Manual Handling and Moving Policy - Welcome to SWASFT policies... · Manual Handling and Moving Policy Page 2 of 28 Trust Policy Foreword SWASFT has a number of specific corporate

Manual Handling and

Moving Policy

Version: 5

Status: Final

Title of originator/author: Health, Safety & Security Manager

Name of responsible director: Executive Director of Nursing and Governance

Developed/revised by group/committee and Date:

Health and Safety Group, 3 September 2015

Approved by group/committee and Date:

Health and Safety Group, 3 September 2015

Effective date of issue: (1 month after approval date)

September 2015

Next annual review date: September 2018

Date Equality Impact Assessment Completed

September 2015

Regulatory Requirement: Manual Handling Operations Regulations 1992 (amended 2002) Lifting Operations and Lifting Equipment Regulations 1998 (LOLER) Health and Safety At Work etc. Act 1974 Management of Health and Safety at Work Regulations 1999

Manual Handling and Moving Policy Page 2 of 28

Trust Policy Foreword SWASFT has a number of specific corporate responsibilities relating to patient and staff safety and wellbeing which should be included within all Trust policy and strategy, as a foreword inside the front cover: Code of Conduct and Conflict of Interest Policy - The Trust Code of Conduct for Staff and its Conflict of Interest and Anti-Bribery policies set out the expectations of the Trust in respect of staff behaviour. SWASFT employees are expected to observe the principles of the Code of Conduct and these policies by declaring any gifts received or potential conflicts of interest in a timely manner, and upholding the Trust zero-tolerance to bribery. Compassion in Practice – SWASFT will promote the values and behaviours within the Compassion in Practice model which provide an easily understood way to explain our role as professionals and care staff and to hold ourselves to account for the care and services that we provide. These values and behaviours reflect the Trust’s commitment to developing an outstanding service through the conduct and actions of all staff. SWASFT will encourage staff to demonstrate how they apply the core competencies of Care, Compassion, Competence, Communication, Courage, and Commitment to ensure our patients experience compassionate care. Duty of Candour – SWASFT will, as far as is reasonably practicable, apply the statutory Duty of Candour to all reported incidents where the Trust believes it has caused moderate or severe harm or death to a patient. This entails providing the affected patient or next of kin (within strict timescales) with: all information known to date; an apology; an explanation about any investigation; written follow-up; reasonable support; and the outcome fed back in person (unless they do not want it). The only exception is where making contact could have a negative impact upon the next of kin. SWASFT employees are expected to support this process by highlighting (early) any incident where they believe harm may have been caused. Equality Act 2010 and the Public Sector Equality Duty - SWASFT will act in accordance with the Equality Act 2010, which bans unfair treatment and helps achieve equal opportunities in the workplace. The Equality Duty has three aims, requiring public bodies to have due regard to: eliminating unlawful discrimination, harassment, victimization and any other conduct prohibited by the Act; advancing equality of opportunity between people who share a protected characteristic and people who do not share it; and fostering good relations between people who share a protected characteristic and people who do not share it. SWASFT employees are expected to observe Trust policy and the maintenance of a fair and equitable workplace. Fit and Proper Persons – SWASFT has a statutory duty not to appoint a person or allow a person to continue to be an executive director or equivalent or a non-executive director under given circumstances. They must be: of good character; have the necessary qualifications, skills and experience; able to perform the work they are employed for (with reasonable adjustments); able to provide information required under Schedule 3 (Health and Social Care Act 2008 (Regulated Activities) Regulations 2014). The definition of good character is not the test of having no criminal convictions but instead rests upon judgement as to whether the person’s character is such that they can be relied upon to do the right thing under all circumstances. This implies discretion for boards in reaching a decision and allows that people can change over time. Health and Safety - SWASFT will, so far as is reasonably practicable, act in accordance with the Health and Safety at Work etc. Act 1974, the Management of Health and Safety at Work Regulations 1999 and associated legislation and approved codes of practice. It will provide and maintain, so far as is reasonable, a working environment for employees which is safe, without risks to health, with adequate facilities and arrangements for health at work. SWASFT employees are expected to observe Trust policy and support the maintenance of a safe and healthy workplace. Information Governance - SWASFT recognises that its records and information must managed, handled and protected in accordance with the requirements of the Data Protection Act 1998 and other legislation, not only to serve its business needs, but also to support the provision of highest quality patient care and ensure individual’s rights in respect of their personal data are observed. SWASFT employees are expected to respect their contact with personal or sensitive information and protect it in line with Trust policy. NHS Constitution - SWASFT will adhere to the principles within the NHS Constitution including: the rights to which patients, public and staff are entitled; the pledges which the NHS is committed to uphold; and the duties which public, patients and staff owe to one another to ensure the NHS operates fairly and effectively. SWASFT employees are expected to uphold the duties set out in the Constitution. Risk Management - SWASFT will maintain good risk management arrangements by all managers and staff by encouraging the active identification of risks, and eliminating those risks or reducing them to the lowest level that is reasonably practicable through appropriate control mechanisms. This is to ensure harm, damage and potential losses are avoided or minimized, and the continuing provision of high quality services to patients, stakeholders, employees and the public. SWASFT employees are expected to support the identification of risk by reporting adverse incidents or near misses through the Trust web-based incident reporting system.


