university of essex

 Health and Safety Incident Form (.doc) Use this version if you want to complete electronically
Health and Safety Incident Form (.pdf)
Health and Safety Incident Investigation Form (.doc)
Health and Safety Incident Investigation Form (.pdf)
Further Information
Serious Incidents  (Health and Safety Bulletin, July 2012)
Ministry of Justice  Claims Reforms (IRM Bulletin, January 2013)
HSE guidance on RIDDOR
HSE Guidance on Investigating Accidents and Incidents (HSG 245)
Advice and Assistance
HSLO / DHSO / DSE Facilitators
Health and Safety Advisory Service (HSAS)
Occupational Health Service (OHS)
Insurance and Risk Manager

Health and Safety Incident Reporting

Health and Safety Incident Form

If you wish to report a health and safety incident, please use the form below and forward it to the Health and Safety Advisory Services (HSAS), Room 4SB5.4, Colchester Campus, marked 'Confidential'. These forms are for use by University of Essex, UECS and Wivenhoe House Hotel.

You can complete forms electronically or by hand. If you submit the form by e-mail, please send to safety (external e-mailers should add and put CONFIDENTIAL in the subject.

Use this version if you want to complete electronically: Health and Safety Incident Form (.doc) updated June 2012

Use this version if you want to complete by hand Health and Safety Incident Form (.pdf) updated June 2012

HSAS will ensure that the form is forwarded to the responsible manager along with the following incident investigation form:

Health and Safety Incident Investigation Form (.doc)

Health and Safety Incident Investigation Form (.pdf)

Alternatively managers can download and complete the form above.

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Reporting Accidents and Safety Incidents

Accidents do happen and all must be reported. It is the department/section/school/units (hereinafter called "the department"), responsibility to inform the Health and Safety Advisory Service (HSAS) (or the Information Centre outside normal office hours) when an accident has occurred. A report form must be completed for each accident, near miss incident or dangerous occurrence which occurs on the University's Campuses, in accommodation administered by the University or during University supervised activities (e.g. field trips). You should keep a copy for your own records and forward the original to HSAS, Room 4SB5.4, Colchester Campus. A Health and Safety Incident Report Form is available by following the link above.

It is important that incidents are reported to HSAS promptly, as certain incidents have to be reported to the enforcing body within strict timescales. Also HSAS will need to investigate serious incidents. As a general guideline the following timescales for reporting an accident should be followed:

Serious incident (see below) Immediately by telephone, followed by form within 24 hours
Accidents requiring first aid treatment By telephone or email and on form within 24 hours
Accidents involving loss of time By telephone or email and on form within 5 days
All minor accidents On form within 1 week of accident
Dangerous occurrence serious near miss By telephone immediately, followed by form
Minor near miss incidents On form within 1 week of incident
When it is known that time will be lost, the department must inform HSAS immediately in order that a report can be made to the HSE.

If a University employee is injured in a road traffic accident whilst on University business the circumstances should be reported to HSAS.

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Serious Health and Safety Incidents

The Colchester Campus Information Centre must be contacted immediately (01206 87(2222)) in the event of a serious accident or fire that occurs on any of the University's campuses, accommodation blocks or during a University supervised activity (e.g. a Fieldtrip).

The Information Centre has the emergency contact details of Health and Safety Advisory Service (HSAS) team and will notify them about the incident.

Any serious accidents or incident could result in a criminal investigation by the Health and Safety Executive (HSE), Police or Fire Service. It is therefore important that:

HSAS's role will be to give advice, initiate an internal investigation and report to or liaise with enforcement officers.

Please refer to the Health and Safety Bulletin on Serious Incidents for further information.

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Occupational Health Support

If employees have been involved in a serious, traumatic incident, Managers should contact the Head of Occupational Health for advice on how to provide support. Additional physiotherapy or counselling support may be available through the University's Insurers, submitted forms will be passed to the Occupational Health Service for consideration.

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Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR)

The University is required by law to report certain major injuries, dangerous occurrences and ill health conditions to the HSE (the enforcing body for health and safety) within legally set timescales.

Departments are responsible for informing the HSAS of any incident that may be reportable under RIDDOR, so that HSAS can inform the HSE.

RIDDOR sets out the requirement to report the following types of incident:

If an employee is absent (or unable to do his/her normal work) for more than 7 days (including weekends) due to an accident at work, it is the departments responsibility to ensure HSAS is informed as soon as the department is aware of the absence, even if an accident form has already been submitted, so that a report can be made to the HSE. If the 8th day of absence falls at a weekend or a holiday, the department should establish with the injured person whether s/he would have been fit for their normal work if it was a normal working day.

Major injuries are defined as:

Examples of reportable ill health/diseases:

There are other types of defined reportable illness or dangerous occurrence, so if in doubt contact HSAS for advice.

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Data Protection Act 1998

The information provided on the safety incident form will be used to monitor, record and investigate safety incidents that take place on University grounds. The information will be processed in accordance with the provisions of the Data Protection Act and is only disclosed within the University to members of staff who need to know it in order to carry out their duties. Relevant information will be disclosed outside the University where it is required by law to do so. In the event of a personal injury claim, information may be disclosed to the University's Insurers. Anonymised data may also be disclosed to relevant trade union officials.

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Accident Investigations

All accidents will be investigated. Minor/initial investigations will be carried out by the manager responsible for the employee or activity. HSAS will notify the Estates Management Section of premises related incidents, so that they can investigate. The investigation outcome should be recorded on the Safety Incident Form. More serious accidents will be investigated by HSAS.

To assist the investigation a note should be made of environmental conditions at the time of the accident:

It is essential that the report is as factual and accurate as possible as this may be used as evidence in the event of a claim. Any equipment involved in the accident should be retained for inspection.

When an accident has occurred within a department, any risk assessments covering the task involved should be reviewed to ensure the circumstances of the accident have been taken into account, and any amendments or adjustments should be made to the assessment accordingly.

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All accidents involving contractors and other visitors to campus must be reported to the HSAS using the Health and Safety Incident Form. In the case of an emergency or serious accident, the Clerk of Works/Project Officer in the Estate Management Section must also be informed immediately. Arrangements must be made to inform the contractors employer.

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