HSE spot check inspections and COVID-19: what to look out for

To ensure safe working in relation to COVID-19, the Health and Safety Executive (HSE) has undertaken a number of spot checks on hospitals. Here, we provide an overview for healthcare providers on the process and focus of such inspections, findings on past inspections and the consequences of any deemed failings.

With the UK Government publishing it’s ‘Living with COVID’ strategy on 21 February 2022, “removing domestic restrictions while encouraging safer behaviours through public health advice”, we anticipate that the HSE will be focusing more on mainstream occupational safety investigations, as opposed to COVID-19 inspections. However, with the government’s plan also observing that “emergence of new variants will be a significant factor in determining the future path of the virus”, hospitals will inevitably still want to ensure that they are continuing to take appropriate steps to protect patients and staff.

When will HSE visit for a spot check COVID-19 inspection?

The HSE can make unannounced visits. They undertook a number of inspections in the winter of 2021 when the risks were greater, as this was pre-vaccination programme taking effect. Much can be gleaned from the outcome of these inspections.

Where do HSE visit and who attends?

Last winter, these inspections took place at a total of 17 acute hospitals, in 13 NHS Trusts in England and two NHS Healthcare Boards in Scotland and Wales.

The note published following these inspections suggests that they were undertaken by a single inspector.

What is the focus of such an inspection?

COVID-19 safety measures primarily. Past inspections have focused on risk assessment, major arrangements specific to COVID, social distancing, cleaning and hygiene measures, ventilation, dealing with specific cases and PPE.

What has been found on past inspections?

  • Risk assessment: Good evidence of training being put in place, with support from the health and safety team and reviews undertaken by relevant senior leaders and frontline staff. However, need for greater consistency across different areas was identified.
  • Major arrangements specific to COVID-19: Impressive high level leadership seen, via Gold (Strategic) and Silver (Tactical) commands, with frequent leadership meetings and briefings provided to staff. Such nationally recognised tiered command and control structures having become commonplace. Engagement with front line staff positively commented on. Although greater need to challenge staff behaviour and need for improved monitoring was isolated.    
  • Social distancing: Secure one-way systems, separate entrances and exits and hand sanitiser found. However, difficulties with occupancy numbers and limited changing facilities were encountered. 
  • Cleaning and hygiene measures: Additional cleaning machines had assisted, with dedicated cleaning teams and auditing being reported. Although scope for more comprehensive cleaning schedules so as to limit risk of missing areas identified.    
  • Ventilation: Checking of ventilation, including velocity, dilution and dwell times found to be good. Although better integration with risk assessment required and not all opportunities for open doors and windows were being taken. 
  • Dealing with specific cases: Well established systems for attending to staff was encountered. 
  • PPE: Testing of close fitting FFP3 respirators was being performed by those trained to do so and PPE stocks were in good supply with separate donning and doffing areas having been created. It was observed however that records were not always readily available and a buddy/mirror not always in place for purposes of fit check. 

What are the consequences of falling foul of the inspector?

Notification of Contravention letters were sent following the winter visits. This was a stronger measure than offering verbal or written advice. However, such letters do fall below the issuing of an Improvement Notice or Prohibition Notice. 

At its most severe, HSE could prosecute for breach of health and safety laws.

A Notice of Contravention informs the organisation about health and safety laws that have been broken and explains how they have been broken and what needs to be done to rectify. Having issued such a Notice, HSE are then entitled to their costs of the visit. An Improvement Notice allows for 21 days to make specific changes. Failing which a criminal offence is committed.

A Prohibition Notice would mean there is an immediate risk of serious personal injury and orders activities to cease pending elements being made safe. Prosecution for breaking health and safety laws or for failing to comply with an Improvement Notice or Prohibition Notice would result in a fine or, in some cases, custodial sentence. 

What about other transgressions? 

Reassuringly, HSE have confirmed that they are not looking for any other workplace transgressions whilst they are undertaking COVID-19 spot checks. However, in the event there is significant transgression, then the inspector has a duty to act. We would expect a verbal warning or Improvement Notice in such circumstances, allowing time for the transgression to be rectified.

Is there an appeal process?

It is possible to challenge an HSE decision. In the first instance, we would recommend making formal representations to the inspector, or their manager or, failing that, the HSE Chief Executive. HSE support such an approach being taken. HSE may then reconsider its decision.

If above fails, contact should be with either the Independent Regulatory Challenge Panel or the Parliamentary and Health Service Ombudsman.  

Read other items in Healthcare Brief - May 2022

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