CONTENTS FLOW CHART – HOW TO FOLLOW THE MANUAL HANDLING REGULATIONS ........................ 4

1. PURPOSE .................................................................................................................................. 5

2. SCOPE ...................................................................................................................................... 5

3. DEFINITIONS ............................................................................................................................ 7

4. DUTIES, RESPONSIBILITIES AND REPORTING ..................................................................... 7

5. ARRANGEMENTS FOR OBTAINING SPECIALIST ADVICE ................................................... 10

6. RISK ASSESSMENT................................................................................................................ 10

7. RISK REDUCTION ................................................................................................................... 14

8. TRUST’S MANUAL HANDLING ACTION PLAN ....................................................................... 14

9. MOVING AND HANDLING AIDS AND EQUIPMENT ............................................................... 15

10. ACCIDENT REPORTING (INTERNAL) ................................................................................... 15

11. INTRODUCING NEW EQUIPMENT ....................................................................................... 15

12. TRAINING REQUIREMENTS ................................................................................................. 16

13. MONITORING ......................................................................................................................... 17

14. REFERENCES ....................................................................................................................... 19

15. ASSOCIATED DOCUMENTS ................................................................................................. 19 APPENDIX A - GUIDANCE ON CARRYING OUT MANUAL HANDLING ASSESSMENTS .......... 20 APPENDIX B - PREVENTING MUSCULO-SKELETAL PROBLEMS ............................................ 25 APPENDIX C - MANUAL HANDLING GUIDELINES ..................................................................... 26 APPENDIX D - HSE GUIDANCE LIFTING CHART ...................................................................... 27 APPENDIX E - VERSION CONTROL SHEET .............................................................................. 28


Flow Chart – How to follow the Manual Handling Regu lations 1992 (as amended 2002 )

Is there a risk of injury?

Is it reasonable practicable to avoid moving the loads?

Yes

Yes/possibly

Is it reasonably practicable to automate or mechanise the operations?

Does some risk of manual handling injury remain? No

Carry out risk assessment Yes/possibly

Determine measures to reduce risk of injury to the lowest level practicable

Implement the measures

Is the risk of injury significantly reduced?

End of initial exercise

Yes

No

No

No

Yes

Monitor and review after five years or when conditions change significantly

No

Yes

REGULATION 4 (1) (a)

Do the regulations apply – i.e. does the work involve Manual Handling operations?

REGULATION 2 (1)

REGULATION 4 (1)(b(i)

REGULATION 4 (2)

No


General Information 1. Purpose 1.1. As part of its commitment to the health and safety of its employees, the South

Western Ambulance Service NHS Foundation Trust takes seriously its obligations under the Manual Handling Operations Regulations 1992 (as amended in 2002) and the Management of Health and Safety at Work Regulations 1999. The Trust is aware that the range and diversity of ambulance work makes it impossible to anticipate every situation employees may be confronted with. However it seeks, through risk assessment, to take the appropriate action to eliminate or reduce the risks arising from manual handling and moving operations to the lowest possible level.

1.2. Manual Handling activities are frequently carried out by clinical and non- clinical

staff at South Western Ambulance Service NHS Foundation Trust (SWAST). SWAST is committed to addressing moving and handling risks in a proactive way. This is through implementing polices and training to inform and instruct staff on the manual handling processes. These comply with the statutory duties set out in the Health and Safety at Work Act 1974.

1.3. Health and Safety at Work Act 1974 Section 2; Management of Health and Safety

at Work Regulation’s 10 and 13 require employers to give their employees information, instruction and training on any risks to their health and safety, by identification of an assessment.

1.4 Nationally more than a third of accidents/injuries reported to HSE are associated

with the manual handling of loads. Many of these injuries are cumulative rather than attributed to a single incident.

2. Scope 2.1. This policy will apply to all employees and those undertaking work on the Trust’s

behalf and any person on Trust premises and/or in vehicles, who is not an employee of the Trust.

2.2. The Trust will keep under regular review, the key manual handling and moving

operations that employees carry out and will, where it is reasonably practicable, adjust techniques and equipment to take account of changes and circumstances in line with the Manual Handling Operations Regulations 1992

2.3. The Trust will assess the risks to employees in the manual handling of loads, in

liaison with Health and Safety Department.

In particular the Trust will:- (using the hierarchy of control) a) avoid hazardous manual handling operations, so far as it is reasonably

practicable, by redesigning the task to avoid moving the load in a hazardous fashion or by automating or mechanising the process;


b) carry out suitable and sufficient risk assessments by competent persons of

any hazardous manual handling operation that cannot be avoided; and

c) reduce , so far as is reasonably practicable, the risk of injury from those operations. Consideration will be given to the provision of mechanical assistance. Where this is not reasonably practicable, other improvements to the task, the load and the working environment will be explored.

