First Aid at Work in UK Care Settings: A Practical Guide

A fall, sudden illness or collapse can happen during an ordinary shift, often before the person who notices it has time to think through every step. For care assistants, HCAs, nurses and managers, good first-aid arrangements make the immediate response clearer: people know who takes charge, where the equipment is and how to call for help.

The practical starting point is a first-aid needs assessment. It should reflect the hazards, size, location and work activities of your service, then guide decisions about trained first-aiders, equipment, facilities and emergency arrangements. If an adult is unresponsive with abnormal breathing, treat this as a cardiac arrest: call 999, start CPR and use an AED as soon as one is available, following its prompts.[^1]

This article focuses on workplace arrangements relevant to UK healthcare and social care teams. Always follow your organisation’s local procedures alongside current national guidance.

What first aid at work means in practice

First aid at work is not simply a box on a wall or a certificate held by one colleague. It is the set of arrangements that enable employees to receive immediate attention when they are injured or become ill at work.

In a care setting, those arrangements need to work during real shifts: when staff are spread across a building, working alone, supporting people in different areas or responding to an incident while other people still need care and supervision.

A workable arrangement answers a few practical questions:

• Who is responsible for first-aid arrangements on this shift?
• Who has first-aid training, and what training is appropriate to the identified risks?
• Where is the first-aid equipment, and can staff access it quickly?
• How will staff summon emergency help?
• Are there additional needs because of the service’s location, size, activities or history of incidents?

The purpose is not to create paperwork for its own sake. It is to make sure the provision fits the workplace rather than relying on assumptions.

Workplace first-aid duties: Great Britain and Northern Ireland

The legal framework is not identical across the UK, so managers should first establish which jurisdiction applies to their workplace.

Great Britain: England, Scotland and Wales

In Great Britain, the Health and Safety (First-Aid) Regulations 1981 require employers to provide adequate and appropriate equipment, facilities and personnel for employees who are injured or taken ill at work. The HSE states that this applies to every workplace, including those with fewer than five employees and self-employed people.[^2]

Employers must assess first-aid needs, considering workplace hazards and risks, the size of the organisation and other relevant factors. The assessment informs the equipment, facilities and people needed.

Northern Ireland

In Northern Ireland, the Health and Safety (First-Aid) Regulations (Northern Ireland) 1982, as amended, require employers to make arrangements so employees can receive immediate attention if injured or taken ill at work.[^3]

HSENI describes a minimum provision of:

• an appointed person to take charge of first-aid arrangements; and
• a suitably stocked first-aid kit.

An appointed person may be appropriate where the needs assessment does not identify a need for a trained first-aider. Their role includes looking after first-aid equipment and calling emergency services when needed; it does not make them a substitute for a trained first-aider where the assessment identifies that requirement.[^3]

Since 31 October 2017, HSENI has not approved first-aid-at-work training providers or qualifications. Employers remain responsible for selecting suitable training based on their needs assessment. HSENI identifies one-day Emergency First Aid at Work and three-day First Aid at Work courses as core building blocks.[^3]

Completing a first-aid needs assessment for a care service

A needs assessment should be specific enough to support sensible decisions, not a generic form filed away and forgotten. HSE and HSENI guidance makes clear that hazards, risks, organisational size and other workplace factors matter.[^2][^3]

For a healthcare or social care service, consider:

• Work activities and hazards: What situations could lead to injury or sudden illness at work?
• Workforce size and deployment: How many staff are present, and are they located together or across different areas?
• Location: Is the service remote, spread over several floors or dependent on lone working?
• Hours of operation: Does provision need to work across all shifts, including evenings and weekends?
• Incident patterns: Are accidents or ill-health events highlighting a need to review arrangements?
• Equipment and facilities: Could the assessment indicate a need for additional equipment, a first-aid room or other facilities?
• Emergency access: Would it be useful to make advance arrangements with emergency services because of the site or activity?

HSENI recommends documenting and reviewing the assessment periodically, including monitoring accidents and ill health so provision can be reconsidered when circumstances change.[^3]

Turn the assessment into visible arrangements

The assessment only improves safety when staff can act on it. Make the resulting arrangements easy to find and understand. Staff should know:

1. who is responsible for first aid;
2. where first-aid equipment is kept;
3. how to summon emergency help; and
4. what local escalation process applies after an incident.

This is especially relevant when bank, agency or newly appointed staff may not yet know the layout or usual routines of a service.

Choosing equipment and training that fit the risk

There is no benefit in treating a generic kit list as a complete assessment. HSENI states that there is no mandatory list of workplace first-aid-box contents; the contents should be appropriate to the assessment.[^3]

For lower-hazard work, HSENI suggests items such as general first-aid guidance, sterile plasters, eye pads, triangular bandages, safety pins, sterile unmedicated dressings and disposable gloves. It recommends that tablets and medicines are not kept in the first-aid box.[^3]

The key point for managers is to match provision to the workplace. A service may need more than the minimum where its assessment identifies higher or more complex risks, particular work patterns or a need for specialist training or additional equipment.

