|This is the statement of general policy and arrangements for: |      (Name of company) |

|      |has overall and final responsibility for health and safety |

|(Name of Employer/Senior manager) | |

|      |has day-to-day responsibility for ensuring this policy is put into practice |

|(Member of staff) | |

|Statement of general policy |Responsibility of: Name/Title |Action/Arrangements (What are you going to do?) |

|Prevent accidents and cases of work-related ill health by managing the health and |      |      |

|safety risks in the workplace | | |

|Provide clear instructions and information, and adequate training, to ensure |      |      |

|employees are competent to do their work | | |

|Engage and consult with employees on day-to-day health and safety conditions |      |      |

|Implement emergency procedures – evacuation in case of fire or other significant |      |      |

|incident. You can find help with your fire risk assessment at: | | |

| | | |

|Maintain safe and healthy working conditions, provide and maintain plant, equipment |      |      |

|and machinery, and ensure safe storage/use of substances | | |

|Signed: * (Employer) |      |Date: |      |

You should review your policy if you think it might no longer be valid, eg if circumstances change.

If you have fewer than five employees, you don’t have to write down your policy.

|Health and safety law poster is displayed at (location) |      |

|First-aid box is located: |      |

|Accident book is located: |      |

Accidents and ill health at work reported under RIDDOR (Reporting of Injuries, Diseases and Dangerous Occurrences Regulations)

To get an interactive version of this template go to

Combined risk assessment and policy template published by the Health and Safety Executive 08/14

All employers must conduct a risk assessment. If you have fewer than five employees you don't have to write anything down.

We have started off the risk assessment for you by including a sample entry for a common hazard to illustrate what is expected (the sample entry is taken from an office-based business). Look at how this might apply to your business, continue by identifying the hazards that are the real priorities in your case and complete the table to suit. You can print and save this template so you can easily review and update the information as and when required. You may find our example risk assessments a useful guide ( Simply choose the example closest to your business.

Company name:       Date of risk assessment:      

What are the hazards?

|Who might be harmed and how?

|What are you already doing?

|Do you need to do anything else to control this risk?

|Action by who?

|Action by when?


| |Slips and trips |Staff and visitors may be injured if they trip over objects or slip on spillages. |General good housekeeping is carried out.

All areas well lit, including stairs.

No trailing leads or cables.

Staff keep work areas clear, eg no boxes

left in walkways, deliveries stored immediately. |Better housekeeping in staff kitchen

needed, eg on spills.

Arrange for loose carpet tile on second floor to be repaired/replaced.

|All staff, supervisor to monitor


|From now on




| |     

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|      |      |      |      |      |      | |     

|      |      |      |      |      |      | |

| | | | | |*Hint, tab here for new row* | |

You should review your risk assessment if you think it might no longer be valid (eg following an accident in the workplace or if there are any significant changes to hazards, such as new work equipment or work activities)

For information specific to your industry please go to

For further information and to view our example risk assessments go to


Combined risk assessment and policy template published by the Health and Safety Executive 08/14



Health and safety policy

Risk assessment