Health, Safety & Risk

Author:	Jono Erodotou
Responsibility:	All Staff
Effective Date:	01 June 2024
Review Date:	30th May 2025
Approved By:
Version Number:	01

Amendment / Review History #

Date	Author	Comments

Purpose #

The purpose of this policy is to:

1. Define how the company will meet its statutory requirements and obligations under prescribed health and safety legislation.
2. Describe how the company will develop systems, processes, policies and procedures to protect staff, contractors.
3. Describe the company’s approach to how incidents, adverse events and near misses are reported, managed and investigated.

Definitions #

1. Accident: an event that results in injury or ill health.
2. Incident:
   Near miss: an event not causing harm but has the potential to cause injury or ill health.
   Undesired circumstance: a set of conditions or circumstances that have the potential to cause injury or ill health, e.g. untrained nurses handling heavy patients.
   Damage only: damage to property, equipment, the environment or production losses. Could also have been a near miss if someone nearby could have been injured.
3. Immediate cause: the most obvious reason why an adverse event happens, e.g. not wearing the required PPE. There may be several immediate causes identified in any one adverse event.
4. Shared Learning: Knowledge that is shared between colleagues or other personnel
5. Underlying cause: the less obvious ‘system’ or ‘organisational’ reason for an adverse event happening, e.g. replacement PPE was not available. Underlying causes lie somewhere between immediate and root causes.
6. Root cause: an initiating event or failing from which all other causes or failings spring. Root causes are generally management, planning or organisational failings, e.g. no system to purchase more PPE before existing stock levels run out.
7. System of Work: is a set of procedures according to which work must be carried out. Safe systems of work are required where hazards cannot be eliminated, and some risk still exists.

References & Resources #

• HSE – Health and Safety Executive
• Nebosh Diploma Documentation.
• The nine Patient Safety Solutions, 2007

Statement #

“The K4 Medical Services is committed, as far as reasonably practicable, to ensuring the health, safety and welfare of all its employees and contractors. We fully accept our responsibility for contractors, visitors or other persons who may be affected by our activities. The successful implementation of this policy and other Health and Safety arrangements and procedures requires total commitment from all levels within the organisation, from the director to the workforce. We will take reasonable steps to ensure that our statutory duties are met at all times, in line with the relevant statutory provisions.

Each employee and contractor will be given such information, instruction and training, as is necessary, to enable the safe performance of their work activities. Each individual has a legal obligation to take reasonable care for his/her own and others health and safety, to adhere to all statutory provisions and to co-operate with any Safe Systems of Work or Code of Practice introduced by the company in the interests of Health, Safety and Welfare.

Policies, arrangements and procedures will be reviewed periodically to ensure that the aims and objectives are achieved and, if necessary revised in the light of legislative or organisational requirements.”

Roles and Responsibilities #

The Ops Manager has overarching responsibility for the design, implementation, and underlying success of the company’s health, safety and risk assessment policy.

General #

The company will utilise safety devices as applicable and available. The company has developed and maintains a safety statement separate to this document. All work equipment will be inspected and tested at least annually. Personal protective equipment will be provided for all staff and contractors where risks exist.

The company has adopted a no-lifting policy in relation to manual handling tasks.
The company will also engage in the assessment and prevention of slips, trips and falls.

Fire Safety #

All staff must do online fire training at least bi-annually.
Patient extraction in fire from ambulance.
A fire drill will be held on the 1st Thursday of every month. This is documented and any actions / concerns that arise are evaluated

Health and Safety #

Advisor, Responsible, Information for Sub-contractors. Committee and reporting.
Legionella – all taps run for 20 seconds at least every 2 weeks
Hot water should be distributed at 50°C or higher (thermostatic mixer valves need to be fitted as close as possible to outlets, where a scald risk is identified). Cold water should be stored and distributed below 20°C.

Electrical Safety #

Portable appliance testing will be conducted annually. Any new equipment will be tested before being put into service. A record of all tests will be held in the office.

Manual Handling #

The company aims to promote a safe manual handling and people handling culture to reflect current best practice and legislation. The purposes of this policy are to provide guidance to staff and managers:

To reduce, so far as is reasonably practicable, the risks to staff and service users associated with manual handling and people handling activities. Provide the highest quality of patient care.
To ensure compliance with relevant statutory requirements and standards and guidelines such as those published by the Health and Safety Executive (HSE).

This policy is applicable across all services within the company and covers all manual handling and people handling activities undertaken by staff during the course of their work.

Workstations & VDU Assessments #

All workstations to be assessed for VDU compliance.

