First Aid on Construction Sites: What the Law Requires

Every construction site in Great Britain needs, at the very least, a first aid box stocked for the number of workers, a person appointed to take charge of first aid, and clear information telling workers who that person is and where to find them. Because construction counts as higher-hazard work in HSE's guidance, any site with 5 or more workers also needs trained first aiders, and sites with more than 50 need at least one First Aid at Work first aider for every 50 workers. Those are minimums for any one time, so shifts, holidays and trades coming and going usually push the real number higher.

The duty comes from the Health and Safety (First-Aid) Regulations 1981, the same law that covers every workplace. What changes on a building site is the level of risk, the number of employers sharing the space and, often, the distance to the nearest hospital.

The minimum on every site

HSE's construction guidance lists three things every site must have:

1. A first aid box with enough equipment for the number of workers on site
2. An appointed person to take charge of the first aid arrangements, look after the equipment and call the emergency services
3. Information for workers on who the appointed person or first aider is and where to find them. HSE suggests a notice in the site hut.

An appointed person is not a first aider and does not need first aid training. On all but the smallest sites, they are a fallback rather than the plan.

How many first aiders a site needs

HSE's suggested numbers for higher-hazard workplaces, which include construction:

Workers on site at the same time	Suggested minimum
Fewer than 5	At least one appointed person
5 to 50	At least one first aider trained in Emergency First Aid at Work or First Aid at Work, depending on the injuries that could occur
More than 50	At least one First Aid at Work first aider for every 50 workers, or part of 50

A site with 120 operatives at peak needs at least three First Aid at Work first aiders on site at that time. If the site runs early and late shifts, each shift needs its own cover, and someone has to cover holidays and sickness. Our free first aid needs calculator works through shifts, floors or zones, and absences to give a realistic number.

Why construction usually means First Aid at Work

The one-day Emergency First Aid at Work course covers the emergencies: CPR and defibrillator use, choking, serious bleeding, shock and minor injuries. The three-day First Aid at Work course adds the injuries a building site is most likely to produce:

• fractures, dislocations and sprains from falls and dropped loads
• head and spinal injuries, including protecting the casualty until help arrives
• chest injuries
• serious burns and scalds, from hot works, bitumen or electrical faults
• eye injuries from dust, grit and chemical splashes
• poisoning from substances on site

That is why HSE's guidance points higher-hazard sites with more than 50 workers to First Aid at Work, and why most contractors choose it for smaller sites too. Our guide to Emergency First Aid at Work or First Aid at Work compares the two in detail.

Shared sites, subcontractors and agency workers

Most sites have several employers working side by side. Each is responsible for its own workers, but HSE's guidance allows one employer to provide first aid cover for everyone, provided that:

• all the employers agree the arrangement
• there is a full exchange of information about the hazards, so the shared cover is adequate
• workers are told who to go to
• the arrangement is written down, which HSE strongly recommends to avoid misunderstandings

On projects with more than one contractor, CDM 2015 makes the principal contractor responsible for planning and coordinating the construction phase, so the construction phase plan is the natural place to settle who provides first aid. Where an employment business supplies workers, it should agree with the site employer that those workers have access to first aid.

Remote sites and large sites

Where a site is far from emergency medical services, HSE's guidance asks employers to:

• arrange suitable transport to hospital in case an ambulance is delayed
• check the first aid kit is adequate for a longer wait
• tell the emergency services in writing where the site is, how to reach it and any particular hazards

HSE's guidance also says a first aid room will usually be necessary on large construction sites, clearly signed with white lettering or symbols on a green background and with someone responsible for it. Our guide to first aid room requirements covers what goes in one.

Kits and extra training

For kit contents, most sites use the British Standard, BS 8599-1. For higher-hazard workplaces it suggests a small kit for fewer than 5 people, a medium kit for 5 to 25, and one large kit for every 25 people above that. Our first aid kit checklist works out the sizes and gives you a printable contents list and inspection log. Workers who travel between sites or work alone should carry a personal or travelling kit.

HSE's guidance also lists construction among the sectors where first aiders may need training beyond the standard course in managing life-threatening bleeding, using haemostatic dressings, wound packing and tourniquets. Your needs assessment decides whether that applies to your site.

A quick site checklist

• First aid box stocked for the current headcount, checked weekly on busy sites
• First aiders' names and locations on a notice in the welfare cabin and in the induction
• Cover agreed in writing with other contractors on the site
• Enough trained first aiders for every shift, plus holiday and sickness cover
• Certificates in date (they last three years; check with our certificate expiry checker)
• Directions for the emergency services, including the site access point
• Accidents recorded, and reportable ones reported under RIDDOR

Train your site team on site

We deliver First Aid at Work for construction teams at your site, welfare cabin or office, for up to 12 people per session, at one fixed, all-inclusive price. Tell us about your site hazards when you book and we will build the practical scenarios around them. Emergency First Aid at Work suits smaller or lower-risk teams.

This article is general guidance, not legal advice. Request a free quote and we will confirm within 24 hours.