CATEGORY OF PAPER Specific action required: …...Largest claim dealt with this quarter £24:414:82...

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CATEGORY OF PAPER

Specific action required: Provides Assurance: For Information:

Board of Directors’ Meeting – 27/07/2017

Report title: Health and Safety Update Report

Purpose of report: Provides an overview of the current position regarding Health and Safety

Key issues: (key points of the paper, how this supports the achievement of the Trust’s corporate objectives, overview of risk implications, main risk details on page 2)

The following report is presented to the Trust Board to provide an overview of the current position regarding Health and Safety. This report shall cover the following areas

1. Accident statistics & General observations 2. RIDDOR reporting 3. Current Litigation 4. Workplace Inspections 5. Outstanding hazards associated with workplace

inspections 6. Risk Assessments 7. Strategic Health and Safety Committee 8. Health and Safety Training 9. Strategic impact (risks & assurances)

Issue previously considered by: Some of the items included within the report have been previously discussed at the Trust Board.

Recommended actions:

The Board are asked to note the content of the report and provide support for the areas of improvement, such as outstanding workplace inspections, members attendance at strategic H&S Committee, implementation of model risk assessments, support for managers to investigate H&S incidents.

Sponsor / approving director: Joanne Baxter, Director of Quality & Safety

Report author:

Andy Lumsden, Health and Safety Manager

Governance and assurance

Link to Trust Priorities: (please tick)

Organisational

Sustainability

Improving

Quality &

Safety

Workforce

& Investors

in People

Clinical Care

& Transport

NHS 111 &

Clinical

Assessment

Service

Comms &

Engagement

Link to CQC / KLOE: (please tick)

Caring Responsive Effective Well Led Safe

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Link to Trust values: (please tick) (Please explain how this paper supports the application of the Trust’s values in practice)

Pride Strive for

excellence Respect Compassion

Take

responsibility

& be

accountable

Make a

difference –

day in & day

out

The engagement and involvement of our staff provides them with a sense of responsibility and accountability

Any relevant legal / statutory issues? (Such as relevant acts, regulations, national guidelines or constitutional issues to consider)

Potential issues falling within the overarching Health and Safety at Work Act (HASAWA) 1974 and relevant subordinate regulations, particularly with

- consultation regulations and the H&S Committee;

- relevant H&S related training;

Equality analysis completed

If this is not relevant please explain why:

Yes No Not Relevant

Key considerations Details

Confirm whether any risks that have been identified have been recognized on a risk register and provide the reference number:

The risks contained within the report are captured within the risk and regulatory services team

Please specify any Financial Implications

Please explain whether there are any associated efficiency savings or increased productivity opportunities?

Financial implications are possible in relation to the risk of further litigation and/or enforcement action by regulators for non-compliance.

If Health and Safety systems are successfully implemented and followed this will facilitate cost improvement in relation to reduced litigation and uninsured loss. This is particularly applicable to staff absences due to accidents. Reducing accidents and involving staff increases productivity/morale, because employees are healthier, happier and better motivated. Whilst financial savings are possible, these would be partnered by performance improvements due to higher morale and availability of staff/resources, appropriately maintained and better equipment and enhanced reputation for corporate responsibility among customers and communities.

Are any additional resources required e.g. staff capacity?

Currently an issue is in existence around capacity to accelerate the training for the use of the Manger Elk.

H&S team are still one resource reduced due to long term ill health

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Is there any current or expected impact on patient outcomes/experience/quality?

Failure to improve overall health and safety standards will impact on service delivery and patient/staff experiences. By ensuring our staff are safe and healthy at work increases morale and productivity whilst reducing absence. Greater focus of health and safety will facilitate risk reduction and improve quality/safety for all stakeholders. The purchase of the Mangar Elk will inevitably benefit patients and staff safety when lifting from the floor. The use of the equipment will reduce time spent on the floor from falls etc. Integrated and robust health and safety management systems and positive cultures will support productivity, service improvement and business development.

Specify whether appropriate clinical and/or stakeholder engagement has been undertaken:

(stakeholders could include staff, other Trust departments, providers, CCGs, patients, carers or the general public)

Health, Safety & Wellbeing is an on-going area of engagement and involvement both internally and externally. This includes all management groups, staff, trade unions, regulators, partner agencies and service users.

Are there any aspects of this paper which need to be communicated to our stakeholders (internal or external)?

(Please tick – if ‘yes’ then please complete all boxes. Please briefly specify the key points for communication and ensure the Comms team are informed via mailto:[email protected])

Yes No Positive Negative

Proactive Reactive Internal External

Awareness needs to be raised of the importance and involvement for all staff in relation to health and safety. Further detail will be discussed directly with the Comms team to create the message. This will cover multiple areas but focus on positive and proactive work.

Report Template

Board of Directors Meeting Health & Safety update report

(27th July 2017)

1. Introduction

1.1. The following report is presented to the Trust Board to provide an overview of the current position regarding Health and Safety for quarter 1 (Apr-Jun) 2017-18. This report covers the following areas;

- Accident statistics & General observations

- RIDDOR reporting

mailto:[email protected]

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- Current Litigation

- Workplace Inspections

- Outstanding hazards associated with workplace inspections

- Risk Assessments

- Strategic Health and Safety Committee

- Health and Safety Training

- Strategic impact (risks & assurances)

2. Executive Summary

The report provides an overview of the main areas of work within Health and Safety. The risks and assurances sections provide further details of the key areas falling within each specific heading.

Whilst progress is been made in relation to the overall health and safety management system it is clear that some areas still provide a challenge. This is clearly evidenced in relation to hazards identified and the investigation of adverse events, managers not attending H&S inspections with reps.

There has been significant investment in staff safety and health;

Trust has now purchased the Mangar Elk lifting cushions, the equipment is simple to use and basic training has commenced with relevant staff although this is taking time.

There have been further discussions to try to escalate the training for the Mangar Elks to ensure staff can use them ASAP.

Positive collaborative work continues with County Durham & Darlington Fire & Rescue Service to assist with complex lifting of patients (difficult environments/Bariatric etc)

Attendance of members at Strategic H&S Committee has been better with the meeting being Quorate in May.

Investigation of incidents is still an issue with lack of documentation etc.

3. Key issues

3.1. Physically assaulted by a person (resulting in injury)

Physically assaulted by a person (resulting in injury) 23 incidents during Quarter 1 2017/18 16 incidents during Quarter 4 2016/17. Incidents include head butting, pinning to the floor, kicking, punching, spitting, scratching, dog bite, lashing out and grabbing.

3.2. Slipped, tripped or fell (resulting in injury)

- 21 incidents during Quarter 1 2017/18


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Safety footwear with toe protection and slip-resistant soles is provided to employees working in operational roles and within the fleet departments. Personal responsibility and self-awareness is also a fundamental factor when working in environmental conditions where floor/stair etc. surfaces are challenging. The dynamic risk assessment process is also an essential element of manual handling training to assess environmental factors before moving equipment/patients.

3.3. Injured whilst handling, lifting or carrying



Bariatric and complex handling remains a challenge for the Trust; project work is on-going to find suitable solutions. H&S are involved in the project work with other appropriate representatives from the Trust.

Mangar Elks are purchased however an escalation plan to speed up the training on the Mangar Elk is currently being discussed with training Dept and Operations. The issue seems to be extraction to train the trainers.

3.4. RIDDOR

18 ‘over 7 day incapacitations’ occurred whilst performing manual handling tasks

8 ‘over 7 day incapacitations’ resulted from slips, trips or falls

4 ‘accidents to non-workers’ reported for trips whilst entering ambulance, contact with buckle during transfer from trolley to bed and wound-glue rubbed into eye

2 ‘specified injuries to worker’ reported for fractures sustained (manual handling; fall)

3.5. Litigation

The Trust has received 13 new litigation claims. 5 Employer Liability claims, 3 Clinical Negligence, 2 Public Liability and 3 Special Losses and Compensation

Largest claim dealt with this quarter £24:414:82 paid to claimant who stepped onto vehicle side step that retracted causing injury, equipment fault.

The overall trend for litigation is slightly higher against the previous quarter, particularly with 3 clinical negligence claims. Manual handling and slips, trips and falls are main issues associated with received employer liability claims.

Some management investigations continue to be an issue as claims are sent in there is a lack of investigative material to defend the claim.

