Managing the Manual Handling Risk
Ruth Robotham MSc, CMIOSH, RN, RNT
Chartered Safety and Health Practitioner
& Back Care Advisor
Sussex Safety Ltd
Objectives
• Why do we need policies and protocols?
• What are the consequences of failing to manage
risks
• Outline a simple management system for reducing
manual handling risks, with ways of improving
safety
What’s Changed in the Last 5 Years?
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 organisation’s activities were
managed by its ‘senior managers’ was a ‘substantial’
element in the breach.
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 2008
For any serious breach of health and safety legislation
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 2011
Aim: to reduce burden of red tape
Findings: Largely fit for purpose & Cost effective
•
•
•
•
Consolidate legislation
ACoP simplify & review (53) eg LOLER
Review absolute liability / SFAIRP
Redirect enforcement to high risk businesses
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 broken
Organisation Needs to Prove
(Guilty until proved innocent)
Everything had been done to
reduce significant foreseeable risks
HSE Safety Management System (HSG65)
(POPIMAR)
Setting Policies
Organising for Health and Safety
Auditing
Planning and Implementing
Measuring Performance
Reviewing Performance
Setting Policies
Manual Handling Policy
• Based on your Health & Safety Policy
• Include therapeutic and bariatric risks, if relevant
• Keep it simple and realistic and achievable
• State how you will monitor that it happens
Organising for Health & Safety
Strategies
• How do you Control what happens
• How do you get Co-operation to ensure safety
• How do you ensure Communication with all staff
• 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 reduction
Generic Risk Assessments for significant risks
eg turning any patient in bed
4 C’s - 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 ill-health 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 materialising
• 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 assessment.
• They should be seen as helpful, multi-disciplinary
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 (HSG65)
(POPIMAR)
Setting Policies
Organising for Health and Safety
Auditing
Planning and Implementing
Measuring Performance
Reviewing Performance
Measuring Performance
Pro-Active Monitoring
To check if the Manual handling policy is being followed
• Are the risks controlled by the measures in place
• Is the standard of patient handling good
• Is patient independence being promoted and goals
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
Reflective Health Diary
Name …………………………
Role ……………………………
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 symptoms.
Date
Task
Health effects /
carried out Symptoms
4/4/06 eg Using my
computer
Possible solution and
effect
I get a pain in the right Removed arms off my chair
side of my neck after
so I can get closer to my
desk, with a right angle at
15 minutes.
my elbow. Pain now less
Your signature ……………………………. Date …………………
Line manager’s 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
Audit
Collecting information on the efficiency, effectiveness
and reliability of the total system
eg Benchmarking against standards
• HOP6
• 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 for
Healthcare Professionals
Conclusion
1.
POPIMAR approach to health and safety is
a tried and tested system to manage risks
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 patient’s independence may increase.