First Aid Needs Assessment: How to Do One (UK Guide)

A first aid needs assessment is how you decide what "adequate and appropriate" first aid means for your workplace, as the Health and Safety (First-Aid) Regulations 1981 require. You look at your hazards, staff numbers, shift patterns, absences, accident history and who else is on site, then decide on kits, an appointed person or trained first aiders, and how many.

What the law requires

In England, Scotland and Wales, regulation 3 of the 1981 Regulations requires every employer to provide equipment, facilities and suitably trained people that are "adequate and appropriate in the circumstances" for giving first aid to employees who are injured or become ill at work. Northern Ireland has its own equivalent, the Health and Safety (First-Aid) Regulations (Northern Ireland) 1982.

The regulations don't say what "adequate" looks like. HSE's guidance, L74, says you should assess first aid needs for each workplace, based on its hazards and risks, and that enough equipment, facilities and people should be available at all times people are at work. That assessment is the needs assessment.

You don't have to write it down, but HSE says a written record lets you show how you reached your decisions. If an inspector asks why you have two first aiders on days and none at night, "we thought about it" won't carry much weight.

What to consider

L74 Table 1 and HSE's needs assessment page set out the factors. In plain terms:

• Hazards: low-level hazards, such as offices and shops, need at least an appointed person and a stocked kit. Higher hazards, such as chemicals or dangerous machinery, may need trained first aiders, extra equipment and a first aid room.
• Number of employees: where there are more than 25 employees, even in a low-hazard setting, L74 says to consider first aiders, extra equipment and a first aid room.
• Who your staff are: inexperienced workers, trainees, and staff with disabilities or particular health problems may need extra provision.
• Accident and ill-health record: provision should match the injuries and illness that actually happen.
• Travelling, remote and lone workers: personal kits and a way to call for help.
• Shifts and out-of-hours work: cover is needed whenever people are working.
• Spread-out premises: consider provision on each floor or in each building.
• Shared sites: agree arrangements with other occupiers, ideally in writing.
• Absences: plan cover for holidays and other planned and unplanned absences.
• Non-employees: such as visitors, contractors and the people you support.

HSE also suggests thinking about how you would support someone experiencing a mental health issue at work.

Appointed person, EFAW or FAW?

• Appointed person: the legal minimum where you decide trained first aiders aren't needed. This person takes charge of first aid arrangements, looks after equipment and facilities, and calls the emergency services. HSE says they don't need first aid training, but they are not first aiders and shouldn't attempt first aid they haven't been trained in. See our guide to the appointed person for first aid.
• Emergency First Aid at Work (EFAW): trains staff to give emergency first aid to someone who is injured or becomes ill at work. HSE guidance says the course should be at least six hours over at least one day.
• First Aid at Work (FAW): covers everything at EFAW level plus a range of specific injuries and illnesses. HSE says at least 18 hours over at least three days. See First Aid at Work training.

HSE says there are no hard and fast rules on numbers. L74 does say that where 25 or more people are employed, even in a low-hazard workplace, at least one first aider should be provided. Its suggested numbers are guidance only. For worked examples, read how many first aiders do I need.

HSE stopped checking and signing off first aid training providers on 1 October 2013, so choosing a suitable provider is now your responsibility.

Shifts, nights and absences

This is where assessments most often fall down. A care home can have six first aiders on the books and nobody trained on a Sunday night shift.

• Work from the rota, not the headcount. L74 says separate arrangements may be needed for each shift.
• Plan for annual leave, training days and sickness. L74 expects cover for planned and unplanned absences.
• An appointed person can stand in for an absent first aider only in exceptional, unforeseen and temporary circumstances. L74 is clear that annual leave doesn't count.

Residents, visitors and other non-employees

The 1981 Regulations don't require you to provide first aid for people who aren't your employees. HSE strongly recommends that you include them in your assessment and make provision for them anyway, and L74 notes that this may mean extra training.

In health and social care, the people you support are often the ones most likely to need first aid: a fall in the lounge, choking at lunch, a seizure in the garden. Their care plans cover their health needs, but your staff on shift still need to respond in the moment. Build that into your assessment.

A simple template

Answer these questions for each site and keep the answers with your health and safety records:

1. What work happens here, and what are the main hazards?
2. What injuries and illnesses does your accident book show over the last year or two?
3. How many people work here at the busiest time, and at the quietest?
4. What are the shift patterns, including nights, weekends and on-call?
5. Do any staff travel, work alone or work in the community?
6. How spread out is the site, and how many floors or buildings are there?
7. Who else is on site: the people you support, visitors, contractors, other employers?
8. What level of first aider does this point to: appointed person, EFAW or FAW?
9. How many do you need on each shift, allowing for leave and sickness?
10. What kits and equipment do you need, including any AED or first aid room, and where will they go?
11. When will you review this, and who is responsible?

For kit contents, see our guide to the workplace first aid kit.

Recording and reviewing it

L74 says employers should review first aid needs from time to time, particularly after changes to how they operate. Good triggers include a new service or building, a change in staffing or shifts, a first aider leaving, and a pattern in your accident book. HSE says first aid certificates last three years and strongly recommends an annual refresher.

You must also tell your staff what the arrangements are: who the first aiders or appointed persons are, and where the kits are kept.

How Kasorb can help

Once your assessment tells you how many first aiders you need, our Emergency First Aid at Work course trains your team at your workplace in one day. It covers the role of the first aider, assessing an incident, CPR and AED use, the unresponsive casualty, choking, seizures, wounds, bleeding, shock and minor injuries, with practical assessments and a multiple-choice theory paper.

Your trainer has used these skills for real. It's one flat rate for the group, so it's easy to train enough people to cover every shift. The certificate is valid for three years, and certificates are emailed the next day.

This guide summarises the law and guidance; it isn't legal advice.

FAQs

Is a first aid needs assessment a legal requirement?

The Health and Safety (First-Aid) Regulations 1981 require adequate and appropriate first aid provision, and HSE guidance says the way to decide what that means is to assess your first aid needs. In practice, you can't show your provision is adequate without one.

Does a first aid needs assessment have to be written down?

No. HSE's guidance says there is no requirement for it to be formal or written down. It does say a written record may be useful, because it shows how you decided on your arrangements if anyone asks, including an inspector.

How often should a first aid needs assessment be reviewed?

HSE doesn't set a fixed interval. L74 says to review it periodically, particularly after changes to how you operate. Review it when staffing, shifts, premises or services change, when a first aider leaves, or when your accident book shows a new pattern.

Do I need a first aider or an appointed person?

It depends on your assessment. An appointed person is the minimum where trained first aiders aren't needed, such as a small, low-hazard workplace. L74 says that where 25 or more people are employed, even in low-hazard work, at least one first aider should be provided.

Do I have to include members of the public in a first aid needs assessment?

The 1981 Regulations don't require it, but HSE strongly recommends including the public and other non-employees and making provision for them. In care settings, the people you support should be part of your thinking, as they are often the most likely to need help.