The ambulance service

HSE inspects around 30 ambulance services in England, Scotland and Wales. Ambulance crews sustain very high levels of reported musculoskeletal disorders, particularly from patient retrieval and moving/handling

Data extracted from the HSE RIDDOR database showed a 3-year mean incidence rate in the Service for manual handling accidents of 3820 per 100,000 employed, with a range of 540 to 20,500. These figures should be treated with some caution due to the relatively small numbers of employees in the ambulance service (approximately 24,000 nationally at the time). Further work has shown that between 50 and 87% of all recorded accidents in the service are coded as involving moving/handling.

Task identification analysis was carried out on 1039 incidents which resulted in a musculoskeletal injury. Three main categories emerged:

• use of stretcher;
• use of carry chair; and
• other patient handling, e.g. floor-to bed and bed-to-chair lifts.

The Health Services Advisory Committee set up a working group to look at musculoskeletal disorders in ambulance service workers. This group commissioned ergonomists from the Health and Safety Laboratory to conduct some work with carry chairs and alternative patient transfer seats. The first phase of this work consisted of a field study of carry chairs in use, and a summary of the report is attached.

• Summary of field study of carry chairs in use [250KB]

The second stage of the work will begin in March 2004 and will the gathering of quantitative data in a controlled environment. Outcomes from the second phase of this work will be:

• To determine musculoskeletal loads imposed on ambulance staff when performing handling tasks involving the use of carry chair equipment;
• To determine the influence of workplace factors and carry chair design characteristics on handling capabilities;
• To provide recommendations and advice on the safe use of carry chairs within the work environment.

Results from the study will be written up as an HSE Contract Research Report.

The Ambulance Service Association (ASA) has established a Health, Safety and Risk Committee to act as a central point of guidance and expertise for the service. It also forms a contact and liaison point for other stakeholders such as HSE and the Health Departments.

The first task undertaken by the Committee was to draw up frameworks, from which, individual services build their own policy and risk management strategy documents for violence and aggression and safer handling of people and loads. The frameworks are structured to be compatible with the risk management system promoted by the NHS Litigation Authority. Each framework is supported by a “mock policy and strategy document.” HSE was involved with the drafting of these frameworks and encourages their adoption.

• Violence and aggression: policy and strategy document 1b
• Violence and aggression: mock policy and strategy document 1a
• Safer handling: policy and strategy document 2a
• Safer handling: mock policy and strategy document 3a
• Infection Prevention and Control
• Violence and Aggression at Work
• Stress in the Workplace

These documents are all available from the ASA website following the path 'publications and download archive', via 'work programmes' to 'health, safety and risk'.

Further frameworks on significant risks will be added in due course.

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