2.4. The Trust will ensure that any equipment provided for manual handling operations

is maintained and serviced to a safe standard. Appropriate alternative equipment will always be available to staff at all times if/ when equipment is being serviced or repaired.

2.5. The Trust will provide information and training on moving and handling techniques

and the risks involved in manual handling. Due to the nature of the work carried out by Trust employees undertake it means that staff who have face to face contact with the public often enter into areas of unforeseeable risks. In these circumstances it is hoped with the training and information employees have had they will be enabled to take steps to promote their own health, safety and well-being as well as that of those they are in contact with.

2.6. The Trust acknowledges that pregnancy has significant implications regarding the

risk of manual handling injury and will take action to other way around risks for pregnant staff.

2.7. The Trust will seek medical advice if there is good reason to suspect that an

individual’s state of health or circumstances might significantly increase the risk of injury from manual handling operations.

2.8. The Trust will ensure that all candidates for employment in positions which involve

regular moving and handling are assessed in terms of their moving and handling capability and receive health clearance to carry out required duties.

2.9. The Trust seeks to continuously identify and monitor the causes of accidents, in

particular, those involving manual handling operations in order to improve training, procedures, equipment and associated manual handling strategies. Detailed information will therefore be requested from employees who have suffered such injuries using the Trust’s incident reporting procedures. Including the TILE risk assessment they carried out.

2.10. The Trust will share information and develop safe systems of work with other

organisations to ensure that any unavoidable moving and handling of patients can be carried out effectively with the minimum of risk to both Trust staff and the patient. Other organisations will include local hospitals, Care Homes, Local Falls Coordinators, Social Services, Fire & Rescue Services and CCG’s, and, where appropriate joint risk assessments will be undertaken to ensure any risk of injury is reduced to the lowest level practicable.

2.11. The Trust recognises there should be continuous monitoring of practice in the

workplace to ensure standards attained in training are maintained and improved.


3. Definitions

Manual Handling – ‘the transporting or supporting of a load by hand or bodily force including lifting, putting down, pushing, pulling, carrying or moving of any load’. TILE: Task - Does the manual handling task involve any of the following: Stooping, twisting, bending, pushing, and pulling, not enough rest or recovery periods. Individual – is the person: Pregnant, disabled suffering from health problems. Load – Is the Load: Heavy, difficult to grip, sharp, hot, cold, content likely to move. Environment – Within the environment is there/are there: Space constraints, uneven flooring, Slippery flooring, unstable flooring, and difference in floor levels, conditions Hot/Cold or Humid. Competent - having suitable or sufficient skill, knowledge, experience, etc., for some purpose; properly qualified Safe System of Work (SSoW ) – A safe system of work is a way of doing something in a safe manner that takes account of all foreseeable hazards to health and safety and seeks to eliminate or minimise these.

4. Duties, Responsibilities and Reporting 4.1. The Board 4.1.1. The Trust’s Board will be responsible for:-

a) ensuring appropriate structures are in place to enable the Trust to fulfil its responsibilities with regards the Manual Handling Operations Regulations 1992;

b) ensuring appropriate structures are in place to effectively implement this

policy; c) committing those financial, managerial, technological and educational

resources necessary to adequately control identified risks from manual handling activities; and

d) monitoring the arrangements in place with regards preventing risk from

manual handling activities. 4.2. Chief Executive 4.2.1. The Chief Executive will be responsible on behalf of the Trust Board for the

effective implementation of this policy.


4.3. Executive Directors 4.3.1. Each Director is responsible for the effective implementation of the policy within

their respective directorates. 4.3.2. Each Director should have an understanding of this policy and the associated

arrangements. 4.4. Heads of Operations/Other Senior Managers 4.4.1. Heads of Operations/Other Senior Managers will be responsible for implementing

this policy with their areas of responsibility. 4.4.2. Heads of Operations/Other Senior Managers must have an understanding of this

policy and the associated arrangements. 4.5. Operational Managers/Line Managers 4.5.1. Operational Managers/Line Managers must have an understanding of the policy

and associated arrangements. Specifically Operational Managers/Line Managers are required to:-

a) create a safety conscious culture in which high standards are encouraged

and poor practice are not condoned; b) be familiar with the Manual Handling Operations Regulations 1992 (amended

2002) and have an understanding of human capability with respect to manual handling;

c) ensure that staff for whom they are responsible receive appropriate

information, instruction and training to protect them for manual handling injuries;

d) carry out specific and generic risk assessments on manual handling

activities, particularly high risk activities; and when doing so consider section 6 (below);

e) identify suitable controls and safe systems of work; f) be able to implement suitable controls and facilitate safe systems of work;

and where necessary seek senior management assistance; and g) monitor the effectiveness of remedial action e.g. by considering statistics on

accidents, legal costs etc. h) Line managers are responsible for ensuring all permanent staff are aware

there is manual handling e-learning through the iPortal. 4.6. Employees


4.6.1. Employees play a crucial role in the delivery of safe working practices. In

particular they have the following responsibilities and should:-

a) co-operate with management to achieve the aims of this policy; b) make use of appropriate equipment provided for them in accordance with

training and guidance; c) follow appropriate systems of work established by the Trust to promote

safety during the handling of loads, particularly carrying out individual risk assessments and maintaining personal competence;

d) notify their line manager of any training regarding the undertaking of manual

handling operations or the use of moving and handling equipment and aids; e) carry out risk assessments and when doing so give consideration to section

6 (below); and f) where applicable, carry out dynamic risk assessments. g) Carry out E- learning Manual Handling course on a yearly basis.