Smoking and Vaping #

• K4 Medical Services operates a smoke-free workplace (which includes the use of e-cigarettes or similar), meaning smoking is strictly prohibited throughout K4 Medical Service’s premises which includes any Company vehicle.
• If you smoke, you must only smoke outside and during break times. When smoking outside, you should refrain from congregating around any of the entrances or exits to the K4 Medical Services premises, and you must dispose of cigarette butts in a bin rather than dropping such on the floor.
• You must not smoke in uniform in public area.

Clinical Risk #

The company has a number of mechanisms for identifying and responding to clinical risk. These include:

• Electronic Incident Report Forms
• Disclosures
• Regulatory Safety Notices
• Supplier Recall Notices.

Chemical Safety #

Chemical safety audits will be carried out regularly.
SDS (Safety Data Sheets) sheets for products used within the service are available.

Waste Management #

K4 Medical Services implements waste segregation of general, recyclable and clinical waste. These are all clearly marked in designated areas. The designated waste area is inspected at regular intervals to ensure waste compliance.
Bins are collected by a licenced waste disposal company when required by K4 Medical Services
Waste disposal companies are used to transport waste materials. (sharps, and clinical waste) single use only.
K4 Medical Services recycle waste in order to limit any damage on the environment

3 bins are provided on site
– General waste: Red Bin
– Recyclable waste: Green Bin
– Clinical Waste: Yellow Bin

Health and Safety Training #

Staff involved in managing the building are regularly trained on risk assessment, Health and Safety, new equipment and technology for the safe operation and maintenance of the organisation buildings and grounds.

▸ Fire safety

▸ Security

▸ Waste Management

▸ Equipment Management

▸ Cleaning Standards

Staff who undertake risk assessment will be provided training in such, this can include IOSH and or NEBOSH safety training.

Housekeeping #

The premises are cleaned on a weekly basis, this is provided by an external contractor. Cleaning materials are supplied by K4 Medical Services as required. The premises are inspected after weekly cleaning to ensure high standards are maintained. Issues identified are addressed with the cleaning contractor, any additional cleaning services required such as light fittings or window cleaning are implemented on request.
KPI’s are in place for rectifying cleaning related problems as they arise.
Vermin and pest control issues are reported to Ops Manager.

Security #

K4 Medical Services staff are issued with a photographic ID card and this needs to be returned to the office when contract is terminated.
Fire safety officer has implemented a walk around check and advised K4 Medical Services on what safety measures we need adjusting. Yearly checks on extinguishers and other fire safety equipment are checked by an external company.
High risk and hazardous materials are managed in designated areas with clear identifying labels.
The K4 Medical Services building has a keypad with security code at the main door entrance, along with a 24hr monitored security and fire alarm system managed by an external company. The building has 24-hour remote camera access.
All staff and crew members are aware of the security access system, codes and cameras.
Any security issues or findings are reviewed and actioned by management, these are recorded and acted on.

Equipment and Fleet #

Emergency power outage is backed up through mobile smart phone, this phone has access to GPS Tracker and What’sApp as way of communication to crew members and also the landline phone number is diverted to the mobile phone.

Environment and Facilities #

• The heating or cooling serviceable systems requiring maintenance or service records contained within the building.
• Any site drawings include site layout, floor plans, fire zones and escape routes.
• There is no furniture or equipment in need of repair left in the building, any damaged equipment or furniture is removed and stored in the garage.
• Any manual handling equipment and handlings aids are provided to staff if needed. Materials and equipment are available and sufficient in number, to enable staff to carry out their duties.
• K4 Medical Services have 1 training rooms and is equipped for a teaching/seminar for staff training and development activities. Office space is separate to the training rooms and is fully equipment.
• Any notices for staff are uploaded on our Salus3 site.
• K4 Medical Services have two bathrooms available for staff.
• K4 Medical Services has no access to modify the existing building.
• K4 Security has operationally responsible for the day to day running of the building.
• Maintenance is carried out immediately and as such there is no records kept.
• All windows above ground floor have safety locks on to prevent falling persons.
• All flooring is appropriate for the area, with steps clearly marked.
• Furnishings and fittings throughout are in good decorative order and free from stains and marks
• There is adequate lighting during the day and the night to allow individuals to remain orientated at all times where possible
• Corridors, doorways and individual areas are kept free of obstruction
• Internal and external sign-posting of buildings and services enables staff and visitors to find their way to the organisation and to find services within the building.
•  
• Any maintenance plan for premises such as redecorating and refurbishment is organised by the Landlord at K4 Medical Services request.

Staff Wellbeing #

The company provides facilities to allow for ‘clean’ eating. Fridges, microwaves, portable ovens and grills allow staff to provide their own healthy lunches. The company also organises social events to aid in team bonding and stress relief. There are structured counselling referral procedures for staff who experience acute or chronic stress.

Reported Incidents #

Immediate Response
The following procedures will be adopted in relation to any accident or incident involving patients and patient care affected by the company’s operations or contractors on company business.