Training should follow the same principle. In Northern Ireland, HSENI advises employers to choose training and competent providers that meet the needs identified by the assessment, and strongly recommends annual refresher training to help first-aiders keep basic skills current.[^3]

Responding to an unresponsive adult: the immediate priorities

In a suspected cardiac arrest, speed and a clear sequence matter. Resuscitation Council UK’s 2025 adult basic life-support guidance advises the following.[^1]

1. Check it is safe to approach and check whether the person is conscious.
2. Call 999 immediately if they are unresponsive. While waiting for the call to be answered, assess breathing.
3. Look for abnormal breathing. Slow or laboured breathing, agonal gasping or panting are abnormal. If the person is unresponsive and breathing abnormally, assume cardiac arrest.
4. Start CPR immediately. If there is doubt, Resuscitation Council UK advises assuming cardiac arrest and starting CPR.
5. Use an AED as soon as it is available. Follow the device’s audio and visual instructions.

Ambulance call handlers can provide instructions during the emergency call.[^1]

Adult CPR: key points from Resuscitation Council UK

For adult CPR, Resuscitation Council UK advises chest compressions at 100–120 per minute, to a depth of at least 5 cm but no more than 6 cm. Allow the chest to recoil fully and minimise interruptions.[^1]

Staff trained to give rescue breaths should use 30 compressions to 2 breaths. A person who is not trained to give rescue breaths should provide continuous chest compressions.[^1]

These are emergency actions, not a replacement for practical, skills-based training. Teams should ensure their competence and local arrangements are appropriate to the risks identified in their workplace assessment.

AEDs: make the device easy to find and use

An automated external defibrillator (AED) analyses the heart rhythm and, when appropriate, instructs the user to deliver a shock. Resuscitation Council UK is clear that anyone can use an AED.[^1]

When an AED arrives:

• turn it on and follow its prompts;
• place the pads on the person’s bare chest as illustrated on the pads or device;
• make sure nobody is touching the person during analysis or shock delivery; and
• restart chest compressions immediately after a shock or a no-shock decision.[^1]

For workplaces that provide an AED, clear signposting and ready access are practical priorities. Resuscitation Council UK also recommends registering public-access AEDs with The Circuit, so ambulance services can identify them during a 999 call.[^1]

Bystander CPR and AED use can increase the chance of survival after out-of-hospital cardiac arrest by two to four times, according to Resuscitation Council UK.[^1] That is why a workplace plan should focus not only on owning equipment, but also on helping people locate it and respond without avoidable delay.

A practical first-aid arrangements checklist

Use this as a discussion prompt for a team meeting, manager review or induction process:

• We know which first-aid legal framework applies to our workplace.
• Our first-aid needs assessment reflects our hazards, workforce, location and activities.
• We review the assessment when incidents, ill health or service circumstances indicate a change may be needed.
• The responsible person and trained first-aiders are known to staff.
• First-aid equipment is appropriate to the assessment and staff know where it is.
• Staff know how to call 999 and follow local emergency arrangements.
• Training is selected to match the needs assessment and is kept current.
• If an AED is provided, it is accessible, clearly signposted and staff understand that they should follow its prompts.

Frequently asked questions

Does every workplace need first-aid provision?

Yes. In Great Britain, the HSE says the first-aid regulations apply to all workplaces, including those with fewer than five employees and self-employed people. The provision required should be adequate and appropriate to the needs assessment.[^2]

Is an appointed person the same as a trained first-aider?

No. In Northern Ireland, an appointed person takes charge of first-aid arrangements, looks after equipment and calls emergency services when required. They may be suitable where the needs assessment does not identify a need for a trained first-aider.[^3]

What should be in a workplace first-aid kit?

The contents should follow the first-aid needs assessment. HSENI does not prescribe a mandatory list and advises against keeping tablets or medicines in a first-aid box.[^3]

What should staff do if someone is unresponsive and gasping?

Treat abnormal breathing, including gasping or panting, as a sign of cardiac arrest in an unresponsive adult. Call 999, start CPR and use an AED as soon as available.[^1]

Can an untrained person use an AED?

Yes. Resuscitation Council UK states that anyone can use an AED. Turn it on, follow its prompts and resume chest compressions immediately after the device gives a shock or no-shock decision.[^1]

Conclusion

Effective first aid at work is built around preparation: a needs assessment that reflects the service, arrangements staff can quickly use and training that matches the risks. In a serious emergency, a calm early response matters: call 999, start CPR when an unresponsive adult has abnormal breathing and use an AED without delay when one is available.

Clarivive MedInsight encourages care teams to use this guidance as a prompt for discussion, refresher learning and a review of local first-aid arrangements.

Sources

[^1]: Resuscitation Council UK, Adult Basic Life Support Guidelines (2025)

[^2]: Health and Safety Executive, Legislation – First aid at work

[^3]: Health and Safety Executive for Northern Ireland, First aid at work