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How to carry out a first aid needs assessment

Updated: Oct 12, 2022

In 2013 the Health and Safety Executive released 2013 First Aid Guidelines for Employers recommending a first aid needs assessment. The assessment is intended to identify what type of first aid training your first aiders will need, how many first aiders you need and where they should be located.

A first aid needs assessment should consider the following topics:

  • the nature of the work, the hazards and the risks

  • the nature of the workforce

  • the organisation’s history of accidents and illness

  • the needs of travelling, remote and lone workers

  • work patterns such as shift work

  • the distribution of the workforce

  • the remoteness of the site from emergency medical services

  • employees working on shared or multi-occupied sites

  • annual leave and other absences of first aiders

  • first-aid provision for non-employees

  • the size of the organisation

The nature of the work, the hazards, and the risks

One of the more complicated areas of the new first aid needs assessment is considering ‘the nature of the work, the hazards and the risks. You should consider the risks and identify what possible injuries could occur to ensure sufficient first aid provision is available.


The following table, compiled using information from the Health & Safety Executive, identifies some common hazards and associated risks:

The table is not comprehensive and does not cover all the risks that could occur in a workplace, so you should look at each area and document the risks and the possible injuries.


One reason for this exercise is to ensure that you provide the correct type of first aiders. There are now two levels of workplace first aider:

You should ensure that your first aiders are trained to deal with the injuries and illness that could occur in your specific workplace.


The table below will help you match your requirements to the most appropriate course:

Extra, specialised training and provision may be needed for hazards such as chemicals, dangerous machinery, working in confined spaces etc. You should also consider the possible illnesses that could occur in the workplace and ensure you have adequate provision.


The nature of the workforce

You should consider the needs and health of all workers and ensure that first aiders are available and trained to deal with specific health needs. You should consider things such as:

  • The Young

  • The Elderly

  • Specific health problems (such as heart conditions, asthma, diabetes etc.)

  • Disabilities

The organisations history of accidents and illness

You should look at the organisation’s history of accidents and illness to try and identify any needs or trends that may influence the location or type of first aider. Different levels of provision may be required in different areas of the workplace.


The needs of travelling, remote and lone workers

First Aid should be available wherever people work so you may need to consider providing personal first aid kits or training to travelling, remote or lone workers.


Work patterns such as shift work

Adequate first aid cover should be available whenever people are at work. There may be circumstances when a higher level of cover is needed when less people are at work, such as overnight maintenance work in a normally low risk environment.


The distribution of the workforce

First Aiders should be able to reach the scene of an incident quickly. Consider extra first aiders on large sites, sites with multiple buildings or buildings with multiple floors.


Remoteness to the site from emergency medical services

If the workplace is remote from emergency medical services, you may need to make special transport arrangements should an incident occur. Consider how employees will summon help – do they have access to a phone?

Even in urban areas you should be aware that it often takes more than 10 minutes for an ambulance crew to reach a casualty, so the correct provision of first aid is a vital link in reducing the effects of illness or injury.


Employees working on shared or multi-occupied sites

On shared work sites it may be possible to share first aid provision, such as the security team providing first aid cover at a large shopping centre. It is important to fully exchange details of the hazards and risks so that adequate first aid cover is provided. Make agreements in writing to avoid misunderstandings.


Annual leave and other foreseeable absences

You should ensure that adequate first aid cover is always available, including when a first aider is on annual leave, a training course, a lunch break or other foreseeable absences. This generally means that workplaces need more than one first aider to ensure that cover is maintained.


If your first aid needs assessment identifies the need for a ‘First Aider at Work’ (18-hour course), it is not acceptable to provide an ‘Emergency First Aider at Work’ (6-hour course) to cover foreseeable absences.


You should also consider what cover is needed for non-planned absences such as sick leave.


First Aid provision for non-employees

The HSE recommend that you include non-employees in your first aid needs assessment. You should consider the duty of care that you assume when a non-employee visits your site. This is particularly relevant if you provide a service for others such as schools, places of entertainment, shops etc. Consider both the injuries and illnesses that could occur.


For large events such as concerts, organisers have a duty of care to ensure that adequate medical, ambulance and first aid cover is available. Organisers of such events should refer to The Event Safety Guide, published by HSE books, for further information*.


*Please note that first aid at work, (FAW) and emergency first aid at work (EFAW) are not suitable qualifications for the event environment. Advance First Aiders (with a minimum of an additional Oxygen Therapy qualification and Anaphylaxis training) can form part of a team under the supervision of higher skill grades (i.e. First Responder or Emergency Medical Technician).


The size of the organisation

The number of people on a site should no longer be the primary basis for determining first aid needs; all the areas of the new first aid needs assessment should be carefully considered. However, in general terms the larger your organisation is, the more first aiders you will need.

After identifying the locations / times that first aid cover is needed, the HSE recommend:

  • That ‘non-manual’, low risk workplaces (such as shops, offices, libraries) have a minimum

  • That ‘manual’ workplaces (light assembly work, warehousing, food processing or higher risks), always have a minimum of one first aider on duty per 50 people (or part thereof).

Workplaces with more than 50 people:

It is likely that if your workplace is large, you will have already identified the need for full FAW (18-hour) training for your first aiders; but in any case, due to the increased probability of illness and injury occurring in larger workplaces, the HSE recommend that full FAW (18-hour) training is provided in workplaces with 50 or more people.

