure a risk assessment has been undertaken and if not, ask for one and ensure one is done immediately 
  • follow the employer's policy on stress (if available) 
  • seek medical advice from your GP and Occupational Health and make sure that a clinical diagnosis is given in your medical certificates, rather than a description of the symptoms of stress.

It may be necessary to make a formal complaint in writing if work-related stress continues. Also, see our advice on accidents and injuries at work and the ACAS guidance on Stress.

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Staffing levels

Staffing levels may be a health and safety issue.

As a registered nurse or midwife, under The Nursing and Midwifery Council (NMC) Code you have a number of responsibilities to act on concerns where you believe actions or situations are putting people at potential or actual risk.

The NMC has produced a publication Raising Concerns: Guidance for Nurses and Midwives (2013).

Although health care assistants and assistant practitioners do not work under The Code, the RCN would support any health care assistant who wished to raise concerns regarding staffing levels.

Read more about staffing levels in different environments and if you are concerned call us on 0345 772 6100.

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Violence at work

Under the Health and Safety at Work Act 1974, employers have an obligation to protect the health, safety and wellbeing of their employees. In addition, legislation requires employers to assess the risk of violence towards their employees and put in place measures to reduce the risk. An effective system of risk assessment is therefore crucial. Some examples of measure that could be taken include:

  • improvements to the physical environment
  • alarms systems
  • signage
  • safe staffing levels, and
  • training for staff. 

The importance of your safety is equal to that of your patients. You need support to identify and avoid working in unsafe conditions, and you need to know how to manage situations that become unsafe.

Find out more about your employers obligations in violence in the workplace.

Call us if you are concerned on 0345 772 6100.

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Hazardous substances

The Control of Substances Hazardous to Health 2002 Regulations (COSHH) apply to all work where people are liable to be exposed to hazardous substances. Guidance can be found on the Health and Safety Executive (HSE).

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Manual handling

The Manual Handling Operations Regulations require an employer to:

  • assess the risk of back injury at work
  • reduce the risk to the lowest level reasonably practicable
  • provide training for staff on safe and healthy practice
  • supervise staff to ensure compliance with the regulations

See our guidance on accidents and injuries at work.

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Workplace temperatures

The Workplace (Health, Safety and Welfare) Regulations 1992 lay down particular requirements for most aspects of the working environment. The temperature in workrooms should normally be at least 16 degrees celsius unless much of the work involves severe physical effort - in which case the temperature should be at least 13 degrees celsius. There is no maximum working temperature, although the temperature should be reasonable.

Further guidance is available on the Health and Safety Executive (HSE) website.

If you have concerns about the temperature in your workplace you should discuss this with your manager and your workplace health and safety representative.

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Cigarettes in the workplace

With a few exceptions, it is unlawful for an employer to allow smoking in the workplace. Your employer should have a policy covering employees who may be exposed to cigarette smoke in a patient’s home or other environments. Concerns about being exposed to cigarette smoke should be raised with your line manager as a health and safety concern. The Health & Safety Executive (HSE) has advice on smoking at work.  

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Lone working

Although there is no general legal prohibition on working alone, the broad duties of health and safety legislation still apply. This requires that the hazards of work are identified, the risks are assessed and measures put in place to avoid or control the risks. Your employer may have a lone working policy which outlines the provisions they have in place to protect you.

If a risk assessment shows it is unsafe for workers to be alone, arrangements for back-up should be in place. If a worker is working at another employer's workplace, that employer should inform the lone worker's employer of any risks. Risk assessment should help decide the right level of supervision.

Establishing safe working for lone workers should be the same as any other employee. Lone workers face particular problems as they may require extra risk controlled measures.

Employers should check there is no medical reason which makes lone working unsuitable. You may need to seek medical advice if necessary and consider any emergencies which may arise.

Lone workers need to be sufficiently experienced and able to understand the risks fully. Employers should ensure that workers are competent to deal with unusual circumstances and when to get help from a supervisor.

How to minimise the risks to lone workers

Procedures will need to be put in place to monitor lone workers to see they remain safe. These may include:

  • supervisors periodically visiting and observing people working alone
  • regular contact between the lone worker and the supervisor using either a telephone or radio
  • automatic warning devices which operate if specific signals are not received periodically from the lone worker 
  • other devices designed to raise the alarm in the event of an emergency and which are operated manually or automatically by the absence of activity
  • checks that a lone worker has returned to their base or home on completion of a task.

The Health and Safety Executive (HSE) has produced guidance to support employers.

