Employee Incident Report Form Template for England and Wales

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Key Requirements PROMPT example:

Employee Incident Report Form

"I need an Employee Incident Report Form for a manufacturing company with 500+ employees, compliant with RIDDOR regulations, that includes specific sections for machinery-related incidents and chemical exposure documentation."

Document background
The Employee Incident Report Form is a crucial document required under English and Welsh law for recording and reporting workplace incidents. It serves as an essential tool for compliance with health and safety regulations, including RIDDOR 2013 and the Health and Safety at Work Act 1974. The form should be completed promptly following any workplace accident, injury, near-miss, or dangerous occurrence. It captures vital information needed for internal investigation, regulatory reporting, and implementing preventive measures to avoid future incidents.
Suggested Sections

1. Incident Details: Date, time, location, and type of incident

2. Personal Information: Details of affected employee(s) and witnesses

3. Incident Description: Detailed account of what happened

4. Immediate Actions Taken: Response measures and first aid provided

5. Reporter Information: Details of person completing the report

Optional Sections

1. RIDDOR Reporting Section: Additional section for incidents that meet RIDDOR reporting criteria requiring HSE notification

2. Medical Assessment: Section for recording details of medical examination or treatment when medical attention was required

3. Equipment Involved: Section for documenting details of any machinery or equipment involved in the incident

Suggested Schedules

1. Witness Statements: Additional detailed accounts from witnesses

2. Photographs/Evidence: Visual documentation of incident scene or injuries

3. Risk Assessment Review: Updated risk assessment following incident

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant Industries
Relevant Teams
Relevant Roles
Industries

Health and Safety at Work etc. Act 1974: Primary legislation governing workplace health and safety in England and Wales. Establishes general duties for employers to ensure employee safety and sets requirements for reporting and recording incidents.

RIDDOR 2013: The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 specifies which incidents must be reported to the Health and Safety Executive (HSE), defines reportable incidents and timeframes, and sets out record-keeping requirements.

Management of Health and Safety at Work Regulations 1999: Establishes requirements for risk assessment, incident investigation and prevention measures in the workplace.

Data Protection Act 2018 and UK GDPR: Governs personal data handling requirements, storage and processing of sensitive health information, data subject rights, and retention periods for incident records.

Equality Act 2010: Ensures non-discrimination in incident reporting, consideration of reasonable adjustments, and protection against victimization.

Social Security (Claims and Payments) Regulations 1979: Sets requirements for accident book records and documentation needed for potential compensation claims.

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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