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:
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.Back to contents
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:
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.Back to contents
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.Back to contents
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:
If you have any concerns that any of these are not in place, contact us for advice and support.Back to contents
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.Back to contents
Health and safety law requires employees to:
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.Back to contents
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.Back to contents
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.Back to contents
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.Back to contents
The NHS Partnership for Occupational Safety and Health in Healthcare (POSHH) Back in Work Back Pack is available on the NHS Employers website.Back to contents