Healthcare Health & Safety Requirements

Healthcare is one of the largest employment sectors and presents unique health and safety challenges. Workers face risks from manual handling, sharps injuries, violence, infection, and hazardous substances - often while caring for vulnerable patients in high-pressure environments.

This guide covers key health and safety requirements for UK healthcare settings, from GP practices to hospitals.

The Legal Framework

Healthcare settings must comply with general workplace legislation plus sector-specific requirements:

Health and Safety at Work etc. Act 1974 - Foundation duties to protect workers and others.

Manual Handling Operations Regulations 1992 - Critical given the physical demands of patient handling.

Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 - Specific requirements to prevent needlestick injuries.

Control of Substances Hazardous to Health Regulations 2002 - Covers chemicals, pharmaceuticals, and biological agents.

Manual Handling and Patient Moving

Patient handling is the leading cause of injury in healthcare, causing significant musculoskeletal disorders.

The Challenge

Healthcare manual handling differs from other sectors:

Patients are unpredictable (may move, resist, or collapse)
Handling often in confined spaces
Emergency situations require rapid response
Patient dignity and comfort must be maintained
24/7 operations create fatigue factors

Assessment

Every patient requiring assistance should have a handling assessment covering:

Patient's mobility, weight, and condition
Level of assistance needed
Equipment required
Number of handlers needed
Specific risks (confused patients, medical equipment)

Equipment

Appropriate equipment dramatically reduces injury risk:

Hoists (ceiling-mounted or mobile)
Sliding sheets and boards
Standing aids
Profiling beds
Wheelchairs and transfer equipment

Key principle: Equipment should be readily available and staff trained to use it. Time pressure should never justify manual lifting.

Training

All staff involved in patient handling need:

Assessment of patient handling needs
Correct use of handling equipment
Techniques for assisted moves
When to refuse unsafe handling
Regular refresher training

Sharps Safety

Needlestick injuries carry risk of bloodborne virus transmission (HIV, Hepatitis B and C).

Legal Requirements

The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 require:

Use of safer sharps devices where reasonably practicable
Prohibition of recapping needles
Safe disposal arrangements
Training for sharps users
Investigation of injuries
Post-exposure procedures

Safer Sharps

Devices with engineered protection mechanisms:

Retractable needles
Shielded needles
Needleless systems where clinically appropriate
Safety cannulas

Safe Use

Never recap needles (primary cause of injuries)
Dispose immediately after use into sharps container
Don't overfill sharps containers
Never pass sharps hand-to-hand
Dispose of sharps personally (not left for others)

If Injury Occurs

Encourage bleeding from wound
Wash thoroughly with soap and water
Report immediately through occupational health
Risk assess the source patient where possible
Post-exposure prophylaxis if indicated
Follow-up testing

Violence and Aggression

Healthcare workers face high levels of violence from patients, visitors, and the public.

Risk Factors

Emergency departments
Mental health settings
Substance misuse services
Night shifts and lone working
Delivering unwelcome news
Wait times and frustration

Prevention

Environment:

Good design (escape routes, visibility)
Security presence where needed
CCTV as deterrent
Alarm systems
Safe interview rooms

Procedures:

Risk assessment of patients
Communication between shifts
De-escalation training
Clear policies on unacceptable behaviour
Support for staff after incidents

Legal protection:

Prosecution support for assaults on staff
Zero tolerance policies
Clear signage about behaviour expectations

Infection Control

Healthcare workers are exposed to infectious agents through patient contact, blood and body fluids, and contaminated equipment.

Standard Precautions

Apply to all patient contact:

Hand hygiene (the single most important control)
Personal protective equipment (gloves, aprons, masks as indicated)
Safe handling of sharps
Safe handling of clinical waste
Decontamination of equipment
Respiratory hygiene

Transmission-Based Precautions

Additional measures for known or suspected infections:

Contact precautions (MRSA, C. diff)
Droplet precautions (influenza, respiratory infections)
Airborne precautions (TB, measles, chickenpox)

Immunisation

Healthcare workers should be immunised against:

Hepatitis B (essential for those exposed to blood)
Influenza (annual)
Other vaccines depending on role and exposure

COSHH in Healthcare

Healthcare uses numerous hazardous substances.

Common Hazards

Substance	Hazards	Controls
Glutaraldehyde	Respiratory sensitiser, skin irritant	LEV, PPE, substitution where possible
Cytotoxic drugs	Carcinogenic, teratogenic	Closed systems, PPE, designated areas
Anaesthetic gases	CNS effects, reproductive concerns	Scavenging systems, monitoring
Latex	Allergy/anaphylaxis	Non-latex alternatives
Cleaning chemicals	Various	COSHH assessment, PPE

Cytotoxic Drugs

Special precautions required:

Preparation in pharmacy isolators
Closed system transfer devices
Designated disposal routes
Spill procedures
Staff training and monitoring

Radiation Safety

Some healthcare settings use ionising radiation (X-rays, radiotherapy, nuclear medicine).

Requirements

Ionising Radiations Regulations 2017 require:

Radiation protection adviser
Local rules and procedures
Controlled and supervised areas
Personal dosimetry
Medical surveillance
Equipment quality assurance

Protection Principles

Justification - benefit must outweigh risk
Optimisation - doses as low as reasonably achievable
Dose limitation - legal dose limits not exceeded

Stress and Wellbeing

Healthcare workers face significant psychological pressures.

Contributing Factors

High workload and staffing pressures
Emotional demands of patient care
Shift work and fatigue
Traumatic incidents
Moral distress (unable to provide desired care)

Organisational Response

Manageable workloads
Adequate staffing
Support after traumatic incidents
Access to occupational health and counselling
Recognition of stress as a health and safety issue

Fire Safety

Healthcare settings have complex fire safety requirements due to patients who may be unable to evacuate independently.

Key Considerations

Progressive horizontal evacuation
Fire compartmentation
Patient mobility assessment
Evacuation equipment (sheets, chairs)
Staff training in evacuation procedures
Fire marshal systems

Common Questions

Frequently Asked Questions

The employer (NHS Trust, private provider, GP practice) has primary responsibility. This includes providing safe systems of work, equipment, training, and supervision. Managers have day-to-day responsibility for implementation. Individual staff must cooperate with safety arrangements.

Yes. Staff should not be required to perform manual handling that puts them at risk of injury. If equipment is available and appropriate, it should be used. Raise concerns through proper channels if safe handling isn't being supported.

Ensure your immediate safety. Report through incident reporting systems. Seek medical attention if injured. Access support services. Consider whether police involvement is appropriate. The organisation should investigate and take action to prevent recurrence.

It's strongly recommended for anyone whose work may expose them to blood or body fluids. Some employers require it for certain roles. If you decline vaccination, you should be informed of the risks and may be restricted from certain exposure-prone procedures.

Employers must assess and manage psychosocial risks. You can raise concerns about workload or stress. Access occupational health services. Employers should provide support and reasonable adjustments. Stress-related illness is covered by health and safety law.

Summary

Healthcare safety requires managing multiple complex risks:

Manual handling - patient handling assessments, equipment provision, trained staff
Sharps safety - safer devices, proper disposal, post-exposure procedures
Violence - risk assessment, training, security measures, support
Infection control - standard precautions, PPE, immunisation
COSHH - assessment and control of hazardous substances

The unique challenges of healthcare - caring for vulnerable patients in pressured environments - require robust systems and genuine commitment to staff safety.