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Moving and handling

This guide for RCN members includes advice on the correct moving and handling techniques, and employer and employee obligations.

Patient-centred care plans

No-one should routinely manually lift patients. Hoists, sliding aids, electric profiling beds and other specialised equipment are substitutes for manual lifting. Patient manual handling should only continue in cases which do not involve lifting most or all of a patient's weight. This rules out for example, the shoulder or Australian lift. Patients often have complex and varying needs. The Health and Safety Executive advise a balanced approach to managing the risks from patient handling. These include:

  • care workers are not required to perform tasks that put them and their clients at risk unreasonably
  • client's personal wishes on mobility are respected wherever possible
  • client's independence and autonomy is supported as fully as possible.

A patient-centred care plan should include information on immobility and detail any handling risks and/or needs. For more information see Backs! FAQs (2005), on the Health and Safety Executive (HSE) website.

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Employer obligations for safer patient handling

Legally, employers are obliged to provide a safe working environment for their staff. Under the Manual Handling Operations Regulations 1992 (as amended) employers are required 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.

Risk assessment should be generic and individual.  A generic risk assessment would consider the needs of the workplace/environment e.g. the equipment needed, safe staffing levels, emergency procedures and the suitability of the physical environment.  Individual risk assessments consider the specific moving and handling needs (e.g. help needed, specific equipment needs and number of staff needed to support the patient) to ensure the safety of staff and the patient/service user.

There is a requirement for a ‘competent person’ to conduct risk assessments. Competency is a mixture of skills, knowledge and qualifications to carry out the role.  For further information see National Back Exchange website.

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Training and updates

Guidance from the RCN, the College of Occupational Therapy, the Welsh Manual Handling Passport Scheme, the Chartered Society of Physiotherapy, the Care Standards Act 2002 and the Health and Safety Executive recommends that update training in client handling is required at least on an annual basis. The National Back Exchange give more information on what is expected, particularly in relation to both induction training and updates.

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Equipment

Additional laws require employers to ensure that moving and handling equipment is maintained and safe to use. Staff should be trained in the safe use of equipment and safe moving and handling.

Further information on the Manual Handling Operations Regulations 1992 is available on the Health and Safety Executive (HSE) website. From the HSE website please also search for ‘moving and handling in health and social care’. Members based in Northern Ireland should check the Health and Safety Executive Northern Ireland (HSENI) website.

The NHS Staff Council’s Health, Safety and Wellbeing Partnership Group (HSWPG) Back in Work Back Pack is available from the NHS Employers website – search for ‘back pack’ in the search box on the homepage.

In summary, employers should have:

  • safer patient handling policies
  • risk management processes
  • regular staff training.

If you have any concerns that any of these are not in place, contact us for advice and support.

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Maximum weight limits

The Manual Handling Operations Regulations 1992 set no specific requirements such as weight limits. An ergonomic approach based on a range of relevant factors should determine the risks. The Health and Safety Executive (HSE) website contains further guidance on this in their FAQ's section. Members based in Northern Ireland should check the Health and Safety Executive Northern Ireland (HSENI) website.

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Employees' duties

Health and safety law requires employees to:

  • take reasonable care of their own health and safety and that of other people
  • cooperate with their employer on health and safety matters and,
  • report any problems.

If you suffer an injury whilst moving a patient you may be able to make a personal injury claim. However, under the Manual Handling Operations Regulations 1992 you also have an obligation to make full and proper use of any system of work provided by your employer.

See our advice guide on making a personal injury claim.

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Safer patient handling in the home - support for carers

We believe that carers should have access to the same equipment as nurses. They should also have access to training which will enable them to lift more safely. Community nurses should be available to assist with safer patient handling. For more information please see the Health and Safety Executive (HSE) website.

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Moving and handling in the community

Nurses and health care support workers in the community should have the same access to equipment as hospital staff. In each circumstance a risk assessment and individual plan of care will have to take place. Depending on the outcome, employers should provide any necessary equipment. Slide boards and sheets are light and easy to carry around and can be taken to the patiet.

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Children's care environments

For staff working with children, it may not be possible to eliminate all lifting. It is still important to avoid the risk of injury to carers and minimise lifting at all times.

By law employers must ensure that risk assessments have been carried out using appropriate guidelines which assess all factors. The design of a cot, for example, may be more of a risk factor than the weight of the baby in it. Poor posture is a greater risk to carers of babies and children than actual lifting.

Another example is the neonate with complex care needs. This baby may have many pieces of equipment attached to them. Each of these require consideration when developing a safe plan for mobility.

In each situation a risk assessment must be carried out and an individual plan of care devised by all involved in the care, for example parents, health visitors, teachers. The day to day needs of children vary. Flexibility can ensure optimum independence of the baby/child whilst minimising carer risk. If you have any concerns then contact us to discuss arrangements for local support.

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Further information

The NHS Partnership for Occupational Safety and Health in Healthcare (POSHH) Back in Work Back Pack is available on the NHS Employers website.

Health and Safety Executive (HSE)

Health and Safety Executive Northern Ireland (HSENI)

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