Occupational Health : Safer People Handling
Preventing back pain and injury in the health and care sectors
A report of the ‘People Handling Summit’ convened by RoSPA on 20 October 2000 and background papers.
Appendix B : Background paper
‘People Handling Summit’
As a distinct contribution to the ‘European Week of Health and Safety 2000’ RoSPA will be holding a ‘People Handling Summit’ to bring key people together; and focus on strategies and best practice for reducing manual handling injury associated with people handling in the health and caring sectors.
The schedule for the Summit will include short informative presentations and facilitated discussion (see Programme). RoSPA will provide the Secretariat for this event by consolidating contributions made throughout into a consensus policy report on the way forward will be circulated widely within the field.
Introduction
Every year, many workers in the UK risk injury due to poor practices associated with handling loads in the workplace. This important occupational health issue will be the focus of European Health and Safety Week this year which will commence on the 16th October. The risk of musculoskeletal injury is an important concern for employees in the health and caring sector and is closely linked to handling people and patients. It has been recognised as a major source of ill health, work absence and staff loss as well as economic loss by employers, unions and the HSE and has been the subject of considerable awareness raising and guidance. Much more requires to be done however if existing good practice is to be spread more widely. Several providers, including The Royal Society for the Prevention of Accidents (RoSPA) and others such as the handling equipment sector, have developed ‘solutions’ ranging from specialised people handling courses (RoSPA and others) to various kinds of handling aids and care and rehabilitation services. A wide range of other organisations are actively involved in campaigning and education (unions, for example), awareness raising and providing information (e.g. BackCare).
As a distinct contribution to the ‘European Week of Health and Safety 2000’ RoSPA will be holding a ‘People Handling Summit’ to explore this specific area. The aim of the event is to bring key people together; and focus on strategies and best practice for reducing manual handling injury associated with people handling in the health and caring sectors.
The schedule for the Summit will include short informative presentations and facilitated discussion. RoSPA hopes that this event will enable key players to review existing practice and progress and identify continuing problems. RoSPA will provide the Secretariat for this event by consolidating contributions made throughout into a consensus policy report on the way forward. This report will be circulated widely within the field.
Manual handling in the Health & Social Work Sectors
Around a third of all accidents reported to the HSE involve manual handling. In the health sector, these accidents account for 50% of those reported. Every year over 5000 manual handling accidents in the health and social work sector are reported to the HSE. A majority of these involve patient handling.
Manual handling accidents and injuries have been an important occupational health risk for many years and the HSE has produced a great deal of guidance on how to make handling loads less hazardous. Effective management policies have successfully reduced risks in some organisations, but progress overall has been slow because many organisations tend to concentrate only on training rather than taking the more proactive safety management based approach required by health and safety legislation.
The HSE suggests in the guidance document : Manual Handling in the Health Services that good manual handling needs to be approached from an ergonomic perspective. This requires the practical and scientific assessment of how workers interact with their environment. Some important elements which contribute to safer handling are summarised in Figure 1.
Figure 1: Important factors in safe manual handling (adapted from HSE, 1998, Manual Handling in the Health Service, ISBN 0717612481)
The risk of injury to workers in the health and caring sectors is likely to continue unless manual handling tasks are eliminated or suitably modified. Around half of the injuries reported to the HSE involve damage to the lower back which means that injured workers can be absent from the workplace for long durations or even be forced to stop work. Every year, nearly 4000 nurses need to retire due to musculoskeletal injuries.
Sickness absence and the employment of temporary staff can be extremely costly to organisations. Further costs can be incurred through compensation claims. Numbers of civil action cases brought against employers are steadily increasing. Furthermore, although average compensation awards for manual handling injury have been around £60,000, some recent cases have involved awards approaching half a million pounds.
Each year, the National Health Service’s Permanent Injury Benefit Scheme receive notification of around 1500 new cases of permanent injury. There are around 10,000 former health service employees now receiving this benefit with costs in excess of £20 million each year. In addition, the cost of Temporary Injury Allowance runs into many millions.
Overview of Current Activity
There is significant information available on manual handling risks and the HSE have focused heavily on this area as an integral part of their inspection programme. In response to research and statistical information which identified back pain as the main cause if ill-health at work and concerns raised by employers, trade unions and related organisation, in 1999, the Health and Safety Executive and the Department of Health jointly launched the Back in Work programme. This programme aims to raise employer’s and workers’ awareness of back pain; encourage preventative action; promote early access to assessment, treatment and rehabilitation and encourage an early return to work. A key part of this programme was to provide support to a number of pilot projects to identify effective interventions. Forty-four projects are currently being supported.
Although, awareness of manual handling problems in the public sector has been steadily increasing, activities are disparate and the level of activity tends to vary between sectors. Nevertheless, heightened focus on musculoskeletal problems within the public sector has helped identify and characterise problem areas. For example, ambulance workers are a high risk group and in, contrast to the widely held view that nurses are most at risk, evidence suggests that nursing support workers, health care and social care assistants are more at risk.
The HSE provides general and sector specific guidance documents aimed at reducing manual handling injury risks in the health and social care sectors. Other organisations such as the Royal College of Nurses and BackCare have also produced guidance material. Despite the availability of guidance, concern has been expressed that this is not frequently applied in practice.
1 Eg: ‘Manual handling in the health services,’ ISBN 07176 1248 1: This guidance was prepared by the health & Safety Commission’s Health Services Advisory Committee. It intends to ensure manual handling risk reduction including those from patient handling
2 Eg: Safer Handling of people in the Community: this provides practical solutions to carers who move disabled or vulnerable people in domestic settings without the support available in hospitals or larger Nursing Homes.
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