However positively the Claims team have conducted investigations and compiled documents etc and have been successful in defending claims and keeping costs to a minimum as proven with limited damages recently paid for claims of noise induced hearing loss (£5000) and vibration white finger (£2500).

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Also due to Claims investigation around use of a trolley and suggestion from staff member that the trolley was a different type with a missing handle than that was actually used. The damages were again kept to a minimum (£1000) bearing in mind no initial investigation had been completed.

4. Strategic impact

The overall strategic impact of health and safety can be split into three main areas, financial, legal and moral. Whilst these are broad ranging factors, overall a good safety management system will positively influence areas such as absenteeism, performance, staff turnover, awards of contracts, injury reduction, productivity and reduce the impact of litigation, prosecutions, staff absence, reputational damage, financial impact etc.

The overriding fact is that a good safety management system and positive safety culture will ultimately assist the Trust in fulfilling our mission, vision and values whilst directly supporting the strategic intentions.

5. Assurances

New H&S policies are drafted and being consulted on;

On-going proactive work of the department and liaison with other directorates/departments. This includes consultation and review of H&S training courses including manual handling /Conflict Resolution and Breakaway training;

Claims team continue to investigate incidents when claims are received to defend the Trust and keep costs to a minimum

Purchase of Mangar Elks for Emergency care to assist staff with lifting of patients from floor;

Breakaway being delivered to frontline staff to compliment conflict resolution training;

New VDI guidance document created and published on Qpulse and amendments to Commencement of Duty SOP undertaken.

Work continues with Fleet Dept around personal hearing protection, personal moulded ear protection has been ordered as a result of a very positive trial.

Fleet Team Leader H&S training course has been developed awaiting confirmation on delivery

Work on-going with Ortus and 30 Trust drivers to collect data on driver behaviour through the use of DVDMS.

Working group was set up to review late finishes, driver fatigue, meal breaks, shift patterns, overtime; deputy chief operating officer is to take this work forward.

C Max Stair Climbing Chair available in each of the three PTS divisions for transfer of complex patient lifting and handling, business case for 3 more to be developed;

Fleet Managers to develop the mobile mechanic risk assessment;

Incident reporting remains consistent with high levels of reporting by staff;

Managers still requested to be involved and lead on inspection process with the H&S reps using the revised inspection forms;

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6. Risks

Litigation costs due to inability to robustly defend claims (poor investigation and lack of evidence)

Open/outstanding incidents and lack of timely/robust investigation;

Time taking to train all relevant staff in the use of the Mangar Elk;

Late finishes / enforced overtime / shift patterns / driver fatigue / meal break

Non-compliance around management engagement during workplace inspections;

Outstanding actions/hazards identified during workplace inspections;

The new Fire and emergency procedure not being implemented and posted on stations;

Bariatric/complex lifting of patients work is on-going however the Trust are left short in relation to providing this service.

Challenging unsafe behaviour;

H&S training for Operational Management (ECCM’s/PTS managers) issues around abstraction;

Support services operatives impact on workload

7. Recommendations

7.1. The Board are asked to note the content of the report and provide support for the areas of improvement.

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Document Information

Author Name: Andy Lumsden

Author Title: H&S Manager

Sponsor Name: Jo Baxter

Sponsor Title: Director of Quality & Safety

Last Saved 2017-07-20 13:22:00

Save Location N:\Public\Chief Executive Directorate\Board Meetings\Cover Sheet 2016.docx

Word Count 679

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Health and Safety Board Update Report

July 27th 2017

Introduction

The following report is presented to the Trust Board to provide an overview of the current position

regarding Health and Safety for quarter 1 (Apr-Jun) 2017-18. This report covers the following

areas;

1. Accident statistics & General observations

2. RIDDOR reporting

3. Current Litigation

4. Workplace Inspections

5. Outstanding hazards associated with workplace inspections

6. Risk Assessments

7. Strategic Health and Safety Committee

8. Health and Safety Training

9. Strategic impact (risks & assurances)

Executive Summary

The report provides an overview of the main areas of work within Health and Safety. The risks and

assurances sections provide further details of the key areas falling within each specific heading.

Whilst progress is been made in relation to the overall health and safety management system it is

clear that some areas still provide a challenge. This is clearly evidenced in relation to hazards

identified and the investigation of adverse events, managers not attending H&S inspections with

reps.

