Gordon Tranter advises on what needs to be taken into consideration when determining a site’s first-aid requirements.

First aid is help given to a sick or injured person until full medical treatment can be accessed. Its availability, which can be a matter of life or death, depends on a person or persons having the knowledge of what to do in the minutes before professional help is available.

The premises manager

The person responsible for managing the site has to understand the extent of the first-aid needs on the premises they manage. The manager has to consider the need to provide first aid for two categories of persons: employees for whom there is a legal requirement to provide first aid and non-employees for whom there is no specific legal duty to provide first aid. The Health and Safety at Work, etc Act 1974, however, requires employers to ensure, as far as is reasonably practicable, the safety of persons other than employees, eg contractors, visitors, the general public and clients.

As well as direct employees, the building manager may have the responsibility for the health and safety of the other employees in the building, whether owner or tenants. These may be casual workers, contractors and members of the public visiting the premises.

Provision of first aid for employees

Under the Health and Safety (First-Aid) Regulations 1981, employers must provide the equipment and facilities needed to enable first aid to be given to their employees if they are injured or become ill at work. The Regulations are supported by guidance issued by the Health and Safety Executive (HSE), L74 The Health and Safety (First-Aid) Regulations 1981. Guidance on Regulations.

Assessment of first-aid needs

Employers have to make a needs assessment that considers the nature of their workplace, workforce, and the health and safety risks likely to be present. This will help them decide the first-aid personnel, equipment and facilities needed to give immediate assistance to casualties with either injuries or illnesses; and to summon an ambulance or other professional help.


In workplaces where there are a large numbers of employees, for example more than 25 employees and/or significant health and safety risks, such as machinery or hazardous materials, a trained first-aider will usually be required. First-aiders will usually hold a valid certificate of competence in either:

  • emergency first aid at work (EFAW), which enables a first-aider to give emergency first aid to someone who is injured or becomes ill while at work; or

  • first aid at work (FAW), which includes EFAW but also equips the first-aider to apply first aid to a range of specific injuries and illnesses.

There are no specific requirements for the exact number of first-aiders needed. The assessment will need to take into account all the relevant circumstances of their particular workplace. L74, the guidance to the First-aid Regulations 1981, does include suggestions on the numbers of first-aid personnel to be available at all times in Appendix 3.

In low-risk workplaces where there are only a small number of employees, a first-aider may not be required and there may only be a need for a first-aid box and a person appointed to take charge of first-aid arrangements such as calling the emergency services and stocking the first-aid box. This person, the appointed person, does not need specific first-aid training.

First-aid container

The needs assessment should identify the materials, equipment and facilities needed. These will include first-aid equipment, identified by a white cross on a green background and easily accessible in all places where working conditions require it. There is no mandatory list of the items to be included in a first-aid container, but L74 does include in Appendix 2 a suggestion of what a minimum stock of first-aid items might be.

The needs assessment may indicate that additional first-aid materials and equipment may be required. These may be for example foil blankets, disposable aprons, individually wrapped moist wipes, adhesive hypoallergenic microporous tape, shears capable of cutting through clothing and sterile disposable tweezers. If mains tap water is not readily available for eye irrigation, sterile water or sterile normal saline should be provided.

Lone workers

An organisation may support employees who work on their own. These could be cleaners, security personnel and maintenance staff who work on the premises out of hours or they may be mobile workers travelling from one building to another. Their needs should be included in the first-aid needs assessment. The assessment should consider the information regarding emergency procedures that should be given to lone workers and whether they need first-aid training. For mobile lone workers the needs assessment should consider whether they should carry a travelling first-aid kit. Guidance on the contents of travelling first-aid kits can be found in Appendix 2 of L74.

Non-employees: contractors and the self-employed

The majority of organisations will occasionally have non-employees working on their premises. Most will be contractors or self-employed persons but some may be workers provided by an employment agency. The organisation still has responsibility for the health and safety of any contractors or self-employed people doing work for it. As far as first aid is concerned, it has to ensure that appropriate first-aid provisions are in place for the contractor’s workers. This may be providing first-aid facilities themselves or by agreeing in the contract that that the contractor provides appropriate first-aid facilities and ensuring it is provided.

Employment agency and business workers

There is a difference between an employment business and an agency in that the “employment business” provides its own workers on a contract basis to the organisation, whereas the “employment agency” introduces staff to an organisation for employment by that organisation. Once taken on, an agency worker is an employee of the organisation he or she is working for and first-aid provision should be the same as for the organisation’s employees.

Although employment business workers are not employed directly, the organisation has a duty of care to ensure that such workers are not exposed to risks to their health and safety. Consequently, employers should include workers from employment businesses in their assessment of first-aid needs and make provision for them. However, where employment business workers are mobile workers the worker may have been given first-aid training and have their own first-aid kit. The organisation should ensure that the contract with the employment business clearly identifies who provides first aid.

The public

The HSE recommends that members of the public should be included in the first-aid needs assessment. Premises managers should consider the duty of care that falls upon them when a member of the public visits their site and decide whether providing first-aid facilities for them is appropriate. Situations where the organisation may have to consider the provision of first aid for members of the public includes businesses such as shops, restaurants and leisure facilities that deal with members of the public.

Employers’ Liability Insurance usually covers the actions of an employer’s first-aiders in respect of liability for damages and legal costs. Where the first-aid provision is intended to cover both employees and non-employees, the organisation should check the liability insurance covers all the activities of first-aiders.


There is no requirement for the assessment of first-aid needs to be formal or written down. However, by retaining a record of their needs assessment the premises manager can demonstrate to a safety representative or an HSE or local authority inspector how they decided on their level of first-aid provision. The insurance company may also want to see the records if there is a work-related claim.

Shared premises

Where the premises has numerous occupiers but is managed by a single organisation, the organisation’s responsible person might consider whether joint first-aid arrangements can be made between the occupiers and self-employed workers on the premises. Where this is the case it is recommended that the agreement is in writing and binding for all parties.

Last reviewed 18 November 2014