4.7. Health, Safety and Security Manager’s Responsi bilities 4.7.1. The Health, Safety and Security Manager has the following responsibilities:

a) liaise with Line Managers, the Trust’s Education Department and training

officers to assist them with the identification of training needs; b) provide risk assessment training; c) co-ordinate generic manual handling risk assessments; d) provide advice to managers and staff on manual handling risk assessments; e) where necessary, assist managers and staff in the carrying out of risk

assessments and advise on suitable controls and safe systems of work; and

e) liaise with appropriate managers such as Fleet Manager, Medical Equipment Co-ordinator (Medical Device Co-ordinators sit under the Logistics Manager) and Resilience Manager and carry out a review of maintenance inspection programs for all handling aids and protective equipment.

f) Reporting to enforcing authorities (HSE) under Reporting of Injuries, Diseases or

Dangerous Occurrences Regulation’s 2013, for any injuries or deaths caused through work based activities.

4.8. Learning Development Officers (LDO’s) and Tra ining Officers 4.8.1. Trainers play a key role in promoting safety conscious working practices.


Responsibilities include:-

a) designing appropriate training courses; b) training others in methods of moving and handling; c) training others in patient handling risk assessment; d) training others in the use of manual handling aids and equipment; e) assessing trainee competence in moving and handling, and in using aids and

equipment; f) training work based assessors in the role of monitoring, moving and handling

practice and ‘one to one’ instruction; g) maintaining accurate training records; and h) identifying individual, function and Trust training needs.

5. Arrangements for obtaining Specialist Advice

Appropriate specialist advice on handling and moving can be obtained from the following:

• Occupational Health via HR • Health, Safety & Security Manager; • Health Safety and Security Officers • Learning Development Officers • Operational Managers.

The above can all be contacted by phone, email or fax. For contact details see the Trust’s intranet.

6. Risk Assessment

Manual Handling risk assessments can be broken down into three main categories:- • Generic; • Systematic; • Personal.

6.2. Generic 6.2.1. In order to reduce the number of manual handling injuries, generic assessments

covering related operations with broadly similar characteristics will be coordinated by the Health, Safety and Security Manager. The Health, Safety and Security Manager, in liaison with other Directorates, will also co-ordinate generic assessments for Headquarters, Control staff and other support areas.


6.3. Systematic 6.3.1. Systematic assessments of manual handling risks will be carried out by local

managers in liaison with Health and Safety Officers and Training Officers, as appropriate:- a) On specific manual handling operations undertaken by employees; b) Where new or changed risks are identified at local level; c) Where an existing practice gives rise to concern as to its safety (e.g. following an accident/injury).

6.3.2. Assessors will use the generic assessments as a basis of a more systematic

assessment; 6.3.3. If not involved in the assessment, the advice of the Health, Safety and Security

Officers should be sought. 6.3.4. Employees conducting manual handling assessments, can check to see if there is

a generic assessment already undertaken (Manual Handling Assessments), using the Manual Handling Assessment Form. Where an assessment (Manual Handling Form) indicates the possibility of risk to employees, a detailed and specific risk assessment must be carried out which must include what action is required to prevent injury.

6.3.5. Four interlinked elements of the operation must be examined. There are

commonly known by the acronym T.I.L.E:

a) Task :- What is the urgency of the task? What is involved in the task? Are there any problems involved? What equipment is available, have I been trained in its use, is it capable of carrying out the task in relation to the circumstances? Where am I going to and from? Will the distance to be travelled create a risk of fatigue? How can I avoid or reduce stooping, stretching, twisting?

b) Individual Capability :-


Have I any medical or physical limitations, which could affect my ability to perform the task? Can all team members do the task within their personal capability i.e? In a reasonably relaxed and comfortable manner? Do I know enough to be able to perform the task safety? Am I the best person to perform this task? Does my height/size meet the requirements of the task? Are there sufficient staff to consider undertaking the task this way? What assistance do we need? Is my or my colleagues’ clothing and footwear appropriate for the task or do we need personal protective equipment?

c) Load (e.g. patient, equipment, etc.):-

Could the patient move if they were given suitable aids or guidance? How independently mobile is the patient and how far can they move? Are there any special needs? Can this patient weight bear or help themselves to move in any way? Where is the patient’s centre of gravity and how will this be affected by my intervention? What handling constraints are there e.g. catheters, resuscitation equipment? What behavioral characteristics of the patient will affect the move e.g. mood, level of co-operation? Could the patient wear more appropriate clothing or footwear to make the task safer? Are there any special communication considerations? Can the patient be adequately secured?

d) Environment:- Is the route to the destination as free from obstruction and risk as practicable? Is the floor uneven or slippery?


