Policy:

HR 051 Back Care and Manual Handling

Executive or Associate Director lead Executive Director of People

Policy author/ lead Health and Safety/Risk Adviser

Physiotherapy Clinical Lead
Feedback on implementation to Moving & Handling Back Care Advisor

Document type Policy

Document status V9
Date of initial draft September 2016
Date of consultation March 2021
Date of approval 28 June 2021
Date of ratification 13 July 2021
Ratified by People Committee
Date of issue July 2021
Date for review 31 May 2024
(Extended from 31 May 2021 by Policy Governance Group
on 28/06/2021)
Target audience All Trust staff
Keywords Manual, handling, back, pain

1
Policy Version and advice on document history, availability, and storage

This is version 9 of this policy. This version replaces version 7, ratified in March 2013.

People Committee ratified a fourth extension to review date on 15/10/2020 to 31/5/2021.

People Committee ratified a third extension to review date on 25 June 2020 to 30/11/2020.
EDG approved a second extension to review date on 20 February 2020 to 30/06/2020.
EDG extended the review date to 29 February 2020.
PGG extended the review date to 31 May 2021.

This policy will be available to all staff via the Sheffield Health & Social Care NHS Foundation Trust
Intranet and on the Trust’s website. The previous version will be removed from the Intranet and Trust
website and archived. Word and pdf copies of the current and the previous version of this policy are
available via the Director of Corporate Governance.

Any printed copies of the previous version (V8) should be destroyed and if a hard copy is required, it
should be replaced with this version.

2
 Contents

Section Page
1 Introduction 3
2 Scope 3
3 Definitions 3
4 Purpose 3
5 Duties 4-5
6 Specific details - i.e. the procedure to be followed
6.1 Manual Handling 5
6.2 Risk Assessment 6
6.2.1 Risk assessment – recording 6
6.3 Skills and training 6
6.4 Specialist advice 6
6.5 Manual handling equipment 6
6.6 Health monitoring 7
7 Dissemination, storage and archiving 7
8 Training and other resource implications 7
9 Audit, monitoring and review – not in 8
10 Implementation plan 9
11 Links to other policies, standards and legislation 9
12 Contact details 9
13 References 10
Appendix A – Version Control and Amendment Log 11
Appendix B – Dissemination Record 12
Appendix C – Equality Impact Assessment Form 13
Appendix D – Human Rights Act Assessment Form and Flowchart 14-15
Appendix E - Development and Consultation Process 16
Appendix F – Policy Checklist 17-18
Appendix G - Techniques to be used in the moving and handling of 19-22
service users (PATIENTS), including the use of appropriate equipment
Appendix H - Techniques to be used in the moving and handling of 23-24
inanimate loads (OBJECTS), including the use of appropriate
equipment
Appendix I - Manual Handling Assessment Form (MH1) 25-26
Appendix J - Patient Handling Assessment Form (MH3) 27-28

3
 1. Introduction

Sheffield Health and Social Care NHS Foundation Trust recognises its responsibilities under Health and
Safety legislation to ensure, so far as is reasonably practicable, the health safety and welfare of its
employees, service users and members of the public.

To this end the Trust will ensure, so far as is reasonably practicable, that manual handling risks are
eliminated, or reduced to an acceptable level, to help protect the health of staff and its service
users.

1.1 Legislative requirements

The Health and Safety at Work Act 1974 (HSWA) requires employers to ensure the health and safety
of all employees, as far as is reasonably practicable.

The Manual Handling Operations Regulations 1992 require employers to eliminate the need for staff
to manually handle loads where possible, or to reduce manual handing risks to an acceptable level,
when such handling is unavoidable.

The Lifting Operations, Lifting Equipment Regulations 1998 (LOLER) aim to reduce risks to people’s
health and safety from lifting equipment provided for use at work.

2. Scope of this Policy

This is a Trust-wide policy which applies to all staff employed by the SHSC Trust.

3. Definitions

 Hazard is anything that has the potential to cause harm.

 Risk is the chance of an undesirable outcome. It considers the combination of the likelihood and
severity of the outcome.
 Likelihood is a measure of the probability that the predicted harm, loss or damage will occur.
 Severity is a measure of the impact that the predicted harm, loss or damage would have on the
people, property or objectives affected.
 Risk assessment is simply a careful examination of what, in your work, could cause harm to people,
so that you can weigh up whether you have taken enough precautions or should do more to prevent
harm.
 Risk Treatment is the action(s) taken to remove or reduce the severity and/or likelihood of an
identified risk.
 A load is a discrete movable object. It can be animate or inanimate.
 Animate load a live load such as a person.
 Inanimate load a non-live load such as a box or a trolley.
 Manual handling is the transporting or supporting of a load by human effort applied directly to the
load.
 Musculoskeletal disorders (MSDs) include problems such as low back pain, joint injuries and
repetitive strain injuries of various sorts.
 Staff All employees of the Trust, including agency, temporary and locum staff.

4. Purpose of this Policy

This policy details the organisational arrangements in place to meet the legal and good practice
requirements to prevent manual handling incidents within the Trust.

