Staff Name:
Is an assessment needed?
(is there a risk of injury)
Yes / No
Work Location:
Risk rating before changes
_________
Site:
Risk rating after changes
_________
Date of Assessment:
Give a brief description for the moving
and handling task this staff member is
involved in.
Staff Name.
Assessor’s Name
Tile:
Give a brief descriptions of the control
measures
Put in place to reduce the risk of injury
Signature:
Signature:
Contact Number:
INDIVIDUAL
ENVIRONMENT
LOAD
TASK
Staff name:
Questions to be considered
Insufficient rest or recovery?
Holding loads away from the trunk?
Twisting?
Stooping?
Reaching upwards?
Long carrying distance?
Strenuous pulling or pushing?
Unpredictable movement of loads?
Repetitive handling?
Loads are / do they
Heavy?
Unwieldy?
Unstable / unpredictable?
Require mechanical assistance?
Are there
Constraints on posture?
Poor floors?
Variations in levels?
Hot / cold /. Humid conditions?
Poor lighting?
Tripping hazard?
Does the job
Have they been referred to Occupational health
Are they on a phase to work programme
How many hours do they work?
Does the role of the Individual require unusual physical
capability?
Could the moving and handling activities on the
ward/Department be Hazardous to those with medical
conditions / previous injury?
Hazardous to those who are pregnant?
Call for special information / training?
Location:
Yes
No
Problems occurring from the task
Other factors: is movement or posture hindered by clothing or Personal Protective Equipment? Yes / No
Possible remedial action
Could activity lead to cumulative strain: Yes / No
Name of Staff
Location
Action required by staff:

All manual handling training is up to date

Ask for further training as necessary

Adhere to the principles of safer handling at all times


Complete an EKHUFT Adverse Incident Form (Datix)
Individual staff must assess own capability and report concerns to the manager
 Staff who are pregnant or have health issues that effect their ability to undertake this activity to inform line manager / visit Occupational Health
Action specific for area:
Specific Action completed by MH Link
Assessor
Signature & Job Title:
Action required by the Manager:



Ensure staff complete manual handling training annually and that the safe systems of work described in the risk assessments are communicated via the MH
Assessor / Line Manager
Staff presenting with any physical condition (including pregnancy) that is affecting their ability to undertake manual handling should be referred to Occupational
Health
Ensure Manual Handling folder is accessible to staff
Manager's Name
(print)
Signature & Job
Title:
Date Agreed: