• Eight English trusts and three Welsh health boards among those breaching health and safety law
  • Issues raised include protecting staff from violence and aggression, asbestos control and handling of sharp instruments
  • Further 18 providers broke health and safety law but were not issued enforcement notices

NHS providers were given 40 official warnings because regulators believed they were failing to protect staff from violence, injury and hazardous substances in the past two years, HSJ can reveal. 

The Health and Safety Executive issued 38 improvement or prohibition notices in 2018-19 and 2019-20 to providers in England and Wales, which were breaking health and safety laws. 

HSE found providers had failed to follow laws aimed at protecting staff from issues such as violence and aggression, injuries from manual handling, asbestos and hazardous substances.

Eight English trusts and three Welsh health boards received the notices — which either set deadlines for improvements or outlined activity which should be banned — during the time period.

HSJ reported last month that around two-thirds of NHS providers inspected by HSE since April 2018 – 21 of 38 providers inspected – were found to be breaking laws aimed at protecting staff from violence and aggression.

Through a freedom of information request, HSJ  has obtained details of the health and safety law breaches which HSE deemed serious enough to warrant enforcement notices. The full list is below.

A further 18 providers in England and Scotland were also found to have broken the law in the period but were not served enforcement notices from HSE.

Welsh health boards Abertawe Bro Morgannwg University Health Board and Hywel Dda UHB had the most enforcement notices in the period, with nine and eight respectively.

Mental health trust Hertfordshire Partnership University Foundation Trust received four improvement notices in 2019-20 — the highest number received by any English trust. HSE told the trust it was breaking the law in relation to violence and aggression risk assessments and investigation arrangements, as well as manual handling.

Meanwhile, two prohibition notices were served to United Lincolnshire Hospitals FT in 2019-20 relating to asbestos. The trust noted in board papers last Decemberthe presence of asbestos was limiting maintenance works at Lincoln County Hospital, and some areas of the trust were sealed off due to the issue.

HSE declined to provide precise reasons beyond a general description of the notice as to why each provider had broken the law, citing an exemption in the FOI act for information held about certain investigations or proceedings.

However, Leeds Community Healthcare FT, which was found to be breaking the law on violence and aggression and manual handling but did not receive an enforcement notice, published its notice of contravention from the HSE in its board papers in December.

HSJ approached all providers which received enforcement notices from HSE for comment.

Providers which received enforcement notices


Countess of Chester Hospital FT

Improvement notices: Two for violence and aggression policies, one for manual handling. The notices related to caring for people with dementia. 

The trust said the inspectors have since signed off the notices.

Bradford District Care FT 

Improvement notices: One for violence and aggression policies.

North Middlesex University Hospital Trust 

Improvement notices: One for the control of hazardous substances.

The trust said the notice related to risks of contact dermatitis — a type of eczema — among theatre staff due to their need to frequently wash their hands, use cleansers and skin scrubs, rubber gloves and sanitisers and detergents. It said it has provided evidence to HSE it is reducing this risk.

Hertfordshire Partnership University FT

Improvement notices: Two for violence and aggression policies, risk assessments and accident investigation arrangements, two for manual handling.

The trust said it has made “some immediate changes” and an action plan is in place.

East and North Hertfordshire Trust

Improvement notices: One for exposure to blood-borne viruses and to sharp instruments in healthcare, one for manual handling, and one for violence and aggression policies.

The trust said it is on track to be compliant by the end of April for violence and aggression and sharps, and by end of July for moving and handling.

United Lincolnshire Hospitals Trust

Improvement notices: One for asbestos in confined spaces.

Prohibition notices: One for asbestos in confined spaces, one for asbestos management.

The trust said the prohibition notices referred to how the maintenance team work in confined spaces in subways below its hospitals in areas not accessible to the public. It added it had provided training and equipment to ensure staff are safe.

Midlands Partnership FT

Improvement notices: Two for violence and aggression policies, one for manual handling.

The trust said it has taken action on the issues, such as training staff in de-escalation, management and intervention, and it was confident no one is at risk of harm. 

Hywel Dda UHB

Improvement notices: Two for violence and aggression policies, four for manual handling, one for incident reporting arrangements and one for sharp instruments in healthcare.

The health board said it has developed an action plan to address the issues, which includes a training programme around challenging behaviours for clinical staff, improvements to manual handling procedures for moving medical records and laundry, and trialling lone working devices such as body-worn video equipment.


Bedford Hospital Trust

Improvement notices: One for manual handling.

The trust said the notice has now been removed after training sessions across the hospital were improved. 

Powys Health Board

Improvement notices: Two for legionella.

Abertawe Bro Morgannwg UHB

Improvement notices: Nine for a range of violence and aggression and manual handling breaches.

The health board said it had been informed by HSE it has complied fully with all the notices.


Providers where a breach of the law was found, but no enforcement notice was issued

The HSE said the following providers breached health and safety law but were not given enforcement notices. The breaches included issues such as manual handling, lifting equipment, reporting of injuries, diseases and dangerous occurrences, fire precautions, hazardous substances, confined spaces and control of asbestos. HSE did not specify which breaches had happened at specific providers.


Leeds Community Healthcare Trust

Central and North West London FT

North West Anglia FT

East Sussex Healthcare Trust

Leicestershire Partnership Trust

Birmingham Community Healthcare Trust

Cornwall Partnership FT

Salisbury FT


NHS Lanarkshire

Sheffield Health and Social Care Partnership FT

Leeds and York Partnership FT

Gateshead Health FT

Camden and Islington FT

St George’s University Hospitals FT

Cambridge and Peterborough FT

Kent and Medway NHS and Social Care Partnership Trust

Avon and Wiltshire Mental Health Partnership Trust

Royal Cornwall Hospitals Trust


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