What distances or changes in height are involved in the route? What space constraints or obstacles are there?

Could furniture be moved to create more space? Is the lighting adequate? What equipment is appropriate for this task? Will the temperature or weather cause any particular problems? What miscellaneous hazards exist e.g. traffic?

6.3.6. Identification of risks will also occur by examining accident and sickness records

and statistics, cost of and inviting the views of staff and Health and Safety representatives.

6.3.7. Risk assessments will be undertaken in line with the Trust’s Risk Management

Strategy, using the Trust’s generic risk assessment procedures. Any record of an assessment must be retained, so long as it is relevant to work practices. This should be available for scrutiny by employees and Health and Safety representatives. A copy of the risk assessment should be provided to the Health and Safety function.

6.4. Personal 6.4.1. Although control measures such as training, guidance and equipment have been

identified and implemented, personal assessments should be carried out by employees at the time of any moving and handling operation/activity.

6.4.2. This is a mental appraisal of the situation and should be ongoing as the

operation/activity develops and if circumstances change. There are two very important factors that must be considered:- 1) Examination of risk - individuals need to identify the hazards and determine

the risks.

2) Determine what action should be taken.

Individuals then need to determine what action can be taken. This action needs to be based on existing control measure in place (e.g. training, guidance and equipment) where further help is required or where no action should be taken.

6.4.3 To make the assessments more manageable and consistent the individual needs

to ask themselves questions based on the T.I.L.E principles outlined in paragraph 6.3.5.


6.4.4 Employees are reminded that personal assessments are not carried out only the once. They are ongoing assessments as activities and circumstances develop or change.

7. Risk Reduction

7.1. Once a manual handling task has been fully assessed, attention should be given to reducing and eliminating risks, and prioritising those with the potential to cause greater harm.

7.2. Consideration of measures to reduce risk might include:-

a) Does the operation need to be undertaken at all? b) The appropriate form of moving and handling, e.g. team work, use of moving

and handling aids/equipment; c) The training and supervising of staff in moving and handling procedures; d) The availability of written safe working procedures and equipment for all

potentially hazardous tasks. No new item of equipment should be introduced without the approval of the Vehicle, Equipment and Uniform Working Group (VEUWG);

e) Addressing adverse environmental factors;

f) The introduction or review of maintenance/inspection/cleaning programs for all handling aids and equipment;

g) Protective clothing to protect against specific hazards e.g. gloves for handling slippery or difficult to grip items;

h) Redesigning handling operations where possible and practicable. 7.3. Where there is a risk of occupational injury, recommendations should be

implemented in line with the Trust’s Risk Management Strategy.

8. Trust’s Manual Handling Action Plan 8.1. All manual handling risk assessments that are completed using the Trust’s

documentation should be sent to the Health, Safety and Security Manager to be collated and examined.

8.2. All identified actions that have strategic importance will be transferred to the

Trust’s manual handling action plan which the Health, Safety and Security Manager will share with the Health and Safety Group on an annual basis. This action plan will contain an organisational overview of the manual handling risk assessments undertaken.


8.3. Responsibilities for carrying out the actions within this plan will be identified by the Health and Safety Group. This Group will also monitor plans against the action plan.

8.4. All identified responsible persons will be required to provide assurances that

recommendations and actions have been implemented. 9. Moving and Handling Aids and Equipment 9.1. The Trust has a wide selection of moving and handling aids and equipment

available to staff including hoists, carry chairs, stretchers, tail lifts, wheelchairs, cylinder trollies etc.

9.2. Because of the variety of vehicles within the Trust’s fleet it is extremely difficult to

provide all operational staff with the same standards and provision of equipment and aids.

9.3 The Trust is committed to providing all staff, so far as reasonably practicable, with

the same standards of equipment and aids. However where this is not possible staff will be sufficiently trained and additional controls put in place to reduce any risk of injury to the lowest possible level.

9.4. Staff have a responsibility to use the most appropriate equipment and resources

available to them based on training provided. 10. Accident Reporting 10.1. Accidents associated with manual handling operations should be recorded in

accordance with the Trust’s Incident Reporting Policy. 10.2. The information supplied will be treated confidentially and, where reasonably

practicable, will be used to identify suitable measures to reduce the risk of accidents.

10.3. Medical advice may be necessary following an accident or period of ill health to

assess whether any changes in an employee’s health are permanent or temporary; and to ensure that the person is medically fit to continue handling loads at work; and to advise on what ‘reasonable adjustments’ may be necessary to enable the employee to be retained within their present role.

10.4 The Occupational Health provider is responsible for assessing the health needs of staff who have adversely affected by work activities for further intervention or treatment, advising on the appropriate course of action for managing the health needs of staff and keeping line management and HR appraised of the employees capabilities.

11. Introducing New Equipment


11.1. No equipment (including vehicles) with implications for manual handling operations should be introduced without proper authorisation (paragraph 7.2 d) and prior to the appropriate assessment and personnel training/familiarisation.