HR 051 Back Care and Manual Handling Policy V9 June 2021 4

 5. Duties

5.1 Trust Board

The Trust Board has ultimate responsibility for the implementation and effective
management of good health and safety practice within the Trust.

 Clinical Directors and Heads of Service

Clinical Directors and Heads of Service will ensure that processes are in place to reduce and control
manual handling risks and that these processes are monitored for continued effectiveness.

More specifically they will:

 Ensure that departmental managers are aware of the policy.
 Ensure that departmental managers correctly manage the risks from moving and handling tasks.
 Ensure that information on manual handling incidents within each Directorate is obtained and
analysed to detect trends or significant concerns and use this information to help introduce actions to
treat the risk of manual handling injury to staff and to monitor improvements.
 Any incident relating to moving and handling tasks will automatically be raised to and reviewed by the
Moving & Handling Back Care Advisor.

 Departmental Managers

Departmental managers are responsible for ensuring that their staff have the necessary information and
skills to safely undertake their roles within the Trust.

These responsibilities include:

 Ensuring the completion of Manual Handling Risk Assessments for all staff and patients. Patients
should have current and accurate Client Handling Assessments in their Care Plans, whilst these
needs are linked to current staff Manual Handling Risk Assessments. (Risk Assessments must
address any specific needs of disabled staff and take into account the possible need to make
reasonable adjustments to help prevent injury or ill health).
 Appoint Manual Handling Key Trainer
 Ensure that staff are aware of, and adhere to, the Back Care & Manual Handling Policy.
 Assessing the skills of their staff to carry out the work for which they are employed and ensuring new
staff do not commence their duties until they have the appropriate skills to do so.
 Ensuring that any new team members are booked on appropriate training and other staff attend
refresher training.
 Moving & Handling Level 1 (Inanimate Loads) refreshed every three years.
 Moving & Handling Level 2 (People) refreshed every three years.
 Ensuring that any equipment required to reduce the risk of injury from manual handling is provided or
necessary changes to systems of working are introduced.
 Encourage the early reporting of any symptoms relating to moving and handling injuries, ensuring that
access to suitable treatment where necessary and support if the problem requires a rehabilitation
programme (contact a HR Advisor for advice on Occupational Health referral).
 Allow sufficient time and provide administrative support to key trainers so they can prepare and deliver
appropriate manual handling training.

 Staff

All staff:
 Must undertake risk assessments for all appropriate manual handling activities.
 Must perform manual handling activities in accordance with the information, instruction and training
provided; for example, those carrying out patient handling will follow the method of transfer shown in

HR 051 Back Care and Manual Handling Policy V9 June 2021 5

 the care plan/records for identified patients.
 Make full and proper use of equipment provided; must visually inspect all equipment before use,
report any defects and remove from service.
 Attend Manual Handling Training at induction and refresher training as identified by individual training
needs.
 Only practice within the limits of their knowledge and skills.
 Inform their team leaders if they have difficulties or concerns associated with the manual handling
activities that are part of their job.
 Report any injury, incident or untoward occurrence in line with the Incident Reporting Policy.

 Manual Handling Key Trainers

Manual handling key trainers will:

 Deliver manual handling and back care training in their work area.
 Provide new staff with induction training relating to manual handling and back care in their work area.
 Provide line manager with details of training given (it is not the key trainers responsibility to maintain
individual staff training records).
 Participate with manual handling risk assessments in their work area.
 Provide advice relating to manual handling equipment.
 Provide a link between the workplace and the Moving & Handling Back Care Advisor.
 Attend update training where necessary. [Moving & Handling Key Trainer / Moving & Handling Key
Trainer Refresher update.

6. Specific Details

6.1 Manual Handling

The employer’s first duty is to find ways of avoiding hazardous manual handling tasks. This might
require the work to be done differently or the handling to be mechanised, for example by the use
of a hoist or other equipment.

6.2 Risk Assessment

 A risk assessment must be carried out for all hazardous manual handling that cannot be
reasonably avoided.

 Staff should be familiar with the process of risk assessment and be able to carry out moving and
handling risk assessment in any circumstance, to reduce the risk to the lowest level that is
reasonably practicable.

 Using the TILE mnemonic to construct a Risk Assessment brings a systematic approach to the
consideration of all the risk factors associated with a manual handling operation. Each risk factor
can be considered in turn:
 The task being undertaken.
 The individual undertaking the task.
 The load (which may be a person).
 The working environment.

 An informal ‘on the spot’ risk assessment will identify the risks that change and cannot always be
kept up to date on a written form, for example the level of patient fatigue, the state of the floor at
that particular time.

HR 051 Back Care and Manual Handling Policy V9 June 2021 6

6.2.1 Risk Assessment - Recording

 Significant findings of risk assessments must be recorded, and the record kept available,
as long as it remains relevant.

 An assessment need not be recorded if it identifies a low risk of ill health or injury and could be
easily repeated and verbally explained at any time because it is simple and obvious and so the
time taken to record it is disproportionate to the risk.

 Handling Assessments for Patients - All service users/patients requiring manual handling must
have patient handling assessments recorded in their care plans. These are recorded on form MH3,
the Patient Handling Assessment Form (Appendix J).

 Handling Assessments for Objects - Risk assessments for inanimate load handling can be
recorded on the Trusts standard risk assessment form (see the Risk Management Policy).

 If you require guidance on the risk factors to consider when assessing the risk, then it is advised
to use form MH1, the Manual Handling Assessment Form (Appendix I) - however, its use is not
compulsory.

6.3 Skills and Training

 All staff must have the skills necessary to carry out their jobs without exposing themselves or
others to unreasonable risk. Due to the range of work undertaken by the Trust different staff
groups will require different skills. Training will be provided to make sure that staff obtain and
maintain these skills.

 New starters must possess skills in the areas identified before working unsupervised in those
areas.

 All staff are required to undertake appropriate training at Level 1 and/or Level 2 for their individual
training needs and as identified in the Trust’s Training Needs Analysis.

 Further details on the approved moving and handling techniques for patients and inanimate
objects are given in Appendices H.

6.4 Specialist Advice

 Staff with significant health problems affecting their ability to undertake their responsibilities can
be referred to the Occupational Health Department for medical advice and return to work issues.

 Physiotherapy: The service is provided by PhysioMed (https://www.physiomed.co.uk/) who can

assess staff over the phone and if extra support is required a referral can be made to one of
their clinics.

6.5 Manual Handling Equipment

In many cases manual handling operations require equipment to reduce the risk of injury or ill health
to an acceptable level. Managers must ensure that:
 There is sufficient appropriate equipment provided to match demand.
 Staff are trained in the use of the equipment.
 The equipment is stored in a safe, convenient and easily accessible place.
 Equipment is serviced and maintained to meet manufacturers’ standards.
 Equipment that is designed to lift a person, e.g., a hoist, is examined at least every 6 months by a
competent person - as required by the Lifting Operations and Lifting Equipment Regulations 1998
(LOLER).

HR 051 Back Care and Manual Handling Policy V9 June 2021 7

6.6 Health Monitoring

 Patient handling is recognised as a significant, but not the sole cause of musculo-skeletal injury
within the health care sector, hence the existence of specific employment law to try and control
its harmful effects.

 Staff with significant health problems affecting their ability to undertake their responsibilities can
access advice from the Occupational Health Department.

 Physiotherapy: The service is provided by PhysioMed (https://www.physiomed.co.uk/) who can

assess staff over the phone and if extra support is required a referral can be made to one of
their clinics.

7. Dissemination, Storage and Archiving

 Links to an electronic copy of the policy shall be circulated via a trust-wide e mail.
 An electronic copy of the policy shall be accessible via the Trust Intranet.
 An archive copy of the previous policy and the new updated policy shall be stored with the
Corporate Governance Department for reference.

8. Training and Other Resource Implications for this policy

 The implementation of this policy should have no additional resource requirements. There are no
other training needs for the implication for this policy. The core moving and handling training needs
requirements has been identified via the Trust’s Training Needs Analysis. For further details, see
the Core Mandatory Training Policy.
 Enhanced training will be offered to Moving & Handling Key Trainers.

HR 051 Back Care and Manual Handling Policy V9 June 2021 8

9. Audit, Monitoring and Review

This policy will be reviewed in 3 years, or earlier if needed due to changes in national guidance, legislation, lessons learned or significant
incidents.

Monitoring Compliance Template

Minimum Requirement Process for Responsible Individual/ Frequency of Review of Results Responsible Responsible
Monitoring group/committee Monitoring process (e.g. who Individual/group/ Individual/group/
does this?) committee for committee for action
action plan plan monitoring and
development implementation
Completion of current Audit Health and Safety At least annually Health and Safety Health and Safety Health and Safety
Moving and Handling Risk Advisor Committee Committee Committee
Assessment

Completion of current staff Audit Health and Safety At least annually Health and Safety Health and Safety Health and Safety
training records showing Advisor Committee Committee Committee
staff attendance at suitable
and sufficient Manual
Handling training
A sufficient number of lifting Audit Health and Safety At least annually Health and Safety Health and Safety Health and Safety
appliances will be readily Advisor Committee Committee Committee
available and checked (as
required under LOLER) to
be in safe working order
Number and type of Review Integrated Governance Quarterly Health and Safety Health and Safety Health and Safety
reported Manual Handling Committee Committee Committee
Incidents

HR 051 Back Care and Manual Handling Policy V9 June 2021 9

10. Implementation

Action / Task Responsible Person Deadline Progress update

New policy to be Director of Corporate Within 5 working
uploaded onto Jarvis Governance days of
and Trust website. ratification
A communication will be Director of Corporate Within 5 working
issued to all staff via the Governance days of
Communication Digest ratification
immediately following
publication.
A communication will be Director of Corporate Within 5 working
sent to Education, Governance days of
Training and ratification
Development to review
training provision.
Reference revised policy Health and Safety Risk June 2021
in Risk Management Adviser
training
Communicate the revised Health and June 2021
policy to the manual Safety Risk
handling key trainers and Adviser
provide guidance/training
in use
Reference revised policy Moving & June 2021
in manual handling Handling Back
training Care Adviser

11. Links to Other Policies

 Risk Management Policy

 Manual Core Mandatory Training Policy
 Incident Reporting & Investigation Policy
 Medical Devices Management Policy

12. Contact Details

Title Name Phone Email

Moving & Handling Aileen 27 18737 [email protected]
Back Care Advisor Knowles
Health and Safety / Charlie 27 16208 [email protected]
Risk Adviser Stephenson

Occupational Health N/A 27 14737

Department,
Northern General
Hospital
PhysioMed N/A 0113 229 1300 https://www.physiomed.co.uk/

HR 051 Back Care and Manual Handling Policy V9 June 2021 10

13. References

 The Health and Safety at Work Act 1974

 HSE, INDG143 (rev3), Manual Handling at Work, A Brief Guide
 HSE, L21 Management of Health and Safety at Work Regulations 1999. Approved Code of
Practice and guidance
 HSE, L23 Manual Handling Operations Regulations 1992. Guidance on the regulation
 HSE, L24 Workplace (Health, Safety and Welfare) Regulations 1992. Approved Code of
Practice and Guidance
 HSE, L113 Lifting Operations and Lifting Equipment Regulations 1998. Approved code of
Practice and guidance
 HSE, Health Services Information Sheet No 4(rev1), How the Lifting Operations and Lifting
Equipment Regulations apply to health and social care
 NHS Employers website, Manual Handling Yorkshire Back Exchange, Hoisting Guidance
(2010)

HR 051 Back Care and Manual Handling Policy V9 June 2021 11

 Appendix A
Version Control and Amendment Log

Version Type of Change Date Description of change(s)

No.
1 Draft policy creation Sept 2016 New Policy format adopted and some
references to post of “Back Care Advisor”
deleted.
V8 Fourth Extension to review Oct 2020 People Committee agreed an extension to
date review date on 15/10/2020.

New Review Date = 31/05/2021.

V9 Final policy version May 2021 References to the Moving & Handling
Back Care Advisor inserted.

HR 051 Back Care and Manual Handling Policy V9 June 2021 12

 Appendix B
Dissemination Record

Version Date on website Date of “all SHSC Any other

(intranet and staff” email promotion/
internet) dissemination
(include dates)
V8 October 2016 October 2016
V9 July 2021 July 2021

HR 051 Back Care and Manual Handling Policy V9 June 2021 13

 Appendix C – Stage One Equality Impact Assessment Form

Equality Impact Assessment Process for Policies Developed Under the Policy on Policies

Stage 1 – Complete draft policy

Stage 2 – Relevance - Is the policy potentially relevant to equality i.e. will this policy potentially impact on staff, patients or the public? If NO – No further
action required – please sign and date the following statement. If YES – proceed to stage 3
This policy does not impact on staff, patients or the public (insert name and date) Yes
Stage 3 – Policy Screening - Public authorities are legally required to have ‘due regard’ to eliminating discrimination, advancing equal opportunity and
fostering good relations , in relation to people who share certain ‘protected characteristics’ and those that do not. The following table should be used to
consider this and inform changes to the policy (indicate yes/no/ don’t know and note reasons). Please see the SHSC Guidance on equality impact
assessment for examples and detailed advice this can be found at http://www.shsc.nhs.uk/about-us/equality--human-rights

Does any aspect of this policy Can equality of opportunity for Can this policy be amended so that it
actually or potentially discriminate this group be improved through works to enhance relations between
against this group? this policy or changes to this people in this group and people not
policy? in this group?
AGE No No
No Yes Amended to be specific about Disabled
DISABILITY
Staff
GENDER REASSIGNMENT No No
PREGNANCY AND No No
MATERNITY
RACE No No
RELIGION OR BELIEF No No
SEX No No
SEXUAL ORIENTATION No No

Stage 4 – Policy Revision - Make amendments to the policy or identify any remedial action required (action should be noted in the policy implementation
plan section)
Please delete as appropriate: Policy Amended / Action Identified / no changes made.

Impact assessment completed by - (insert name and date) C Stephenson. September 2016. Reviewed and updated May 2021 by Kate Scott & Anita Winter

HR 051 Back Care and Manual Handling Policy V9 June 2021 14

 Appendix D - Human Rights Act Assessment Form and Flowchart

You need to be confident that no aspect of this policy breaches a person’s Human Rights.
You can assume that if a policy is directly based on a law or national policy it will not
therefore breach Human Rights.

If the policy or any procedures in the policy, are based on a local decision which impact on
individuals, then you will need to make sure their human rights are not breached. To do this,
you will need to refer to the more detailed guidance that is available on the SHSC web site
http://www.justice.gov.uk/downloads/human-rights/act-studyguide.pdf
(relevant sections numbers are referenced in grey boxes on diagram) and work through the
flow chart on the next page.

1. Is your policy based on and in line with the current law (including case law) or
policy?

 Yes. No further action needed.

 No. Work through the flow diagram over the page and then answer questions 2
and 3 below.

2. On completion of flow diagram – is further action needed?

✓ No, no further action needed.

 Yes, go to question 3

3. Complete the table below to provide details of the actions required

Action required By what date Responsible Person

HR 051 Back Care and Manual Handling Policy V9 June 2021 15

 Appendix D - Human Rights Act Assessment Form and Flowchart

Human Rights Assessment Flow Chart

Complete text answers in boxes 1.1 – 1.3 and highlight your path through the
flowchart by filling the YES/NO boxes red (do this by clicking on the YES/NO text boxes
and then from the Format menu on the toolbar, choose ‘Format Text Box’ and choose red
from the Fill colour option).
Once the flowchart is completed, return to the previous page to complete the Human
Rights Act Assessment Form.

1.1 What is the policy/decision title? Back Care and Back Care & Manual Handling Policy
1
1
1.2 What is the objective of the policy/decision? To help reduce incidents of injury or ill health for SHSC staff

1.3 Who will be affected by the policy/decision? SHSC staff 1

Flowchart exit

Will the policy/decision engage There is no need to continue with this checklist.
anyone’s Convention rights? NO However,
2.1
Be alert to any possibility that your policy may
YES discriminate against anyone in the exercise of a
Convention right
Legal advice may still be necessary – if in any
Will the policy/decision result in the NO doubt, contact your lawyer
restriction of a right? Things may change, and you may need to
2.2
reassess the situation
YES

YES
Is the right an absolute right?
3.1

NO 4 The right is a qualified right

Is there a legal basis for the

Is the right a limited right? NO restriction? AND
3.2
Does the restriction have a legitimate
YES aim? AND
Is the restriction necessary in a
Will the right be limited only to the democratic society? AND
extent set out in the relevant YES
Are you sure you are not using a
Article of the Convention? 3.3 sledgehammer to crack a nut?
YES NO

Policy/decision is likely to be Policy/decision is not likely to be human rights

human rights compliant compliant please contact the Head of Patient
Experience, Inclusion and Diversity.
BUT

Access to legal advice MUST be

Get legal advice authorised by the relevant Executive
Regardless of the answers to these questions, once human Director or Associate Director for policies
rights are being interfered with in a restrictive manner you (this will usually be the Chief Nurse). For
should obtain legal advice. You should always seek legal further advice on access to legal advice,
advice if your policy is likely to discriminate against anyone in please contact the Complaints and
the exercise of a convention right. Litigation Lead.
HR 051 Back Care and Manual Handling Policy V9 June 2021 16
 Appendix E
Development, Consultation and Verification

Significant changes to the Policy

 The policy has been placed into the new format as set out in the Policy on Policies. The
policy has followed the appropriate Policy Consultation and Governance Process.

 Policy verified by the Trust Health and Safety Committee May 2021 and noted in the
minutes of that meeting.

 The policy has been revised to take into account the appointment of a Moving &
Handling Back Care Advisor.

HR 051 Back Care and Manual Handling Policy V9 June 2021 17

 Appendix F –Policies Checklist

Please use this as a checklist for policy completion. The style and format of policies
should follow the Policy Document Template which can be downloaded on the
intranet.

1. Cover sheet
All policies must have a cover sheet which includes:
 The Trust name and logo
 The title of the policy (in large font size as detailed in the template)
 Executive or Associate Director lead for the policy
 The policy author and lead
 The implementation lead (to receive feedback on the implementation)
 Date of initial draft policy
 Date of consultation
 Date of verification
 Date of ratification
 Date of issue
 Ratifying body
 Date for review
 Target audience
 Document type
 Document status
 Keywords
 Policy version and advice on availability and storage

2. Contents page

3. Flowchart N/A

4. Introduction

5. Scope

6. Definitions

7. Purpose

8. Duties

9. Process

10. Dissemination, storage and archiving (control)

11. Training and other resource implications

12. Audit, monitoring and review

This section should describe how the implementation and impact of the policy will be
monitored and audited and when it will be reviewed. It should include timescales
and frequency of audits. It must include the monitoring template as shown in the
policy template (example below).

HR 051 Back Care and Manual Handling Policy V9 June 2021 18

 Monitoring Compliance Template
Minimum Processfor Responsible Frequency Review of Responsible Responsible
Require- Monitoring Individual/ of Results Individual/group/ Individual/group/
ment group/ Monitoring process (e.g., committee for action committee for
committee whodoes plan development action plan
this?) monitoring and
implementation
Describe e.g. e.g. e.g. e.g. e.g. Education e.g. Quality
which Review, Education Annual Quality & Training Assurance
aspect audit & Assurance Steering Committee
this is Training Committee Group
monitoring Steering
Group

13. Implementation plan

14. Links to other policies (associated documents)

15. Contact details

16. References

17. Version control and amendment log (Appendix A)

18. Dissemination Record (Appendix B)

19. Equality Impact Assessment Form (Appendix C)

20. Human Rights Act Assessment Checklist (Appendix D)

21. Policy development and consultation process (Appendix E)

22. Policy Checklist (Appendix F)

HR 051 Back Care and Manual Handling Policy V9 June 2021 19

 Appendix G
Techniques to be used in the moving and handling of service users (PATIENTS),
including the use of appropriate equipment

General principles:

 Avoid if reasonable to do so.