Any occurrence, which results in patient injury, or any occurrence which could have resulted in patient injury during the course of duty with the company, will be notified to office. Where the patient requires further examination or treatment, the individual(s) concerned will report the nature of the adverse incident to receiving healthcare staff.

The Ops Manager, having received notification of an accident or incident should obtain the following details:

▸ Nature of the accident / incident / near miss.

▸ Location and Time of incident.

▸ Name of patients injured / involved / associated with near miss.

▸ Details of action(s) taken by personnel to advert the near miss / or after the accident / incident.

▸ Requirement(s) for medical assistance or other after the incident.

▸ Real or perceived impact on patient care immediately after the incident / near miss.

Reporting on incidents is done using our online forms, this is then sent to the Operation Manager
Link to form: TO FOLLOW

Where necessary, arrangements should be made for the person(s) to receive appropriate medical assistance. It will be the responsibility of the director to arrange any follow up contacts with the relevant hospitals / institutions / locations where the accident / incident / near miss occurred.
The company operate a policy of open disclosure in relation to reporting of adverse incidents.
Personnel, who fail to self-report report accidents or incidents in a timely manner, usually less than 48 hours, may be subject to disciplinary procedures or dismissal.

Identification / Rectification:
The ops manager will maintain a file which should contain all reports, medical certificates, photographs, notes, etc., pertaining to the accident / incident / near miss. These files will be reviewed on a regular basis by management and safety representatives to identify situations or hazards requiring attention. Where necessary the accident / incident / near miss will be progressed to the clinical audit process, or other statutory / no statutory body as appropriate.

Review / Communications:
Where necessary, lessons learned and issues requiring attention will be addressed following discussions with the relevant staff members and/or concerned parties or experts by the issuing or revision of a policy or procedure.

K4 Medical Services will commence an annual review on the number of adverse incidents and run an annual audit along with the revision of the policy.

Approach #

In order to meet legislative, regulatory and industry requirements’ the company will adopt the following approach:

• Set out a clear vision for the company along with associated values and objectives.
• Develop and implement documented, researched & considered policies and procedures inline with national / international best practice and industry norms.
• Involve key stakeholders in the development of the company’s policies and procedures and service delivery.
• Adopt a 360-degree feedback policy for all individuals involved with service delivery.
• Capture performance and operational data in relation to internal and external KPI’s.
• The company will take a proactive approach to Health & Safety, Risk Assessment, Compliance and Quality Assurance.
• Will seek the assistance of subject matter experts when required.
• Carry out regular operational and clinical audits in relation to service delivery.
• Operate and encourage an environment of honesty, transparency and accountability.
• Invest in individuals, infrastructure and equipment to support service development and delivery.

 

Approach – Policy & Procedure Development #

The company will develop all policies and procedures with regard to the following steps in order to aide in the development of Safe Systems of Work.

• The Standard. Sets out what should be done in order to protect patients / provide high level of clinical care etc. i.e. Have a system of recording medications in use within the company.
• The Guidelines / Legislation / Best Practice. Indicates either the legal requirements / guidance documents or best practice that state what the policy should say. i.e. The Misuse of Drugs Regulations 1988 and (Amendment) Regulations states that controlled medications must be signed out in a booklet and stored for audit purposes.
• The Policy. Sets out what the company will do to achieve this standard. i.e. The company will keep records of all medications, ordered, stored, allocated to locations / vehicles, disposed of and administered.
• The Procedure. Sets out the steps the company will follow to achieve its policy. i.e. Medication bag numbers will be recorded, security seals will be numbered and recorded. Used stock recorded against PCR numbers etc.
• The Implementation. How will be policy be enacted with the company. What training do people need to comply with the policy?
  Induction training will be provided for individuals so that they are aware of the requirements for recording bag numbers, medications used etc.
• The Evidence. Is there evidence that this policy is in effect. Can you demonstrate that we do what we say we will do? Policy says we will record bag seal numbers. Where is this done? What form is used. Where can we point to a form / documents and show where this is done? i.e. Security tag section on shift sheet.
• Monitoring. How do we track how well the policy is being followed. How do we know if it is working well or not? Can we measure its success? i.e. The number of shift sheets where a tag number is recorded vs where nothing is recorded.
• Risk Assessment. How does this reduce any of the risk we have identified on the risk register, if not is there anything we can include to do so?

 

Data Recording #

Issues
Non-compliance issues and issues that are identified by stakeholders will be recorded on Salus3.