There has been significant investment in staff safety and health;

- Trust has now purchased the Mangar Elk lifting cushions, the equipment is simple to use

and basic training has commenced with relevant staff although this is taking time.

- There have been further discussions to try to escalate the training for the Mangar Elks to

ensure staff can use them asap.

Positive collaborative work continues with County Durham & Darlington Fire & Rescue Service to

assist with complex lifting of patients (difficult environments/Bariatric etc)

Attendance of members at Strategic H&S Committee has been better with the meeting being

Quorate in May.

Investigation of incidents is still an issue with lack of documentation etc.

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Key Areas/Issues

1. Trust wide injury accident / incident statistics

TOTAL INCIDENTS TRUST WIDE Qtr3 2016/17 Qtr4 2016/17 Qtr1 2017/18

Paramedic (incl. student, ECCM, HART) 99 64 70 Advanced (and E Care)Technician 12 12 16 Emergency Care Assistant (and ECSW) 43 24 40 Ambulance Care Assistant (& Apprentice) 19 42 20 Support Services 7 7 4

TOTAL: 180 149 150

Injuries by Type TYPE OF INJURY TRUST WIDE Qtr3 2016/17 Qtr4 2016/17 Qtr1 2017/18 Abrasion 3 4 3

Ache / pain 47 37 44

Allergic / adverse reaction 1 1 0

Bite 4 0 1

Bleeding 6 1 2

Bruise 10 7 8

Burn 2 0 1

Choke 0 0 0

Dislocation 1 1 0

Fracture 0 3 2

Graze / scratch 2 5 1

Irritation - eyes 2 2 2

Irritation - skin 1 0 0

Laceration 6 13 4

Musculoskeletal / Strain / Sprain 81 66 71

Needle stick 6 3 5

Shock 1 0 0

Sickness 0 0 0

Swelling / bump 7 6 6

TOTAL: 180 149 150

The injuries that have seen the largest decrease in Quarter 1 2017/18 compared to Quarter 4 2016/17 are:

laceration

graze /scratch The injuries that have seen the largest increase in Quarter 1 2017/18 compared to Quarter 4 2016/17 are:

ache / pain

musculoskeletal / strain / sprain

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Injuries by Cause

INCIDENTS TRUST WIDE BY CAUSE Qtr3

2016/17 Qtr4

2016/17 Qtr1

2017/18

Contact with material / object 20 17 11 Environmental factors 0 1 1 Equipment issue 8 6 8 Exposure / contact biological / infections 1 0 2 Exposure / contact with harmful substances 1 1 1 Fire / explosion / electricity 1 0 0 Ill health 8 1 0 Information/instruction/supervision/training 1 0 0 Manual handling 74 68 73 Needle stick / clinical sharps incident 8 3 5 Slips / trips / falls 22 31 21 Vehicle incident 5 5 5 Violence / assault / aggression 31 16 23

TOTAL: 180 149 150

The occurrences which have seen the largest decrease in Quarter 1 2017/18 compared to Quarter 4 2016/17 are:

slips / trips /falls

contact with material / object The occurrences which have seen the largest increase in Quarter 1 2017/18 compared to Quarter 4 2016/17 are:

violence / assault / aggression

manual handling

GENERAL OBSERVATIONS Physically assaulted by a person (resulting in injury)

23 incidents during Quarter 1 2017/18 16 incidents during Quarter 4 2016/17 Incidents include head butting, pinning to the floor, kicking, punching, spitting, scratching, dog bite, lashing out and grabbing. Contributory factors include

Intoxication / substance abuse

Mental illness

Violence / aggression resulting from a clinical condition (e.g. post-ictal, hypoxic, pyrexic, hypoglycaemic, dementia)

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Actions taken in response to the incidents include welfare and support from line managers and the Risk Team. Several new addresses have been flagged; flags range from 6 months to 12 months. Two employees are choosing to pursue prosecutions against individuals and the Trust is attempting to recover the cost of damages to an ambulance. Employees are being encouraged and supported by Risk to prosecute where incidents of this nature have occurred.