 Encourage the service user to be as independent as possible.
 Assess what cannot be reasonably avoided.
 Keep your back as straight as possible, avoid combinations of bending and twisting the spine, 
keep close to the service user to avoid reaching.

Common Manual Techniques without the Use of Equipment:

1. Helping the Service User to Stand from a Sitting Position

 Stand as close as possible beside the service user facing forwards.

 Get the service user to place their feet beneath their knees.
 Support the service user across the back with the arm nearest to the service user and on the
front of the shoulder with the farthest arm.
 Encourage the service user to lean forwards from a sitting position into standing.
 Stay close to the service user throughout the procedure.

2. Supporting a Service User when Walking.

 Face forward positioned beside and behind the service user.

 Support the service user on the far hip and near shoulder similar to when standing the
Service user.
 Stay close to the service user.
 Watch for signs of fatigue and if present guide the service user to the safety of a chair.

3. Rolling a Service User on a Bed

 Adjust the bed to a suitable working height.

 Raise the cot side on the side to which the service user is being rolled, or position a
colleague to ‘receive’ the service user. Never roll a service user without some form of
barrier to prevent them falling off the bed.
 When rolling a patient from supine to the right; ask the service user to bend their left
knee keeping their left foot on the bed, to rotate their head to the right, to reach
across their body with their left hand and to move their right arm out of the way.
 Place your hands on the service users left thigh and left shoulder and gently roll
them onto their side.

NB: These are examples of common techniques only. This is neither a prescriptive nor an
exhaustive list. More often than not these techniques will have to be adapted to suit the
unique circumstances. In adapting the techniques the risk assessment is the principal
guidance.

Commonly Used Small Items of Equipment

 Slide sheet
 Transfer board
 Turning frame, e.g. Etac turner, Rotunda
 Rollator
 Grab rail
 Bed lever
HR 051 Back Care and Manual Handling Policy V9 June 2021 20
 Hoisting

There are many different hoists available. These can be categorised into 3 basic types:

1. Lifting hoists in which the service user is lifted completely, fully suspended by the
hoist.
2. Standing hoists in which the service user’s feet are supported on the hoist thereby
fixing them in a standing position.
3. Bath hoists which are specifically designed to transfer service users in and out of
baths.

Hoists can be electrically or manually powered, lifting hoists can be freestanding or use
ceiling tracks.

Hoisting Guidelines

The aim of these guidelines is to ensure safe hoisting in all service areas. A suitable and
sufficient written risk assessment must have been completed in accordance with the Manual
Handling Operations Regulations 1992 and an up to date handling care plan must be in
place.

The handling care plan should contain the risk reduction measures i.e. equipment,
techniques, number of handlers required etc. In addition to this pictures and line drawing can
be used as a visual aid.

These guidelines assume that the handler has received relevant and current moving and
handling training: they are not a substitute for training.

Safety checks prior to each use

Handlers must do an ‘on the spot’ risk assessment to check there is no significant change
from the handling care plan and do a visual check of all equipment prior to using it.

Prepare environment for hoisting, ensure there is sufficient space to use the hoist safely.

For hoists, ensure:

 Safe working load (SWL) of the hoist and is clearly displayed
 The hoist is fully charged and the battery fitted correctly
 There are no obvious signs of damage
 Any leads are connected correctly
 The emergency stop button is set correctly
 There are no fluid leaks
 The lifting tape is intact and not frayed (applies to ceiling track, certain mobile hoists)
 The castors are moving freely
 The base adjustment moves freely
 The raise/lowering mechanism works
 LOLER checks are in date (6-monthly safety check under the Lifting Operations and Lifting
Equipment Regulations 1992)

For the sling, ensure:

 It has been assessed for the client and is fit for purpose
 The sling is compatible with the person and the hoist
 All labels are legible and show SWL and unique identifier
 There are no signs of fraying, tears, excessive wear, etc.
 Any Velcro (if present) is secure
 Any buckle (if present) is secure
 The sling is clean
HR 051 Back Care and Manual Handling Policy V9 June 2021 21
  LOLER checks are in date

For the environment, ensure:
 There is sufficient space to use the hoist safely
 The floor is clear of obstacles
 There is sufficient access around and under furniture
 There is a suitable and safe area to store and charge (if applicable) the hoist
 The environment is prepared for the task

If a fault is identified with either the hoist or sling it should be immediately withdrawn from use
and reported in line with relevant policy.

