Hospitals: Using the full health and safety toolkit

The employer has a legal duty to protect the health, safety and welfare of their employees, but also anyone who might be affected by its daily business activities, premises and facilities. That means patients, visitors, contractors and any employees of other healthcare organisations who might be visiting the hospital or working on-site.

Hospitals exist to look after people’s health, so why is health and safety so necessary?
By the very nature of their conditions, patients are classed as ‘vulnerable’ people, so it’s essential that their healthcare is provided in the right environment. The facilities - including medical devices and non-medical equipment - must be ‘safe and suitable’, cleaned and well maintained. And all of this must be operated by people who are trained and competent to do so, which is why health and safety is so vital in a hospital environment.

What’s more, in a safe, healthy environment, staff feel looked after, experience a morale boost and are more motivated, which promotes higher standards of care. The more employees are off sick because of work related injury or ill health, the more chance there is that the quality of service to the patient may be affected due to a number of factors including inconsistency, poor communication and lack of investment in individuals’ situations. Good health and safety in hospitals increases efficiency and reduces lost time through reduced sickness absence.                           

What areas of health and safety does a hospital have to cover?
A hospital must utilise everything in the health and safety toolkit. It has to consider safe access and exit, moving and handling, slips, trips and falls, management of sharps and management of waste. It also needs to make sure it controls contractors, looks out for and prevents violence and aggression, cleans and maintains all of its buildings and equipment and provides proper training and information on health and safety issues.

Many of the activities of a hospital will also fall under the jurisdiction of the Control of Substances Hazardous to Health (COSHH) Regulations 2002, and they must provide proper infection control, legionella prevention and management of other harmful bacteria and microorganisms. It also includes chemicals, ionising and non-ionising radiation and a host of other substances.

What are the most prolific health and safety issues that a hospital might face?
The issues will vary from hospital to hospital, but they should all be identified by risk assessments and dealt with in a way that best controls the risks to patients, staff and other visitors or employees within the premises. Experience shows that maintenance of equipment, facilities and grounds can be areas for concern as they aren’t in the spotlight and can be the first area to suffer budget cuts in times of austerity.  Back log maintenance is an area where things can be missed due to lack of funding and investment.

We often find that the management and control of contractors can be overlooked as they fall between the gaps of hospital visitors, employees and patients. But health and safety managers and hospital bosses should be just as diligent, making sure that the work of contractors meets the same standards, as it’ll be their responsibility if things go wrong and injury and ill-health incidents creep up.

How do you look after staff experiencing stress/mental health issues/depression?
Many hospitals are trying to be proactive, even in these austere times, to reduce the risk of stress to protect its staff, especially as high sickness and absence levels can affect service delivery. Almost across the board there have been wellbeing groups set up and health and fitness sessions made available, with flexible working catered for where possible. If staff feel the effects of stress, many hospitals have confidential counsellors for them to discuss problems with. To help reduce the source E E of stress it’s now common for the hospital’s occupational health department, human resources department and the staff member’s manager to work together to find a solution.

What are the areas that require most vigilance in a healthcare setting?
The main risks to staff tend to be violence and aggression, moving and handling, slips, trips and falls and sharps injuries, so it’s vital that they are properly trained in those areas and understand where they can get information and support. In terms of patients, the areas I often see posing a risk are slips, trips and falls and infection control.

What kinds of tasks does a health and safety manager of an average-sized hospital meet in his day-to-day work?
There may well be some routine in their job, such as delivering induction training, attending committee meetings, dealing with correspondence and email - but it can vary from day-to-day. Policies will need to be written or revised, departments might need assistance with their risk assessments and specialist training might need to be delivered. On occasions, there may be incidents to investigate or contractors to monitor.  A health and safety manager has a great deal of liaison with other departments, such as facilities, or estates, and even pathology when the need arises. It’s also important for them to get out from behind the desk to walk the patch and carry out safety tours when they can. After all, they need to be known by everyone and accessible by all managers and staff.

How far up a hospital’s priorities should health and safety rank?
Health and safety is about being sensible. Hospitals are there to provide safe, quality services to patients and be a good employer to the employees who provide those services on their behalf – good health and safety should be an important part of enabling them to succeed in that mission. A hospital should be managing the risks that could prevent it from achieving its aims - health and safety is a part of that. This said, compliance with health and safety legislation, such as the Health and Safety at Work Act 1974, should be treated with as much seriousness as compliance with any other law that governs how a hospital manages its business. This includes the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission (CQC) Essential Standards.

Are there any risks to current hospital health and safety posed by budget cuts to the NHS?
Without a shadow of a doubt. A properly resourced hospital is a safe and healthy hospital. After all, if equipment and facilities are not properly maintained, this poses a risk to the safety and welfare of patients, staff and visitors. It’s somewhat ironic if a place which is supposed to promote and improve health is also risking it. Adequate funding enables the delivery of safe and quality services, but also makes sure the workforce providing the service are properly resourced, healthy, safe and happy – it allows them to provide a good level of care. A hospital with poor health and safety can suffer legal sanctions, prosecution, court costs, fines, legal fees and compensation claims, which are all hugely costly. Sickness absence and injury from inadequate health and safety can also mean a hospital becomes inefficient, while experiencing more down time and higher personnel turnover, which all adds to the cost.

In the long run, it makes far more financial sense to properly resource a hospital so it can maintain facilities, equipment and buildings, keep staff healthy and safe and look after contractors, patients and visitors.

Do people appreciate the importance of good health and safety in hospitals?
Managers and staff who work in a hospital where health and safety is a priority will understand the innate value it brings. But all staff and patients unknowingly appreciate the benefits of good health and safety, as quite often, it goes unnoticed when everything is working properly. Senior managers need to realise that health and safety is not an additional burden, but an integral and essential part of their delivering a safe, quality service to patients and purchasers of healthcare services from the hospital.

Is the role of health and safety in a hospital different to a factory or a public space? Why?
A hospital has a greater risk portfolio than any individual factory. Factor in the patients and visitors and it makes it a very complex place to manage health and safety. It has so many high risk areas and activities going on at the same time, such as construction or refurbishment activities, hazardous waste, laboratories, radiation and a need for complete sanitation. It’s a very high risk industry.

About IOSH
Founded in 1945, IOSH is the biggest health and safety membership organisation in the world. The IOSH Healthcare Group meets the professional development needs of 1,800 members working in public and independent healthcare, including primary care, acute services, mental health, ambulance services, social services and learning disabilities. Every year, IOSH organises four networking events in locations across Britain and Ireland, choosing topics that are identified as areas of interest through the feedback received from members.

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