Employees are being trained in breakaway techniques to compliment conflict resolution training. Staff feedback on this training has been very positive. A total of 118 incidents were reported during the period under the violence/assault aggression cause group. The incidents include:

- Injured by animal (1) - Intelligence/information (7) - Intimidating behaviour (28) - Injury physical abuse – patient on staff (16) - Patient lashing out (14) - Physical abuse (no injury) (8) - Physical disruptive behaviour (2) - Racial abuse (1) - Racial disruptive behaviour (1) - Sexual abuse – patient on staff (3) - Sexual disruptive behaviour (2) - Verbal abuse – patient on staff (23) - Verbal disruptive behaviour (12)

Slipped, tripped or fell (resulting in injury) 21 incidents during Quarter 1 2017/18 31 incidents during Quarter 4 2016/17 Incidents include

- exiting vehicle (fall from tail lift; side step not fully deployed; off rear vehicle step) - slip from vehicle step whilst entering / exiting vehicle - slips / trips on kerbs - slips / falls on wet / uneven ground (seaweed, grass, rocks / gravel) - slip in the rear of vehicle (wet footwear) - slip whilst carrying patient on downstairs on chair - trip whilst carrying equipment

Safety footwear with toe protection and slip-resistant soles is provided to employees working in operational roles and within the fleet departments. Personal responsibility and self-awareness is also a fundamental factor when working in environmental conditions where floor/stair etc. surfaces are challenging. The dynamic risk assessment process is also an essential element of manual handling training to assess environmental factors before moving equipment/patients.

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Injured whilst handling, lifting or carrying 73 incidents during Quarter 1 2017/18 68 incidents during Quarter 4 2016/17 Incidents include

- lifting patient from floor - handling of bariatric patients - carry chair downstairs - carry chair upstairs - patient movement whilst handling - transferring patient between bed, chair, trolley, etc. - lifting trolley over steps - repositioning patient

Staff welfare has been demonstrated as a priority for managers when closing out incidents. Managers have offered advice in relation to techniques and reminders regarding the importance of undertaking a dynamic risk assessment and requesting assistance as required. Unfortunately it is not always possible to provide an additional operational crew to assist. Additional training requirements were identified in some cases. Bariatric and complex handling remains a challenge for the Trust; project work is on-going to find suitable solutions. H&S are involved in the project work with other appropriate representatives from the Trust. An escalation plan to speed up the training on the Mangar Elk is currently being discussed with training Dept and Operations. Needle stick / Clinical Sharps Incidents (resulting in injury)

5 incidents during Quarter 1 2017/18


Incidents include:

- patient pulled out cannula - cannulating combative patient - disposal following failed cannulation - patient stood up unexpectedly - patient pulled arm away

Vehicle Incidents (resulting in injury) 5 incidents during Quarter 1 2017/18


Incidents include:

- rear impact with third party - emergency stop – passenger (escort) not wearing seatbelt impacted with seat - impact with third party emerging from side road

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- third party reversed into ambulance - impact with third party whilst travelling through red light (with lights and sirens)

It is imperative that staff are familiar with the vehicles they drive/use. Vehicles are classed as work equipment under the Provision and Use of Equipment regulations and as such staff must be competent in their use. The Trust is embarking on a driver behaviour programme trial where approx 30 volunteer drivers will log into a response vehicle with a card. This will assess their driving and provide reports on standards of driving. This work has been in the pipeline with insurers and providers of DVDMS for some years. Cranfield University have been involved with the setting up of driver parameters. This sees NEAS at the forefront of driver behaviour programmes nationally. 2. RIDDOR Reportable Incidents

RIDDOR Qtr3 2016 - 17 Qtr4 2016 - 17 Qtr1 2017 - 18

Specified injuries to workers 2 3 2

Over 7 day incapacitation 44 34 27

Accidents to non-workers (non-fatal) 8 4 4

Dangerous Occurrence 0 0 0

- 18 ‘over 7 day incapacitations’ occurred whilst performing manual handling tasks - 8 ‘over 7 day incapacitations’ resulted from slips, trips or falls - 4 ‘accidents to non-workers’ reported for trips whilst entering ambulance, contact with

buckle during transfer from trolley to bed and wound-glue rubbed into eye - 2 ‘specified injuries to worker’ reported for fractures sustained (manual handling; fall)

RIDDOR TRUST WIDE BY JOB ROLE Qtr3

2016/17 Qtr4

2016/17 Qtr1

2017/18

Paramedic (incl. student, ECCM, HART) 22 14 10 Advanced (and E Care)Technician 2 5 3 Emergency Care Assistant (and ECSW) 16 6 11 Ambulance Care Assistant 7 13 3 Support Services 0 0 2 Volunteers 1 0 0

TOTAL: 48 38 29

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3. Current Litigation information quarter 1 (April – June 2017-18) Claims information (provided by Claims Manager, Stephen Carmichael) Graph 1 – Open Litigation Case

Cases Received

In quarter 1 2017/18 the Trust has received 13 new litigation claims. 5 Employer Liability claims, 3

Clinical Negligence, 2 Public Liability and 3 Special Losses and Compensation see figure 2.