General guidance - good practice for all hoisting tasks

 Do not use the equipment unless you have had the necessary training
 Read the handling care plan and ensure it is current and relevant
 Familiarise yourself with the hoists emergency lowering systems
 Communicate with all involved in the task at all times
 Ensure safety, dignity and comfort of person at all times
 Reassure and observe the service user at all times
 Never use the hoist as a threat
 Brakes must not be applied during the hoisting procedure
 Double check the sling attachments and the sling and person are in the correct position prior to
raising
 Apply sling first, bring hoist in last
 Ensure the support surface is ready to receive the person
 Hoist the person just above both support surfaces to obtain sufficient clearance
 Avoid using the hoist to transport over distances – hoist to transfer, not transport
 Place hoist on charge when not in use

Additional guidance for mobile hoists:

 Control the decent of the spreader bar and lower to the level of the person’s chest or
below for sling attachment
 Store in safe place with boom/jib in lowest position with brakes on when not in use

Additional guidance for ceiling track/overhead hoisting systems:

 The motor should be directly overhead, ensure the lifting tape is vertical to the lift to
avoid wear and tear and/or malfunction
 Elevate the spreader bar to its highest position when not in use
 Return the hoist to its docking station for charging when not in use
 Ensure the tracking is clear of obstructions

Additional guidance for standing hoists:

 The person must be able to consistently and reliably bear weight through their legs
and have sufficient upper body muscle strength
 The person must be able to physically participate in the hoisting process

Additional guidance for bath hoists:

 Ensure the environment is safe i.e. slippery, wet floors, ventilation, sufficient space,
etc.
 Do not leave the service user unattended

HR 051 Back Care and Manual Handling Policy V9 June 2021 22

 Flow Chart for Safe Use of Hoists and Slings

Have you had up to date

moving & handling
training, including hoist no
training?
Do not Start the
yes use task

Is there a current &

relevant handling care no
yes
plan?

yes Have you done the visual

checks?
 Clean and undamaged
Is the service user’s no  Label legible
condition the same as  SWL clearly displayed
when they were assessed no
 Unique identifier
for this transfer?
 LOLER compliant

yes
yes
Check
Are there sufficient staff with
available to safely perform
no
manager Suitable for specific
the task? no service user?
yes
yes
Are you trained on this
equipment? no
no Compatible with hoist?

yes

Environment
Sling

Do not
Is the environment safe? use yes
 Sufficient space
 No obstructions no
 Dry and clean Have you done the visual
 Suitable access checks?
no  Battery checks
 Obvious damage
yes
 LOLER checks
 Casters free moving
Hoist  SWL not exceeded

HR 051 Back Care and Manual Handling Policy V9 June 2021 23

 Appendix H
Techniques to be used in the moving and handling of inanimate loads (OBJECTS),
including the use of appropriate equipment.

Contains public sector information published by the Health and Safety Executive and
licensed under the Open Government License v1.0

Here are some practical tips, suitable for use in training people in safe manual handling:

 Think before lifting/handling. Plan the lift. Can handling aids be used? Where is the
load going to be placed? Will help be needed with the load? Remove obstructions such
as discarded wrapping materials. For a long lift, consider resting the load midway on a
table orbench to change grip.

 Adopt a stable position. The feet should be apart with one leg slightly forward to
maintainbalance (alongside the load, if it is on the ground). The worker should be
prepared to movetheir feet during the lift to maintain their stability. Avoid tight clothing
or unsuitable footwear,which may make this difficult.

 Get a good hold. Where possible, the load should be hugged as close as possible to
thebody. This may be better than gripping it tightly with hands only.

 Start in a good posture. At the start of the lift, slight bending of the back, hips and
knees ispreferable to fully flexing the back (stooping) or fully flexing the hips and knees
(squatting).

 Don’t bend the back any further while lifting. This can happen if the legs begin to
straighten before starting to raise the load

 Keep the load close to the waist. Keep the load close to the body for as long as
possiblewhile lifting. Keep the heaviest side of the load next to the body. If a close
approach to the load is not possible, try to slide it towards the body before attempting
to lift it.

 Avoid twisting the back or leaning sideways, especially while the back is bent.
Shouldersshould be kept level and facing in the same direction as the hips. Turning by
moving the feetis better than twisting and lifting at the same time.

 Keep the head up when handling. Look ahead, not down at the load, once it has been
held securely.

 Move smoothly. The load should not be jerked or snatched as this can make it
harder tokeep control and can increase the risk of injury.

 Do not lift or handle more than can be easily managed. There is a difference between
whatpeople can lift and what they can safely lift. If in doubt, seek advice or get help.

 Put down, then adjust. If precise positioning of the load is necessary, put it down first
thenslide it into the desired position.

Good Handling Technique for Pushing and Pulling

Here are some practical points to remember when loads are pushed or pulled:

 Handling devices - Aids such as barrows and trolleys should have handle heights that
are between the shoulder and waist. Devices should be well maintained with wheels that
run smoothly. The law requires that equipment is maintained. When you buy new trolleys
HR 051 Back Care and Manual Handling Policy V9 June 2021 24
 etc., make sure they are good quality with large diameter wheels made of suitable
material and with castors, bearings etc. which will last with minimum maintenance.
Consulting your employees and safety representatives will help, as they know what works
and what doesn’t.

