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Managing the Manual Handling

Ruth Robotham MSc, CMIOSH, RN, RNT
Chartered Safety and Health Practitioner
& Back Care Advisor
Sussex Safety Ltd


Why do we need policies and protocols?

What are the consequences of failing to
Outline a simple management system for
manual handling risks, with ways of

Whats Changed in the Last 5

Financial constraints:

12 hour shifts

Moving staff between specialties

Difficulty releasing staff for training,

or reduced time

Corporate Manslaughter Act 2007

Fatality caused by a gross breach of a duty
of care.
The way that the defendant organisations
activities were managed by its senior
managers was a substantial element in the
Where the prosecution can show the gross
breach falls far below what can reasonably
be expected, juries are likely to convict.
A Positive Safety Culture is vital.
Compliance with Guidance will be scrutinised.

Health and Safety (Offences) Act

For any serious breach of health and safety
Magistrates Court
Fines: Up to 20,000 per breach
Imprisonment: 6 months
Crown Court
Fines: Unlimited
Imprisonment: Up to 2 years

Fee for Intervention (FFI)

Health & Safety (Fees) Regs 2012
Duty on the HSE to recover its costs for carrying
out its regulatory function from those found to
be in material breach of health & safety law.
124 per hour based on time spent by HSE
identifying the breach, investigating & taking
enforcement action.

Lofstedt Health and Safety Review

Aim: to reduce burden of red tape
Findings: Largely fit for purpose & Cost

Consolidate legislation
ACoP simplify & review (53) eg LOLER
Review absolute liability / SFAIRP
Redirect enforcement to high risk

Criminal Prosecution
If the Organisation has breached health and
safety law
Enforcing Agency needs to Prove
A statutory duty was owed and the law was
Organisation Needs to Prove
(Guilty until proved innocent)
Everything had been done to
reduce significant foreseeable risks

HSE Safety Management System

Setting Policies
Organising for Health and Safety

Planning and Implementing

Measuring Performance
Reviewing Performance

Setting Policies

Manual Handling Policy

Based on your Health & Safety Policy
Include therapeutic and bariatric risks, if
Keep it simple and realistic and achievable
State how you will monitor that it happens

Organising for Health & Safety

How do you Control what happens
How do you get Co-operation to ensure
How do you ensure Communication with all
How do ensure staff Competence
If you can say you achieve these, there is
likely to be a
good safety culture

Planning and Implementation

A planned and systematic approach to risk
Generic Risk Assessments for significant risks
eg turning any patient in bed
4 Cs - eg policies & procedures individual patient
handling assessments, mechanical handling
devices, small handling aids, footwear and
clothing, at risk staff, health monitoring,
information, training and supervision, reporting illhealth and injuries, etc

Hierarchy of Control Measures

Avoid or Eliminate the hazard - Always the first
choice (Redesign to avoid the handling task)
Use mechanical handling devices -electric
profiling beds and trolleys, hoists, mechanical
transfer devices, where possible
Procedural controls Safe working procedures,
handling aids, control of agency staff
Behavioural controls Information, instruction,
training, supervision, PPE (safety shoes)

Action Plan Implementation

Ensure the generic risk assessment is
discussed at the right level
Write a convincing business case for what
you realistically need
If it is a significant risk, ask for it to be put
on the Risk Register
Keep risk assessments under review

Role of Senior Management

To consider the nature and extent of the risks
facing the organisation on the risk register
To decide whether those risks are considered
as acceptable
To assess the likelihood of the risks
To assess their ability to reduce the incidence
and impact of the risks
To put suitable and sufficient measures in
place to control the risks

Improving Patient Safety

Write an individual patient handling
They should be seen as helpful, multidisciplinary documents
They should reflect the goals set for patients,
especially in longer term patients/residents
They should say what the patient/resident is
able to do for themselves
Consider using pictures to demonstrate how
to position patients, but maintaining their
confidentiality. eg CVA patients.
Staff must report ill-health and injuries to
patients due to manual handling eg frozen
shoulder, skin damage from positioning slings,
etc. (safeguarding issues)

HSE Safety Management System

Setting Policies
Organising for Health and Safety

Planning and Implementing

Measuring Performance
Reviewing Performance

Measuring Performance
Pro-Active Monitoring
To check if the Manual handling policy is being
Are the risks controlled by the measures in place
Is the standard of patient handling good
Is patient independence being promoted and
being achieved
ie spot observations; or working with staff;
checking risk assessments; key performance
indicators; is equipment available; evaluate the
impact of introducing new equipment, etc



Health Diary

Identify the tasks you carry out each day, eg carry out
a leg ulcer dressing;
input data on the computer; catheterisation; carry out
venipuncture; driving the car, carrying equipment.
Things you do outside of work can also be included.
Discuss work issues with your manager, or get advice
from the manual handling advisor or Occupational
Health, to work out what you can do to reduce your
Health effects Possible solution


4/4/0 eg Using

/ Symptoms

and effect

I get a pain in
the right side of
my neck after 15

Removed arms off

my chair so I can
get closer to my
desk, with a right
angle at my elbow.
Pain now less

Your signature
. Date

Line managers
signature . Date.

Measuring Performance
Reactive monitoring system
Manual handling accidents and incidents
Sickness absence -musculo-skeletal disorders
Patient injuries due to handling
Nationally 2011/12
17% fall in reported MSD caused or made
worse by work

HSE Safety Management System

Collecting information on the efficiency,
and reliability of the total system
eg Benchmarking against standards


NBE Standards in Manual Handling

NBE Moving and Handling Strategy

Review Performance
Learn from experience, improve performance,
respond to change, share best practice.
Update your policy, if necessary

I would recommend BCA /MHA consider

completing a
risk management course - IOSH Managing Safely
Healthcare Professionals


POPIMAR approach to health and safety is

a tried and tested system to manage
and costs

2. The threats are now greater, so robust

systems are needed
3. If everyone knows the goals they are
aiming for, then handling practice should
improve, and patients independence
may increase.