1. GWASANAETHAU IECHYD A DIOGELWCH / HEALTH AND SAFETY SERVICES HOW TO COMPLETE AN ACCIDENT & INCIDENT FORM Essential elements of an Accident & Incident Form

2. Why report? All accidents and incidents that occur at the University or whilst on University led activities, whether there is an injury or not, must be: recorded on a University Accident & Incident Form. This can be done by the person directly involved in the accident, or someone on their behalf eg Line Manager, Tutor the completed Accident Form then handed to your local contact (eg. Head of School) and a copy sent to Health and Safety Services investigated to a level appropriate to the seriousness or potential seriousness of the event For the more serious accidents Health and safety Services should be informed as soon as possible. By doing the above you can help establish the cause of the accident / incident, preventing it from happening again GWASANAETHAU IECHYD A DIOGELWCH / HEALTH AND SAFETY SERVICES

3. The Accident & Incident Form Unfortunately a number of old forms are still in circulation. The correct version, which includes an accident / incident investigation section can be found at: Accident & Incident Form GWASANAETHAU IECHYD A DIOGELWCH / HEALTH AND SAFETY SERVICES

4. Completing the Accident & Incident Form The 1 st page deals with general details of the person involved in the accident and the accident location GWASANAETHAU IECHYD A DIOGELWCH / HEALTH AND SAFETY SERVICES Part A: Deals with personal details of the person involved in the accident. It is important you give the person’s exact name and which School etc they work or study for. In addition, include the person’s job title, or if a student their level of study ie MSc and their course title. The address should be where the person resides whilst at the University. If you are reporting a near miss please enter N/A. Part B: Requires specific accident details. It is important you give the correct date and time (making it clear if it was am or pm). Precise location details are also essential so the area can be checked if necessary. Just putting a building name will not help - give the exact room / corridor location or a good description of the area eg steps to Deiniol Rd side of Thoday (closest to Memorial Arch).

5. Completing the Accident & Incident Form This page requires information on the injury itself and how the injury (accident / incident) occurred GWASANAETHAU IECHYD A DIOGELWCH / HEALTH AND SAFETY SERVICES Part C: Provide as many details about the injury as possible and which part of the body was affected. Remember to include left and right if applicable. Please take care when ticking the boxes as the incorrect information could lead to the HSE being informed unnecessarily. Where the accident involved no injury tick ‘None of the Above’. NOTE: Remember to provide details of the total number of days you were off work. Include the dates as well. Part D: Asks for information on what caused the accident. If you don’t feel the boxes fit the cause, tick the box which fits the closest and add a note.

6. Completing the Accident & Incident Form GWASANAETHAU IECHYD A DIOGELWCH / HEALTH AND SAFETY SERVICES Part E: Outline how the accident happened, remembering to include relevant contributory factors. For example don’t just put the person tripped and fell, consider: Environment eg weather conditions if outside, lighting Floor surface condition eg damaged, wet & slippery The person’s own footwear What they were doing at the time The person’s behaviour ie distracted, rushing Impact of others eg knocked into, tripped over trailing cable Part F: Provide details of the person who has completed the Form and who will be able to answer further, general queries about the accident if necessary. NOTE: Remember to provide information if First Aid was administered or the person had to visit their GP or go to hospital. In addition, detail the action, including interim actions that were / will be taken to prevent a repeat of the accident / incident. For example, rubbish cleared, flooring taped and reported to Estates for repair, slippery floor signs displayed when being cleaned.

7. Completing the Accident & Incident Form GWASANAETHAU IECHYD A DIOGELWCH / HEALTH AND SAFETY SERVICES The investigation process is important in preventing a re-occurrence of the accident / incident. However, remember the amount of time and resources spent on the investigation should reflect the seriousness / potential seriousness of the accident / incident In most cases a few simple actions, which can often be taken immediately will be sufficient. Contact Health and Safety Services if you are unsure about what action you should take Part G: This section is essentially a summary of the information already provided but broken down into specific headings. The headings on the next page are very important as they require information on what caused the accident / incident and what action is required to stop it happening again. NOTE: Further information on how to carry out an accident investigation can be found on the HSS Website: Information Sheet OHSU P16 – 2 Accident and Incident Investigation

8. Completing the Accident & Incident Form GWASANAETHAU IECHYD A DIOGELWCH / HEALTH AND SAFETY SERVICES Part G: When considering what action will be taken, don’t forget to consider: The scene – environment, time, housekeeping, weather, lighting etc The equipment, materials and activity – consider the nature of the activity and any equipment materials used People – did the injured person and others involved have the necessary experience and capability to undertake the task Management Controls – are safety procedures in place eg risk assessments, policies, supervision levels? Are these used and do people know about them eg signs, posters, handbooks

9. GWASANAETHAU IECHYD A DIOGELWCH / HEALTH AND SAFETY SERVICES Always send a copy of the Accident & Incident Form to: Health and Safety Services, Penbre, College Road Or email a copy of the Form to: healthandsafety@bangor.ac.uk But remember