Reviewing the first aid needs assessment

You should review your first aid needs from time to time, particularly if you have operational changes in your workplace. It is recommended that a record is kept of incidents dealt with by first aiders to assist in this process.


Annual refresher training

Due to the wealth of evidence on the severity of ‘first aid skill fade’, the HSE now recommend that all First Aiders attend annual refresher training. The sequence of training is shown below:


Frequently Asked Questions

What has changed?
  • The way that you should carry out a First Aid Needs Assessment (employers must do this by law).

  • There are now two types of approved First Aider.

  • The introduction of annual refresher training.

Where can I see examples of first aid needs assessments?

Do I need to re-train my existing ‘First Aid at Work’ first aiders?

Existing First Aid at Work Certificates will still be accepted by HSE, so you only need to retrain existing staff as their certificates expire (when they will move onto the new training regime).

You may wish to consider annual refresher training for your existing first aiders, which falls in line with the new guidance.


My first aid needs assessment says I need emergency first aiders; do I have to retrain my appointed persons on this course?

If your appointed persons were trained by us, we guarantee that they have completed all the topics on the EFAW course, so you can justify using them as ‘Emergency First Aiders’ until their existing certificates expire, when you should re-train them on the EFAW course.


You may however wish to consider annual refresher training for your appointed persons to fall in line with the new guidance.


What if a First Aid at Work Certificate has expired?

Your First Aider at Work (FAW) can attend the 2 day re-qualification course up to 3 months before or 28 days after their current certificate expires. The new certificate will be valid from when the old one runs out. If the certificate expires by more than 28 days the First Aider must attend the full 3 day initial course.


The Emergency First Aid at Work course doesn’t cover all the topics that my first aiders need to learn. Can you add topics to this course?

Yes, if we run a course at your premises we can tailor it to your needs. However, we would need to add extra time to the course to cover extra topics. Please give us a call if you would like to discuss your needs.


First Aid Needs Assessment - Examples

Example 1:

An engineering company with 150 employees carried out a first aid needs assessment. They have 2 shifts with 75 employees on each shift. Because they are a larger employer with more than 50 staff on site they need full FAW (18 hour) training for their first aiders (irrelevant of what risks are present).


Taking account of the number of employees on each shift, the company need a minimum of 2 first aiders on duty at all times (one for every 50 people or part thereof). To ensure that this level of cover is maintained during foreseeable absences, which in this case includes annual leave, changing shifts to attend meetings and regular staff training, the company decided to train an extra 3 first aiders on each shift (total 5 first aiders per shift).

Example 2:

An accountancy company have 25 employees in an office. Manual work is limited to employees lifting small boxes. The hours of work are 9 to 5. Having considered the possible illness and injuries that could occur, the company decided to provide EFAW (6 hour) training for their first aiders. To ensure that cover was provided at all times the company trained 2 emergency first aiders. The holiday rota system was adjusted so that only one first aider could book annual leave at a time.

Example 3:

A retail store identified different areas of risk in different areas of the workplace. The company identified that the office area only required EFAW first aiders, but reviewing the accident records they identified that slips and trips had occurred in the store and a customer suffered a severe asthma attack last year. The company felt that they assumed a duty of care when customers were on their premises so they decided to provide FAW (18 hour) training for their first aiders. This ensured that the first aiders were trained to deal with the possible injuries and illness that could occur in the store and also provided adequate cover for the office.


To cover shifts and foreseeable absences, the company decided to train 3 first aiders on each shift.

Example 4:

An electrical contracting company have a team of 20 electricians who work mainly on building sites, but sometimes they work for domestic clients. The electricians work in pairs. When the electricians work on building sites, the main building contractor always assumes responsibility for first aid provision (this is documented in writing). There is no first aider provided when the electricians work for domestic clients.


The company decided that due to the risk of electrical shock, electrical burns, slips, trips and manual handling injuries they would provide full FAW training for all staff. This ensured that they could send any electrician to any job without pre-arranging that first aid cover would be provided by the customer. The company provided a first aid kit in each company van and all the staff had access to a mobile phone which ensured that they would be able to call emergency services wherever they were working.

Example 5:

A call centre employs 450 staff in a 10 storey office building. Health & Safety Executive advice recommends 1 FAW first aider per 100 employees (or part thereof), which required at least 4 first aiders on duty at all times. The company decided to train 1 first aider on each floor (10 in total) which ensured that cover was available for foreseeable absences and the first aiders would be distributed evenly throughout the building should an incident occur.


The same call centre expanded and employed a further 250 employees to work on an evening shift in the same building. An extra 5 first aiders were trained to cover this shift, they are spread over several floors but are in close proximity to where people work.

Example 6:

A small office based company have an excellent health and safety record and found that the risk of injury to staff is minimal. When considering the likelihood of illness that could occur however, the company identified that a member of staff suffered from heart problems. The company decided to provide FAW (18 hour) training for the first aiders to ensure that they were able to deal with the sudden illness that could occur.


How can we help?

We get that regulations can be hard to get your head around, knowing the different legislation or just staying on top of changes, there’s lots to get to grips with – we are here to help to the load off you. We’ll equip you with all the knowledge you need to be able to produce your own documentation and support you with managing the process as your business changes and grows.

Our Health & Safety experts can visit your business,identify any gaps in your current processes, and advise onany recommendations.

If you would like tailored advice for your workplace, want to book training for your businessor organisation, then get in touch with Train Direct.

tel. 0330 223 5586,

or complete the form on our homepage to request a call back.

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