11.2. Maintenance/inspection programs for all handling aids and protective equipment

must be confirmed by the relevant manager e.g. Fleet Manager, Medical Devices Coordinator or Resilience Manager (as above) and reviewed by the Health, Safety and Security Manager.

11.3 The Fleet Department are responsible for ensuring that all equipment that comes

under the Lifting Operations and Lifting Equipment Regulations 1998 (LOLER) e.g. tail lifts on vehicles and hoists and chains in vehicle maintenance unit are tested and maintained. They must maintain records of testing results and any actions that are needed.

12. Training Requirements 12.1. All staff that may be required to undertake manual handling operations, which may

cause injury, will be provided with appropriate training and information. Once training has been provided it will then need to be refreshed or updated on a regular basis in accordance with the Trust’s Training Needs Analysis (TNA’s) iPortal.

12.2. The provision of effective training is especially important for operational

ambulance staff who are regularly required to move patients. 12.3. Training should enable employees to:-

a) recognise potentially hazardous handling activities;

b) gain a clear understanding of why they should avoid or modify operations,

where possible, making full use of appropriate equipment and good handling techniques.

12.4. The syllabus for manual handling training should include:-

a) manual handling and the law, including employees’ responsibilities; b) the reporting of accidents, adverse incidents and near misses; c) the theory and practice of kinetic handling techniques, including the use of appropriate training mannequins; d) spinal awareness, keeping the back healthy including healthy lifestyles; e) selection and use of handling and moving aids; f) knowing personal capabilities and limitations, including factors affecting individual capability;


g) correct use of any Personal Protective Equipment (PPE); h) principles of safe manual handling of loads and people; j) personal risk assessments including consideration of the task, individual

(capability of crew members), load (patient) and environment (TILE);

k) the importance of proper assessment, planning, organisation and teamwork; l) practical aspects of patient handling; and m) moving ill and injured patients, using equipment (operational ambulance staff

only).

12.5. Training and information will be provided by employees competent to instruct in

handling and moving techniques in accordance with the TNA:

a) on induction for all staff and Ambulance Care Assistant (ACA’s are PTS, what about ECA’s) and Paramedic training courses;

b) at regular intervals, i.e. during Post Basic Training for accident and

emergency ambulance staff or during refresher training for Patient Transport Staff (PTS);

c) when new or changed risks are identified;

d) on introduction of new items of equipment for use during handling and

moving operations; e) as part of any return to work assessment, as appropriate; f) where a training need is identified (e.g. following an accident or when raised

by an employee); and g) during working hours and at no cost to employees.

With the exception of training on induction and qualification courses, line managers, in liaison with the Trust’s Education Department, Training Officers and the Health, Safety and Security Manager, will be responsible for identifying individual training needs associated with this policy. This will necessitate them receiving training and information on recognising and assessing handling problems and in ensuring that suitable action is taken to implement improved methods of working. Risk assessment training will be provided by the Health, Safety and Security department.

13. Monitoring 13.1. The Trust’s Health and Safety Group will receive an annual report from the Health,

Safety and Security Manager which will contain a section on manual handling and which will demonstrate the effectiveness of this policy and include information on:


• whether all those with duties and responsibilities for manual handling are

fulfilling their duties under this policy; • whether staff are adopting suitable and appropriate techniques for the

manual handling of patients and objects; • whether staff are accessing and using the appropriate equipment to carry out

the manual handling of patients and objects; • whether managers and staff are accessing and utilising specialist advice

from those listed in section 5 above; • examination of all the manual handling risk assessments completed; • a summary of the controls put in place to protect staff, patients and others

from the risk of manual handling injuries; • a summary of the actions which have strategic importance and which have

been identified via the risk assessment process to protect staff, patients and others from the risk of manual handling injuries and which have been placed on the Trust’s organisational manual handling action plan;

• a summary of the Trust’s organisational manual handling action plan and

details of the actions that have been implemented and completed to establish whether the Trust is taking an organisational overview of the manual handling risk assessments undertaken.

13.2. Any exceptions to compliance with this policy will be included in the annual health

and safety report which will be reported to the Health and Safety Group and the relevant Manager. Any exceptions identified will be included on the Health and Safety Action Plan.

13.3. Careful consideration will be given to accident, sickness absence records and ill

health retirements which will indicate how successful the policy has been in reducing manual handling injuries. This will be included in the annual report.

13.4. The Trust will seek to reduce the number of manual handling injuries through

planned initiatives and actions in line with the Trust’s annual Health and Safety Action Plan.

13.5 If an employee has an injury linked to a manual handling incident, Health and Safety department may request the Injured Person to undertake refresher e-learning through the iPortal.