13 new litigation claims received in Qtr 1 2017-18. In the same period last year the Trust received

5 claims.

Graph 2 – Litigation Cases received in Apr 17 – Jun 17

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Cases Received

Employer Liability (EL) claims:

- Carrying Patient Down stairs - Alleged no Training Electric Chair - PTS (NORTH) - Alleges not enough room to secure wheelchair - Slips Trips and Falls - PTS (NORTH) - Slipped on a damaged vehicle step - Slips Trips and Falls - EC (SOUTH) - Tripped over a rock on beach - Slips Trips and Falls - EC (SOUTH) - Lifting patient from ground - Moving / Lifting Patient - EC (NORTH)

Clinical Negligence claims:

- Alleges Paramedics dropped patient from Scoop - Moving Stretcher - EC (SOUTH) - Alleges failed to use the correct Triage for symptoms of Stroke - Ambulance Care - Care

Provided Not Of Standard Expected - EC (NORTH) - Alleges failed diagnosis possible sepsis - Ambulance Care - Failure / Delay In Hospital

Admission - OPERATIONS

Public Liability claim

- Alleges Tripped over step after failed to fully deploy - Equipment / Failure Step – A&E

(SOUTH)

- Failure to secure patient Wheelchair, collided with vehicle - Sustained Injury PTS

(CENTRAL)

Special Losses & Compensation claims:

- Forced Entry - (Patients Door) EC £204.00



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Closed Litigation

12 Cases closed during period:

Employers Liability; 6 cases closed, 2 cases at total cost of £43,580.82, 4 case closed no costs.

Public Liability; 2 case closed, 2case at total cost of £82513

Minor Loss 4 cases closed 3 cases at total cost of £1160.80. 1 case closed no costs.

Employers Liability

Incident Nature Division Total loss to Trust

Claimant working on a Ambulance, Vehicle on Axle Stands rubber blocks had moved out of the axle stand , causing the body work to drop

Operations £19,166.00

Claimant alleges that trust hadn’t risk assessed a property, alleged injury that resulted from a ramp at the patients home.

PTS (SOUTH) £0.00

Stepped onto vehicle side step that retracted causing injury, equipment fault.

A&E (SOUTH) £24,414.82

Alleged repetitive shoulder strain injury by lifting the Life pack 10s, A&E (CENTRAL)

£0.00

alleged stepped back out of the vehicle onto the hoist and as placed left foot down, stepped onto a plug on the end of a charging lead causing ankle injury

OPERATIONS £0.00

Claimant parked in a Layby , was assaulted by two unknown individuals

DUCT £0.00

Public Liability


Patient suffered severe burns to his foot from the heater in the Ambulance

NA £75,358.00

Staff dropped patient from chair whilst attempting lift, patient suspected fracture to right-side of Rib Cage

PTS (SOUTH) £6,155.00

Minor Losses Compensation


Patient rang and advised she lived at number 53 crews attended, no answer at the address crew checked again with control that correct address was given and they advised 53 was the number stated

N/A £740.80

The decision was made to gain entry due to clinical concern as this was potentially time critical. EOC informed prior to crew forcing entry.

N/A £204.00

At the time Contractor was called to secure property - Cancellation - Code Purple, Patient Deceased

N/A £0.00

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Minor Losses Compensation


Injury - Patient was unable to get out of chair to unlock door for crew - Fire Brigade had to force entry - Patient refused allow Crew to expose or examine leg.

N/A £216.00

Graph 3 – Claim Experience 16 / 17

Slight increase in Clinical Claims on previous year although still down from average 8 per year Poor or lack of investigations, remains a concern.

