Gerry Devine - Practice Manager Adviser

The 5 step approach to risk assessment

Madonna recently had a fairly high profile works accident - one which might prompt us all to consider how employers evidence their duty of care to keep employees safe. 

If all accidents aren’t preventable, how do we evidence that we have minimised the risk from those which may be considered foreseeable? The simple answer is... by doing a risk assessment. The assessment is a core ingredient for any practice in evidencing that it is caring, well led and employee focussed. 

Where does the need for Risk Assessments come from? 

The 1988 Control of Substances Hazardous to Health (COSHH) Regulations were the first to require employers to carry out and record risk assessments. However, it was the introduction of the health and safety legislation, commonly referred to as the ‘six-pack' in 1993 - six new sets of regulations were introduced at the same time - that really brought risk assessment to the forefront of controlling safety. 

Much of the 'six-pack' has since been revised and updated, but risk assessment is still the fundamental approach that underpins much of what is required by legislation 

Regardless of any legislative need, a practice that understands the hazards it may be exposing its employees to, and puts in place measures to mitigate any such risk, is generally viewed as a responsible employer. It seems even more poignant within general practice - whose business is healthcare – that you should strive to be exemplars in the management of the health and safety of their employees 

Are Risk assessments the preserve of Health and Safety Experts? 

No, they should be part of everyday the tool kit of every operational manager. 

The Health and Safety Executive promotes a five step approach to risk. 

You should first prioritise which risk needs assessed at first. This can be easily determined using a simple probability/consequence matrix such as the one below.  


     Likelihood        Minor             Moderate        Major    


  Tolerable risk level - Risk must be reduced.
  Broadly acceptable risk level - Monitor and reduce.
  Intolerable risk level - Immediate action required


The 5 step approach 

Step One – Identify the hazards

This step requires the responsible manager to physically tour the workplace and determine objects and practices that could potentially cause harm. 

It is highly recommended that the manager engages with employees to gather their opinions on these potential hazards. After all the employees are the individuals who have the most contact with them. 

It may also be useful to review records of previous accidents and see if it is possible to identify any recurring themes. 

Step Two – Who is at risk?

Try to determine who is most likely to be harmed by the hazards already identified - this will inform your decision regarding how best to manage the risk. 

Your assessment should refer to groups of people rather than specific individuals. For example, you should ascertain that 'clinicians may be harmed by needle stick injuries', rather than 'Jill Smith could have an accident with a syringe’. 

Step three – Put precautions in place

Putting precautions in place is perhaps the most practical step. This involves formulating measures to mitigate any risks that may have been identified.

 Your first concern should be to ascertain whether or not the risk can be eliminated altogether. The law recognises that, in some cases, this is not possible. If this is true of your workplace, your actions should be judged against accepted 'best practice'. 

If a risk cannot be eliminated, a less hazardous alternative should be sought. However, If this is not possible then access to the hazard should be prevented, exposure should be limited, safety equipment should be issued, or welfare equipment should be made available. 

Step Four – Record results 

If your Practice has fewer than five employees you are not legally required to make a written record of the assessment, but you should still make all staff aware of the potential hazards in the workplace. 

Furthermore, you should be able to demonstrate that the assessment has been acted upon and that the identified risks have been mitigated or managed to a sufficient degree. 

Step five – Review assessments regularly 

This should generally occur annually, but more frequent reviews may be necessary if the workplace conditions change more often. 

So those are the five simple, practical steps to aid you in making your Practice a safer place to work.  

Alternatively, you could be like Madonna and make it a big song and dance about it. 

FPM members can access the Risk Assessment Toolkit which provides the background to assessments as well as a table to record your findings. 

If you want introduction or refresher training to ensure you have a clear understanding of the legislative and best practice health and safety requirements of your practice, you might also want to consider Thornfield’s Health & Safety for Primary Care Managers workshop. 


© First Practice Management, 2015. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited.

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integrated healthandwellness 28/11/2018

Great Blog Thank You

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