Coronary heart disease is the largest single cause of death in the UK. It is estimated that 12,000 people suffer a cardiac arrest in a public place each year. With this in mind, many employers, particularly those whose workplaces are open to the public, consider providing an automated external defibrillator (AED). Here we discuss the legal issues around providing them.
There is no specific legal requirement for employers to provide defibrillators in the workplace. The Health and Safety (First-Aid) Regulations 1981 require employers to ensure the provision of such equipment and facilities as are adequate and appropriate in the circumstances for enabling first aid to be rendered to employees if they are injured or become ill at work.
As such, employers have no obligation to provide first aid for members of the public. However, many organisations provide a service for others and the Health and Safety Executive (HSE) strongly recommends that employers take into account the public and others on their premises when making their assessment of first aid needs.
The responsibility for deciding whether to provide a defibrillator and train staff in its use lies with an individual organisation. A decision should be made after conducting a well-documented risk assessment at the site in question. The HSE states that “there is no legal bar to employers making a defibrillator available in the workplace if the assessment of first aid needs indicates such equipment is required”.
First aid needs assessment
The level of first aid provision depends on workplace circumstances. No fixed level exists, but each employer needs to assess what facilities and personnel are appropriate. Employers may delegate the responsibility for carrying out the assessment and advising on first aid to an occupational health service.
When assessing what is adequate and appropriate, the employer must take account of a number of factors, namely:
the number of first aid personnel needed, including consideration of annual leave and other absences
workplace hazards and risks — higher risk workplaces will need a higher trained and possibly more specialised type of first aid depending on the types of hazards, eg chemicals
size of the organisation
organisation’s history of accidents
nature and distribution of workforce
remoteness of site from emergency medical services
needs of travelling and remote and lone workers
employees working on shared or multi-occupancy sites
employment agency employees
whether non-employees, eg members of the public, customers or service users will be provided with first aid coverage.
The HSE provides guidelines on what should be considered when assessing first aid needs. To supplement this, the Resuscitation Council also provides guidance. For example, important factors to consider when assessing the risk of cardiac arrest will include the number of people using a facility and the risk of cardiac arrest occurring at the site.
Current international resuscitation guidelines advise that evidence supports the establishment of public access defibrillation programmes with the installation of an automated external defibrillator when the:
frequency of cardiac arrest is such that there is a reasonable probability of the use of an AED at least once in two years
time from call out of the conventional ambulance service to delivery of a shock cannot reliably be achieved within five minutes
time from collapse of a victim until the on-site AED can be brought is less than five minutes.
L74 First Aid at Work. The Health and Safety (First-Aid) Regulations 1981. Approved Code of Practice and Guidance from the HSE provides guidelines on what should be considered when assessing first aid needs
The Resuscitation Council also provides guidance on defibrillator provision at www.resus.org.uk
Last reviewed 28 November 2012