If you are a lone worker with concerns about health and safety within your workplace, call us on 0345 772 6100.

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Health and safety risk assessments

What is risk management?  

This involves identifying and assessing risks and forms an important part of protecting workers and organisations whilst complying with the law. It is about taking practical steps to protect people from real harm and suffering. Employees have the right to work in a healthy and safe workplace and the people using healthcare services are entitled to care and support that is safe and takes their needs, freedom and dignity into account.

Risk assessments

It is the employer's responsibility to carry out risk assessments, and to ensure those staff carrying out risk assessments are trained and competent to do so.

The purpose of the assessment is to identify what needs to be done to control health and safety risks. A risk assessment should be carried out before you do work which presents a risk of injury or ill-health and when there are changes to systems of work or different approaches to patient care or when new equipment is introduced. Typical hazards can include, moving and handling, slips and trips, violence, aggression or challenging behaviour. Whilst specific hazards to people using care services may also include, falls from windows and balconies, scalding and burning, bedrail entrapment and Legionella.

The HSE advise 'When considering the individual risks for particular people using a service, you must also bear in mind that health and social care is regulated by other organisations who may expect some form of care assessment. Usually the health and safety risks identified for the individual will be recorded as part of this ‘care assessment’ or ‘support plan’.

In many situations straightforward measures can be put in place to avoid harm, such as ensuring spillages are cleaned up promptly so people don’t slip. The aim is to stop any activities that might possibly lead to harm.

Key points to consider when balancing risk include:

  • concentrating on real risks where there is a realistic risk of harm
  • close liaison with the individual, carer and family when carrying out risk assessments which is essential to achieve outcomes that matter to them
  • how the risks flowing from an individual’s choice can best be reduced, so far as is reasonably practicable, by putting in place sensible controls
  • when organising group activities, think how the most vulnerable can be protected without unnecessarily restricting the freedoms of the most capable.

The law doesn’t expect elimination of all risks. The individual and the organisation should take responsibility and the aim is to protect patients and staff as far as “reasonably practicable”. This means balancing the level of risk against the measures needed to control the real risk in terms of money, time or trouble.

How often should risk assessments take place?

Risk assessments should take place continuously and reviewed as changes occur such as new equipment, changes to systems of work or different approaches to patient care.

The Health and Safety Executive (HSE) has further guidance, including templates and example risk assessments, on their website.

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Reporting health and safety concerns

It can often be difficult to raise concerns at work. Our raising concerns guide provides guidance to support you through the process of reporting acts of wrongdoing or misconduct.

What information should I include when reporting a health and safety concern?

You should inform your line manager of your concerns and ask for a risk assessment to be carried out. When reporting concerns, the following points should be considered:

  • what exactly is the problem
  • who is affected
  • how many employees are affected
  • how many pieces of equipment are involved
  • what work procedures are involved
  • how are employees affected
  • where is the problem
  • when and how does the problem occur
  • what might happen if the problem is not dealt with.

If you cannot resolve your concerns informally you may wish to take out a grievance. Please call us for advice before taking any formal action on 0345 772 6100.

Can my manager dismiss me for highlighting or pursuing a health and safety concern at work?

No. Under the Employment Rights Act 1996, any unfair treatment or dismissal because you have highlighted a health and safety issue is deemed unlawful. View our guidance on discipline for further information.

Reporting accidents externally

Under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR) employers have a duty to notify the Health and Safety Executive of any reportable accidents. Further details, including a list of reportable accidents, can be found on the Health and Safety Executive website.

HSE guidance indicates that workplace incidents resulting in incapacitation of more than seven days should be reported under the RIDDOR process. Additionally, accidents in the workplace should be reported internally following local protocol and policy.

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RCN safety representatives: reporting concerns to the HSE

After pressure from the RCN and other unions reacting to the removal of phone numbers and contact information from the Health and Safety Executive’s (HSE) website, the HSE has produced an online form to allow safety representatives to notify them of concerns.

Reps should use internal mechanisms to raise and resolve health and safety issues wherever possible but if the employer refuses to address the concern the form can be used.  Reps are advised to discuss the use of the form with their mentors/regional & country contacts.

The form can only be used by union accredited safety representatives and is available on the HSE website

In all cases where there is a serious risk to life or limb which cannot be prevented by notifying the employer, safety representatives should contact the RCN and the HSE immediately (HSE Concerns Team, telephone: 0300 0031647).

Interested in becoming an RCN safety representative? Find out more here.

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Need more advice?

Call RCN Direct on: 0345 772 6100