Graph 4 – Trends

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Observations around litigation

Work is ongoing in relation to H&S accident management and Claims and reference to this is

included in this report.

The overall trend for litigation is slightly higher against the previous quarter, particularly with 3

clinical negligence claims. Manual handling and slips, trips and falls are main issues associated

with received employer liability claims.

However the Claims team having conducted their own investigations have been successful in

defending claims and keeping costs to a minimum as proven with limited damages recently paid for

claims of noise induced hearing loss (£5000) and vibration white finger (£2500).

Also due to Claims investigation around use of a trolley and suggestion from staff member that the

trolley was a different type with a missing handle than that was actually used. the damages were

again kept to a minimum (£1000) bearing in mind no initial investigation had been completed.

The main focus of work for the department relates to the prompt and effective local management

investigation of incidents and secondly the provision of robust evidence/documentation to defend

litigation. These two areas are intrinsically linked; Risk & Regulatory services are supporting the

specific departments/areas to develop their own compliance and service improvement. Risk &

Regulatory services are reaffirming the importance of investigations etc at the Essential

Management Training and through other general meetings where appropriate.

There is strong evidence that some managers are not conducting thorough and robust accident investigations. Investigations should cover basic investigative techniques such as;

- What happened (background); - Where did it happen; - When did it happen; - Have photos/videos/statements been collated and stored; - Has equipment/documents been seized; - Why did it happen (conclusions); - How can we learn from the incident; - Recommendations for improvement to prevent reoccurrence

The list is not exhaustive and will invariably change depending on the level of investigation. 4. Workplace Inspections and future Audits

It has been discussed at Strategic H&S Committees that H&S inspections must be conducted

collaboratively with managers. This will ensure local issues can be addressed and dealt with

immediately in most instances without the necessity to add to risk registers.

As stated in previous report the vision remains to conduct full audits once new structures and

geographical boundaries are in place and H&S staff are all back at work. This shall be undertaken

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using the current OHSAS 18001standards and RoSPA Quality Safety Audit toolkit. There is

consultation on a new standard ISO 45001 which will be reported on further once a date has been

set for transference and implementation sometime in 2017.

Record of Documents Received Following Workplace Health and Safety Inspection – March 2017

Number of Areas to be Inspected Number of locations inspected by Safety Reps

Number of locations with action by Manager

66 41 5

5. Outstanding Health and Safety Actions by Division / Department

There are currently no outstanding health and safety actions on the Risk Register.

The current number of outstanding actions as Action Points is 8, a decrease of 5 since the last

inspection.

Division/Location Number of locations

Number of outstanding actions – Risk Register

Number of outstanding actions – Action Points

North Division 28 0 2

South Division 26 0 5

Fleet 2 0 0

Equipment / Medical Electronics 1 0 0

Central Stores 1 0 0

Workforce & Organisational Development

3 0 0

Emergency Operations Centre 2 0 0

HQ 1 0 0

Electronics 1 0 0

HART & Resilience 1 0 1

6. Risk Assessments

The Trust has a legal obligation to undertake and monitor generic risk assessments where

significant risk is evident under the Management of Health and Safety at Work Regulations 1999.

There are various other pieces of legislation for specific risk assessments.

A suite of model risk assessments for Trust premises is complete. A plan is in place to implement

these assessments with operations to ensure continued compliance identified in the assessments.

However there are some training solutions required, work is ongoing.

In relation to the review of the existing risk assessments, it is planned that the Strategic Health and

Safety Committee and operational staff shall assist with the review of the generic assessments bi-

annually or where change has occurred that would dictate a review.

The H&S team are conducting a full review of the current generic risk assessments with a new

template. The new template has been created to simplify the process to engage end users.

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Fire Risk Assessments

Head of Estates has indicated that all physical remedial work identified in the fire risk assessments

has been completed. However issues arise when action plans are not complete

Management of fire

H&S have visited numerous stations and there is no evidence that the new fire evacuation

procedure has been implemented and posted prominently on station. The new procedure was sent

out to heads of Dept and Dept managers in April 2016.

7. Strategic Health and Safety Committee

The meeting was held 5th May 2017 and was very well attended. It is imperative that all members ensure their consistent attendance at a quarterly meeting. The law is quite clear on consulting with employees and the poor attendance at these meetings becomes a non-compliance with statutory provisions issue.

