The use of contractors and sub-contractors is increasing in the NHS, yet according to a National Audit Office (NAO) report, A safer place to work: improving the management of health and safety risks to staff in NHS trusts, a third of trusts believe that they have limited control over their contractors' health and safety.
Both the employer and the contractor have specific responsibilities under health and safety law for staff working in a contract arrangement. However, there can be confusion about who is responsible for delivering information and training on health and safety, providing equipment and protective clothing or undertaking risk assessment. There is also evidence that temporary staff may be placed in greater danger due to their lack of knowledge or familiarity with NHS employers' policies.
Employers are responsible for protecting contractors and sub-contractors from harm caused by work activities.
The legal position
Employers have a legal responsibility to ensure the health, safety and well-being of contractors and sub-contractors. The Health and Safety at Work etc Act 1974 states that it is the duty of every employer to ensure, so far as is reasonably practicable, the health, safety and welfare of all their employees.
It is also the duty of every employer to ensure, so far as is reasonably practicable, that people who are not in their employment, but who may be affected by their activities, are not exposed to health and safety risks.
Employer responsibilities
When dealing with contractors, employers should consider the following areas:
Identify the job
All employers need to identify all aspects of the work they want contractors to carry out. Employers will need to assess the level of risk involved and training required for all staff involved. At this stage, employers will need to decide on levels of co-operation, consultation and supervision between all parties to ensure compliance with legislation.
Select a suitable contractor
Employers need to satisfy themselves that contractors are competent, that is, that they have sufficient skills and knowledge to do the job safely, without posing risks to health and safety. Employers must ensure that contractors are aware, at the start, of what is expected of them regarding training, competencies and general behaviour in the workplace. They should explain the health and safety arrangements, procedures, and policy statements and draw up a list of the main points to be considered.
Provide information, instruction and training
Under the Health and Safety at Work etc Act 1974, all employers have a duty to give employees information, instruction and training on anything that may affect their health and safety. This is no different for NHS employers and contractors. NHS employers should consider what information their contractors need and ensure they receive appropriate instruction and training. The information must be specific to the work being carried out and NHS employers must inform contractors and other parties of risks, such as asbestos, which may be unknown to the other party.
Management and supervision
NHS employers should decide what they need to do in order to manage and supervise the work of contractors. The greater the impact the contractor's work has on the health and safety of individuals, the greater the supervisory and management responsibilities of the NHS employer are. In all circumstances, employers need sufficient knowledge and expertise to manage and supervise the contracted work. It is essential that the nature of the controls exercised by the employer is agreed before the work starts.
