Study notes produced in April 2000 by Mike Griffin, last updated 11th April 2004
These are study notes, not a definitive statement of law and the situation may change with subsequent case law, guidelines or legislation. If you need to seek clarification, consult a lawyer.
The law relating to manual handling consists of specific Acts of Parliament, regulations and Approved Codes of Practice (ACoP). Acts published after 1988 are available in full at the HMSO website (www.hmso.gov.uk).
This remains the basis of health and safety legislation, and
"sets out the general duties which employers have towards employees and members of the public, and employees have to themselves and to each other" (HSE, 1996)
HSE leaflet "Health and Safety Regulation" (HSC 13) 1996
The Act states that employers must ensure, as far as reasonably practicable, the health, safety and welfare of their employees whilst at work and any other persons affected by their business activities. The Act is a general piece of legislation and not specific to moving and handling so is not considered here in detail.
These regulations refined the 1974 Act and require employers to carry out risk assessments, recording the significant findings. It also requires employers to:
Source: HSE leaflet "Health and Safety Regulation" (HSC 13) 1996
Thus, employers have a duty to ensure that workers using manual handling equipment are given training and instruction in its use. The duty to work together with other employers would presumably cover situations where both health and social services staff are using the same equipment in a client's home, or situations where equipment is used also by agency care assistants as well as in-house staff.
The 1992 regulations were revoked and replaced with The Management of Health and Safety at Work Regulations 1999 (below).
MHOR (Health and Safety Executive, 1992) came into force on 1st January 1993 to implement European Directive 90/269/EEC. The regulations add to the duties placed on employers by the Health and Safety at Work Act (1974). MHOR requires a risk assessment approach that takes into account whether it is reasonably practicable to automate or mechanise the process. The employer must provide equipment to avoid the hazardous manual handling of loads. The regulations apply wherever things or people are moved by hand or bodily force.
The responsibility for implementing safety requirements tends to fall on personnel directly responsible for the co-ordination and supervision of work. However, where the risk reduction measures identified entail the purchase and supply of equipment, the employer may be involved in decisions about financing capital items of equipment. In such circumstances, senior managers must be involved in the risk reduction strategy.
Source: McGuire T, Moody J, Hanson M (1997): Managers' attitudes towards mechanical aids. Nursing Standard. 11, 31, 33-38.
The Health and Safety Executive states:
1. The Manual Handling Operations Regulations 1992, which implement the Manual Handling of Loads Directive, came into effect on 1 January 1993 and apply to all manual handling activity with a risk of injury.
2. The Regulations impose duties on employers self employed people and employees. Employers must avoid all hazardous manual handling activity where it is reasonably practicable to do so. If it is not, they must assess the risks in relation to the nature of the task, the load, the working environment and the capabilities of the handler and tale appropriate action to reduce the risk to the lowest level reasonably practicable. Employees must follow appropriate work systems introduced by their employer to promote safety during the handling of loads.
Copies of Manual Handling: Guidance on Regulations, L23, ISBN 0 7176 2415 3, price £8.00, are available from HSE Books, PO Box 1999, Sudbury, Suffolk, CO10 6FS, tel: 01787-881165 or fax: 01787-313995, or from booksellers.
Source: HSE Press Release E259:98 - 30 November 1998.
The employer's duties:
The Employee's duties:
Health and Safety Executive guidelines (1998, see references) give a general guide to the weight limits at which risk assessment should be triggered but these are not hard and fast rules and there is no simple answer. You have to consider many different factors (different abilities of the people doing the handling, differences in environments, bed height, carpets if hoists are to be used, changes in level, room to manoeuvre, the specific behaviours of the client, the height of the object being lifted as well as its size and the distribution of mass within it, the specific movements needed, etc.). Arbitrary weight limits are no substitute for a proper risk assessment. The general guidelines are presented here (pop-up window) but are general guidelines only. The HSE guide states:
"Each box in the diagram above shows guideline weights for lifting and lowering.
"Observe the activity and compare to the diagram. If the lifter's hands enter more than one box during the operation, use the smallest weight. Use an inbetween weight if the hands are close to a boundary between boxes. If the operation must take place with the hands beyond the boxes, make a more detailed assessment.