8. Health and Safety Training

Plans are being prepared to deliver H&S management and risk assessment training to all

ECCM/PTS manager levels within the Trust. This will be a large undertaking however there is

evidently a gap in the H&S training that this tier of management currently receives. Support from

operational senior management will be required to support this.

H&S training is also on the agenda for Station Support Operatives as they look after the stations

and conduct fire alarms tests etc.

9. Strategic Impact

The overall strategic impact of health and safety can be split into three main areas, financial, legal and moral. Whilst these are broad ranging factors, overall a good safety management system will positively influence areas such as absenteeism, performance, staff turnover, awards of contracts, injury reduction, productivity and reduce the impact of litigation, prosecutions, staff absence, reputational damage, financial impact etc. The overriding fact is that a good safety management system and positive safety culture will ultimately assist the Trust in fulfilling our mission, vision and values whilst directly supporting the strategic intentions.

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Risks

- Litigation costs due to inability to robustly defend claims (poor investigation and lack of

evidence)

- Open/outstanding incidents and lack of timely/robust investigation;

- Time taking to train all relevant staff in the use of the Mangar Elk; - - Late finishes / enforced overtime / shift patterns / driver fatigue / meal break

-

- Non-compliance around management engagement during workplace inspections; - - Outstanding actions/hazards identified during workplace inspections; - - The new Fire and emergency procedure not being implemented and posted on stations;

- Bariatric/complex lifting of patients work is on-going however the Trust are left short in

relation to providing this service.

- Challenging unsafe behaviour;

- H&S training for Operational Management (ECCM’s/PTS managers) issues around

abstraction;

- Support services operatives impact on workload

Assurances

- New H&S policies are drafted and being consulted on;

- On-going proactive work of the department and liaison with other directorates/departments. This includes consultation and review of H&S training courses including manual handling /Conflict Resolution and Breakaway training;

- Claims team continue to investigate incidents when claims are received to defend the Trust and keep costs to a minimum

- Purchase of Mangar Elks for Emergency care to assist staff with lifting of patients from floor;

- Breakaway being delivered to frontline staff to compliment conflict resolution training;

- New VDI guidance document created and published on Qpulse and amendments to Commencement of Duty SOP undertaken.

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- Work continues with Fleet Dept around personal hearing protection, personal moulded ear

protection has been ordered as a result of a very positive trial.

- Fleet Team Leader H&S training course has been developed awaiting confirmation on delivery

- Work on-going with Ortus and 30 Trust drivers to collect data on driver behaviour through the use of DVDMS.

- Working group was set up to review late finishes, driver fatigue, meal breaks, shift patterns, overtime; deputy chief operating officer is to take this work forward.

- C Max Stair Climbing Chair available in each of the three PTS divisions for transfer of

complex patient lifting and handling, business case for 3 more to be developed;

- Fleet Managers to develop the mobile mechanic risk assessment;

- Incident reporting remains consistent with high levels of reporting by staff;

- Managers still requested to be involved and lead on inspection process with the H&S reps using the revised inspection forms;

- The Model Risk Assessments for Trust premises have been finished and are ready for

implementation to assist with compliance, difficulties are the monitoring processes/staff on station.

Fire Accidents and other emergencies Visitors and contractors Internal and external access Office, kitchen and garage equipment Services Hazardous substances (Legionella testing is being conducted by contractors on a monthly

basis with reports provided to the Estates)

Manual handling Display screen equipment Personal protective equipment; Support has been given by Paul Liversidge to carry out some work on stations re training of SSO’s and implementation however concerns were raised by senior manager at SH&S Committee re the SSO workload. Board commitment required.

- Accident Reduction Officer involved with stakeholders/external customers to reduce vehicle

incidents and devise a reduction plan.

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Recommendations The Board are asked to note the content of the report and provide support for the areas of improvement. Authors and Sponsor Name: Andy Lumsden, H&S Manager - Dawn Atkinson, H&S Adviser Name: Joanne Baxter, Director of Clinical Care and Patient Safety Date: July 27th 2017

CATEGORY OF PAPER Specific action required: …...Largest claim dealt with this quarter £24:414:82...

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Transcript of CATEGORY OF PAPER Specific action required: …...Largest claim dealt with this quarter £24:414:82...