14. References

● Health & Safety at Work etc Act 1974; ● Management of Health and Safety at Work Regulations 1992 (amended

1999); ● Manual Handling Operations Regulations 1992 (amended 2002); ● Provision and Use of Work Equipment Regulations 1998 (PUWER); ● Lifting Operations and Lifting Equipment Regulations 1998 (LOLER);

• The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013;

• HSE Manual Handling Approved Code of Practice L23 (Third Edition) 2004; • HSE INDG 143 Manual Handling at Work: A brief guide; • Reference to the document are you making the best use of lifting and

handling aids? • HSE INDG 383 Manual handling assessment charts (the MAC tool); • HSE HSG 241 Health and safety in motor vehicle repair associated

industries; • HSE INDG 356 Reducing ill health and accidents in motor vehicle repair. • Mandatory Workbook.

15. Associated Documents

This policy links to: ● Health & Safety Policy ● Personal Protective Equipment Policy ● Incident Reporting Policy ● Risk Management Strategy ● Slips, Trips & Falls Policy ● Workplace (Health, Safety & Welfare) Policy ● Risk Assessment Policy • Training Policy and Training Needs Analysis • Provision and Use of Work Equipment Policy • Standard Vehicle and Equipment Policy • Fleet and Transport Policy • Lone Working Policy • Workplace Inspection Policy • Lifting Operations and Lifting Equipment (LOLER) Policy


Appendix A

Guidance On Carrying Out Manual Handling Assessment s The Task : - Could the task involve holding the load away from t he trunk? Regardless of the handling technique used, failure to keep the load as close to the body as possible will increase the stress. For example, holding a load at arm’s length reduces the safe lifting capacity by about 80% compared to holding the same load close to the body. The risk of injury is therefore increased and this must be taken into account in the assessment. Could the task involve sudden movements? Sudden or unexpected movements during the task or of the load can present a serious risk of injury. Could the task involve twisting the trunk? Stress on the lower back is increased significantly if twisted trunk postures are adopted. Still worse is a twist while supporting a load. Could the task involve poor posture such as stoopin g? Poor posture during manual handling introduces the potential for loss of control of the load with a consequent increase in the physical stresses. Could the task involve excessive carrying distances ? It is important to avoid carrying items over excessive distance without staged breaks and without changing positions. Could the task involve excessive lifting or lowerin g distances? Stresses are increased when loads are handled at extremes of vertical movement. Lifting, carrying or supporting a load outside the range between mid-thigh and shoulder may increase the risk of injury. Could the task involve excessive pushing or pulling of the load? Like lifting and lowering, if pushing or pulling are carried out with the hand significantly below waist height or above shoulder height the risk of injury can be greatly increased. Generally it is better to push than pull. Due to the way in which pushing or pulling forces have to be transmitted between the crew member’s feet and the floor, there is a risk of slipping. For this reason it is important to consider the floor surface and handler’s footwear.


Does the task pose additional risks because of the position in which it is undertaken? It is more difficult to assist a patient to move fr om a sitting position? To what extent can the task be controlled by the ha ndler? If the task cannot be adequately controlled it is important to re-plan. The capability of a two person team is approximately two thirds the sum of their individual capabilities. The Individual Capability :- (The Handler) Will the handler require additional training? Clearly, the assessor must have knowledge of the skill levels of the handlers who will be involved in assisting the patient to move. If all staff have been trained using the Moving People package then the assessor will know exactly which techniques they have been taught to use safety. New items of effective patient handling equipment are constantly becoming available. If an item of equipment is to be used from another organisation, it is essential this is risk assessed. The assessor should consider whether staff have been given training on using all items of equipment. Would the task require enhanced knowledge? If the movement of a patient is likely to be particularly complex or delicate the technique may need to be adapted to suit the patient, this must be taken into account. Would the task require unusual skill or strength? As a general rule the risk of injury should be regarded as unacceptable if the task cannot be performed satisfactorily by most reasonably fit, healthy crew members. Generally if a task requires unusual skill or strength, the risk increases. Will the handler’s personal characteristics affect the task? Consideration should be given to standards associated with fitness, experience, size health, pregnancy, strength. Psychological factors may also be relevant, such as a reluctance to seek help, a reluctance to admit a lack of knowledge or experience, stress etc. The Load :- The most variable factor in most risk assessments will be the patient who come in a wide variety of shapes and sizes. They may or may not be able to co-operate and ability to co-


operate may change with time which may require the task to be reviewed. Could variations in the size and shape of patients present handling difficulties? The combination of a patient’s weight and shape may present problems that need to be considered, such as exceeding the weight limit for the safe use of certain pieces of equipment. Where is the centre of gravity? The patient’s centre of gravity may be outside the body mass. It is important that the handler considers the effect of this on the maneuver and compensates accordingly. Will the patient be able to weight bear? This factor will affect how much assistance is required. The patient who is able to assist even minimally with a manual transfer will much reduce the strain employees have to take. A patient who is unable to weight bear at all will require assistance with most, if not all, of their movement and, as such, represents a greater risk of handling injury. Will the patient be able to balance? Balance can be crucial in conducting transfers. Many patients, for a whole variety of reasons, may not be able to hold themselves upright, either standing or sitting, without losing their balance. Will the patient be able to walk unaided? If the patient can walk unaided, even for very short distances, it may considerably reduce the amount of handling assistance required. It is important that crew members provide assistance if necessary. What is the level of co-operation from the patient? A patient who understands what the crew members require and co-operates fully at each stage of a transfer, is less likely to pose a risk of injury to employees. The Patient Handling Risk Assessment Forms provided in this policy allow for the assessment to have regard to any problems with communication or co-operation staff may experience. Does the patient pose any other special risks? Certain medical conditions may have an impact on the level of handling risk a patient presents. Some of these risks may not be immediately apparent to either the assessor or staff. Special risks of this kind may include:-