"The weights assume that the load is readily grasped with both hands.
"The operation takes place in reasonable working conditions with the lifter in a stable body position.
"Any operation involving more than twice the guideline weights should be rigorously assessed - even for very fit, well-trained individuals working under favourable conditions.
"There is no such thing as a completely 'safe' manual handling operation. But working within the guidelines will cut the risk and reduce the need for a more detailed assessment."
The guidelines are general and deal with simple inanimate objects, but they show just how low the threshold for risk assessment is when you consider moving and handling humans. It is difficult to imagine many examples of moving and handling clients that would not require risk assessment.
LOLER came into force 5 December 1998 and aims to reduce risks to health and safety from lifting equipment provided for use at work. LOLER requires that equipment be:
Hoists, slings and bath hoists are covered by the regulations. The regulations state that lifting equipment should be thoroughly examined by competent people at least every six months in the case of equipment used to lift people, and at least annually in the case of other equipment
LOLER (above) is a specific regulation covering lifting equipment but any other equipment used or issued by OTs for work purposes is covered by PUWER, a more general regulation. PUWER came into force on 5 December 1998 replacing the Provision and Use of Work Equipment Regulations 1992. PUWER states that equipment provided for use at work is:
As you can see, PUWER is quite similar to LOLER, but while LOLER covers only lifting equipment, PUWER is more general and applies to all equipment used by an employee at work. It would therefore apply to equipment used by members of the occupational therapy service or provided by OTs for paid carers to use. It would include, for example, cookers used in an assessment kitchen and office equipment.
RIDDOR obliges employers to report major injuries, dangerous occurrences and diseases.
Over three day injuries. HSE states:
If there is an accident connected with work (including an act of physical violence) and your employee, or a self-employed person working on your premises, suffers an over-three-day injury you must send a completed accident report form (F2508) to the enforcing authority within ten days. An over-three-day injury is one which is not major but results in the injured person being away from work or unable to do their normal work for more than three days (including non work days)
If an employee suffered a moving and handling injury that resulted in inability to do her/his normal work for more than three days, the employer would be obliged to report. An example of this could be: A care assistant suffers a back injury when lifting a heavy load and is unable to work for four days
Major injuries include:
Dangerous occurrences include:
Diseases: Including certain musculoskeletal disorders and upper limb disorders related to manual handling.
See also: www.riddor.gov.uk.
The 1992 regulations were revoked and replaced with The Management of Health and Safety at Work Regulations 1999 which re-enact the provisions of the 1992 regulations and consolidate amendments made to the 1992 regulations. They also revoke the Management of Health and Safety at Work (Amendment) Regulations 1994.
The regulations came into force on 29 December 1999 and include the following main changes:
Source: HSE Press Release C058:99 - 23 December 1999.
This would presumably imply that organisations should have their own moving and handling advisors rather than rely on externally contracted services.
Update, February 2003. A recent court case has highlighted the conflict between the rights of disabled people and the rights of paid carers — an issue that often introduces confusion into moving and handling considerations. East Sussex County Council was sued over its refusal to instruct carers to lift two disabled sisters. It seems clear that blanket 'no lift' policies cannot be imposed, and it may raise the question of whether lifting should be used if hoisting is an alternative but is refused. The judgement does seem to seriously question the Royal College of Nursing guidance which advises that "...the manual lifting of patients is eliminated in all but exceptional or life threatening situations" (RCN Code of Practice for Patient Handling, 1996). The report can be viewed on http://www.channel4.com/news/2003/02/week_3/18_disabled.html (accessed 11th April 2004) and also on http://news.bbc.co.uk/1/hi/england/2782083.stm (published 19 February, 2003, accessed 11th April 2004). A more comprehensive, considered and reliable reflection on this case by Michael Mandelstam can be found in November 2003's British Journal of Occupational Therapy [Mandelstam M (2003) Disabled People, Manual Handling and Human Rights. British Journal of Occupational Therapy 66(11):528-530]. BAOT/COT members can download it from the College of Occupational Therapists website (membership number required).
Recommended further reading: Mandelstam M (2002) Manual Handling in Health and Social Care. London, Jessica Kingsley Publishers.
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