Issues will be categories into the following categories:

▸ Quality Improvement
▸ Accident/Fall
▸ Admin Procedure
▸ Behaviour
▸ Therapy/Diagnostics
▸ Documents
▸ Environmental Hazards
▸ Infection Control
▸ Medical Equipment
▸ Medication
▸ Personal Property / Data
▸ Service Performance
▸ Vehicle

Serious Incident
In accordance with the NHS England Serious Incident Framework (March 2015), Serious Incidents (SIs) in healthcare are adverse events, where the consequences to patients, families and carers, staff or organisations are so significant or the potential for learning is so great, that a heightened level of response is justified. 

Risk Strategy #

Aims
This strategy aims to
▸ Ensure compliance with legal and regulator requirements as a minimum standard.
▸ Integrate risk management into the culture of K4 Medical Services
▸ Manage risk in accordance with best practice whilst ensuring best value
▸ Reduce the overall cost of risk
▸ Prevent injury, damage and losses to stakeholders, employees and property.
▸ Raise awareness of the need for risk management by all of those connected with K4 Medical Services.

Objectives
▸Establish clear roles, responsibilities and reporting lines within Medicore Medical Services for risk management.
▸ Embedding risk management into Medicore Medical Services decision-making process, service delivery, project management and partnership working.
▸ Providing opportunities for training and shared learning on risk management across Medicore Medical Services.
▸ Reinforcing the importance of effective risk management as part of the everyday work of employees.
▸ Incorporating risk management considerations into all levels of service planning
▸ Monitoring of arrangements, at all levels, on an ongoing basis by management.
▸ Monitor arrangements continually and seek continuous improvement.

Management Structures & Accountability
The person with overall responsibility for Risk management is the Ops Manager. Responsibility for specific risk areas may be delegated to other managers. In some instances, the company will be guided by external subject matter experts (i.e. Human Resource Issues).
The company will include Risk Management as a regular item at its monthly management meetings.
The company will provide feedback mechanisms for all practitioner’s across operational areas to identify risk and report on same.
The company will produce an annual report giving an overview of risk activities and reported incidents.
The company will maintain a work organisational wide risk register.

Legislative & Regulatory Framework
▸ Health, Safety Executive – HSE
▸ The nine Patient Safety Solutions, 2007
▸ Driver & Vehicle Licensing Agency – Driving for Work
▸ Cylinder storage and handling – BOC Healthcare
▸ Health Products Regulatory licence conditions
▸ Health & Safety Authority – Safety Alerts
▸ Manufacturers device specific recommendations

Risk Breakdown
K4 Medical Services is faced with both strategic/corporate and operational/service risk that could impact on the achievement of its long-term and day to day delivery of services

▸ Clinical – Those associated with the provision of pre-hospital emergency care and transport. Clinical risk will be monitored inline with Clinical Audit & CQC KPI compliance.
▸ Financial – those affecting the ability of the company to meet its financial commitments; failure of major projects; internal and external audit requirements; failure to prioritise and allocate resources effectively; poor contract management; initiative overload
▸ Technological/Legal – those associated with the capacity of the company to deal with the pace/scale of technological change, or its ability to use technology to address changing demands. It would also include consequences of internal failures on the company ability to deliver its objectives.
▸ Partnerships/contractual – those associated with the failure of partners/contractors to deliver services to an agreed cost and specification: compliance with procurement policies (internal/external); ensuring open and fair competition; Corporate Risk Management Strategy
▸ Human Resources – those associated with professional competence of staff; lack of training and development; over reliance on key personnel; ineffective change/project management; recruitment and selection issues
▸ Organisational – those associated with the review of service and delivering continuous improvement
▸ Health & Safety/Physical – those related to fire, security, accident prevention and health & safety which pose a risk to both staff, the public and patients; safeguarding and accounting for physical assets.

Monitoring & Mitigation
The company will continuously monitor operational performance, stakeholder feedback (formal and informal) and human resource issues to identify new undocumented risks.The company will develop individual reporting mechanisms to allow crews directly report new or recurring risks to management in a timely manner.As part of the company’s monthly management meetings, managers will discuss:

▸ Newly identified risk and associated rating.
▸ Recurring Risks.
▸ Avoidance and Mitigation strategies.

The company will employ the following mitigation strategy:
The company will also integrate risk identification training into its induction and refresher training.

The risk register will be populated with information from:

• Stakeholder Feedback
• Patient Feedback
• Staff & Contractor Feedback
• Regulatory Changes
• Complaints
• Adverse Incidents & Near Misses
• Internal & External Audits
• Other sources that may provide salient information.

The management will adopt a proactive approach with regard to risk identification and mitigation.

Investigations & Reporting #

As per Nebosh Documents
All actual injuries and illnesses must be reported immediately. Where possible minor injuries and illnesses will be dealt with by the local first aider. Any serious injuries will be forward to the nearest emergency department or emergency ambulance.
All death to be reported to CQC.

Implementation Plan
The health and safety policy will be implemented with immediate effect. The effectiveness will be monitored continuously at the quality improvement meetings.