• pressure sore, skin fragility etc;

• pain and stiffness;

• peripheral vascular disease;


• hypo/hypertension;

• diabetes;

• paralysis;

• muscular spasms;

• amputation;

• rigidity;

• vertigo/dizzy spells;

• drunkenness;

• drug abuse;

• fractures.

For non-patient loads, it will also be essential to consider potentially damaging temperature, chemical spills, sharp edges of loads etc.

ENVIRONMENT:- Will there be any limitations on the free movement of the handler(s)? Limitations may be caused by poor design of a building or be due to factors such as entrapment. Restricted headroom will enforce a stooping posture. Is appropriate equipment available? In assessing the risk, the assessor must take into account the suitability of the equipment available. Will the lighting be adequate? Poor visibility increases the risk of slips and falls. Are there variations in the level of the floors or work surfaces? Excessive variation between the heights of working surfaces will increase the range of movement and the scope for injury. Will the floors be slippery or uneven? Uneven and slippery floors create greater risks. Will there be extremes of light/hot/cold/humid cond itions?


When it is too hot or there is poor ventilation, people tire more easily. Perspiration on hands may also affect grip, as may extremes of cold. How often should the assessment be updated? There are no strict guidelines available to indicate how often a risk assessment should be updated. However, if new or changed risks are identified (e.g. changes to the patient’s condition, equipment used or the environment) then the assessment should be reviewed to ensure it is up to date. The Trust will, as a routine, consider reviewing the effectiveness of their risk assessments. Feedback from employees and others will be used. OTHER:- Is movement or posture hindered by clothing or pers onal protective equipment? Is personal protective equipment provided where the re is a specific risk from a load, e.g. gloves, safety shoes?


Appendix B

Preventing Musculo-Skeletal Problems Although the Trust has a legal responsibility only to avoid or reduce the risk of injury from moving and handling operations. There are a number of practical steps that employees can adopt whether in work or outside of work, to prevent musculo – skeletal problems. These include:-

• avoid or minimise potentially hazardous moving and handling and apply the right techniques;

• lift within your own capabilities;

• consider your body weight;

• stop smoking;

• adopt good posture;

• avoid standing or sitting for too long in one position;

• take regular exercise;

• use warm up exercises wherever possible and practicable, and;

• consider medical advise to address any lifestyle concerns

Start in a good posture Adopt a stable position with feet apart and one leg slightly forward to maintain balance

Keep the load close to the waist

Keep your head up when handling Avoid twisting your back or leaning sideways, especially while the back is bent

Put down, then adjust

Appendix C - Manual Handling Guidelines Prevent Workplace Injury

Manual handling is one of the most common causes of injury at work and causes over a third of all workplace injuries which include work related Musculoskeletal Disorders (MSDs) such as upper and lower limb pain/disorders, joint and repetitive strain injuries.

This is for guidance only: there is no guidance wei ghts for the back and there is no safe weight

Appendix D HSE Guidance lifting chart.


Appendix E

Version Control Sheet

Version Date Author Summary of Changes

2 15/7/08 John Dunn Section 4 – Responsibilities - This section amended to include the responsibilities of the Board (section 3.1); the Heads of Operations/Operations Managers/Other Senior Managers (section 3.4); the Health, Safety and Security Manager (section 3.7).

Section 4.5 - Responsibilities of Operational Locality Managers/Line Managers expanded upon, in particular duty to carry out a risk assessment.

Section 4.6 - Responsibilities of Employees expanded upon, in particular duty to carry out a risk assessment.

Replace the word ‘sound’ with ‘kinetic’.

Section 13 – Monitoring - This section has been expanded.

Version Control Sheet - Delete reference to ‘through arm lift’.

3 2/10/09 John Dunn Title - Change the title of the policy from ‘Handling and Moving Policy’ to ‘Manual Handling and Moving Policy’; and throughout document.

Section 7.3 - Replace ‘Risk Management Policy’ with ‘Risk Management Strategy’; and do this throughout the document.

Section 8.2 - Add new sentence stating: ‘The action plan will contain an organisational overview of the manual handling risk assessments undertaken.’

Section 13.1 - Amend the second bullet point so that it reads: ‘Whether staff are adopting suitable and appropriate techniques for the manual handling of patients and objects;’

Section 13.1 - Add the following to the last bullet point: ‘to establish whether the Trust is taking an organisational overview of the risk assessments completed.’

Include version control sheet.

Appendix A - Amended form

5 June 2015

Claire Wiscombe

Review of Policy.