 Force - As a rough guide the amount of force that needs to be applied to move a load
over aflat, level surface using a well-maintained handling aid is at least 2% of the load
weight. For example, if the load weight is 400 kg, then the force needed to move the load
is 8 kg. The force needed will be larger, perhaps a lot larger, if conditions are not perfect
(e.g. wheels notin the right position or a device that is poorly maintained). The operator
should try to push rather than pull when moving a load, provided they can see over it and
control steering and stopping.

 Slopes - Employees should get help from another worker whenever necessary, if they
haveto negotiate a slope or ramp, as pushing and pulling forces can be very high. For
example, ifa load of 400 kg is moved up a slope of 1 in 12 (about 5°), the required force
is over 30 kg even in ideal conditions – good wheels and a smooth slope. This is above
the guideline weight for men and well above the guideline weight for women.

 Uneven surfaces - Moving an object over soft or uneven surfaces requires higher forces.
Onan uneven surface, the force needed to start the load moving could increase to 10% of
the load weight, although this might be offset to some extent by using larger wheels. Soft
ground may be even worse.

 Stance and pace - To make it easier to push or pull, employees should keep their feet
wellaway from the load and go no faster than walking speed. This will stop them
becoming too tired too quickly.

How do I know if there’s a risk of injury?

It’s a matter of judgement in each case, but there are certain things to look out for, such as
people puffing and sweating, excessive fatigue, bad posture, cramped work areas, awkward
or heavy loads or people with a history of back trouble. Operators can often highlight which
activities are unpopular, difficult or hard work.

It is difficult to be precise - so many factors vary between jobs, workplaces and people. But
the general risk assessment guidelines in the next section should help you identify when you
need to do a more detailed risk assessment.

HR 051 Back Care and Manual Handling Policy V9 June 2021 25

 Appendix I
Manual Handling Assessment Form (MH1)

For inanimate load handling

Use separate patient handling form (MH 3) for named patient handling assessment.

Description of activity being assessed

Where does this activity take place?

Why can’t this activity be avoided?

Who is at risk from this activity?

Yes No Sometimes
Does the activity involve?
Holding loads away from trunk?
Twisting?
Stooping?
Reaching upwards?
Long carrying distances?
Strenuous pushing or pulling?
Repetitive handling?
Insufficient rest or recovery time?
Does the activity:
Require unusual physical capability?
Present a hazard those with a health problem?
Present a hazard to those who are pregnant?
Call for special information/training?
Is the load:
Heavy?
Bulky or unwieldy?
Difficult to grip?
Unstable or unpredictable?
Intrinsically harmful (e.g. sharp/hot/infection risk)?
Does the working environment have?
Constraints on posture?
Variations in levels?
Poor floors?
Poor lighting conditions?
Infection control hazards that affect the manual handling?

HR 051 Back Care and Manual Handling Policy V9 June 2021 26

 Manual Handling Assessment Form (MH1) (page 2)

Frequency of activity
How often does this activity take place during a single working shift? seldom regularly often
How many staff undertake the activity? minority some most

What are the current control measures?

With these controls in place Unacceptable Acceptable but Adequately

the risk is (tick one box) needs further controlled
control
Red Amber Green

List the further control measures required:

Control measure Responsibility Date completed

1.

2.

3.

4.

5.

Directorate Provider Standards & Public Corporate

(circle one box) Services Engagement Health Performance Services Strategy Finance

Assessment completed by: Date:

Job role: Service:

Review date for assessment: Signed:

HR 051 Back Care and Manual Handling Policy V9 June 2021 27

 Appendix J - Patient handling assessment form (MH3)

Patient handling assessment form (MH3)

To be completed for all patients with moving and handling needs.
This assessment is part of the formal patient record/car plan.

Patient name: Date of birth NHS no:

Weight (enter known date or estimate) Weight: kg Light Medium Heavy

Height (enter known height or estimate) Height: m. Short Medium Tall

Bed type/mattress (tick box) Height Airflow Other (specify):

Bed location: Double Single adjustable Profiling Moveable mattress

Falls risk (tick box) Low Medium High

Pain:

Skin lesion:

Problems with comprehension/understanding:

Problems with behaviour/understanding/anxiety:

Environment:

Cultural/belief considerations:

HR 051 Back Care and Manual Handling Policy V9 June 2021 28

 Patient handling assessment from (MH3)

Patient name: Date of birth NHS no:

Code I: independent S: Supervision A1: Assistance of 1 A2: Assistance of 2 U: Unable N/A: Not applicable
Activity Code Equipment How to assist
Walking.
full-partial-touch-non-
weight bearing (circle)
Stairs

Standing from sitting

Sitting balance

In/out of bed

Turning in bed

Moving up bed

On/off commode or toilet

Help with urinal

Help with slipper/bed pan

Dressing/undressing
Washing/grooming
Other:
Other:
Other:

HR 051 Back Care and Manual Handling Policy June 2021 29