Work Place Near Misses
"Near Misses" in the work place can be a scary thought. But this should not be the case. They should be looked upon as a lesson from which we can learn.
Using foresight can prevent many accidents in the work place. The use of risk assessments is the most common way of stopping future accidents.
But risk assessments don't see every possible accident, and day in day out, there are "Near Misses", which under different circumstances could have resulted in an accident actually occurring.
That is why we have created a "Near Miss" report to assist you in seeing, reporting and adjusting your work practices to help those "Near Misses" turn into Missed by Miles
The idea is for your staff, who also have an obligation under the health and safety at work act, to act responsibly and help you highlight and solve possible problems.
The "Near Miss" report can also be used as Accident Report or Property Damage Report facilitating many of your daily health and safety documents needs all in one.
Please remember that to ensure the "Near Miss" report is used correctly by your staff, it needs to be used as a benefit. This is why, if the member of staff wishes to, he/she can remain anonymous.
Handling Your Handling Needs
|Date Of The Incident|
|Time Of The Incident|
|Department Where Incident Occurred|
|Place Where Incident Occurred|
|Who Was Involved? (Optional)|
|What, If Any, Damage Was Caused Or Could Have Been Caused?|
|What Happened That Was Dangerous Or Could Have Been Dangerous?|
|What Could Have Been The Outcome Of The Incident?|
|What Stopped The Incident Becoming An Accident?|
|Suggest, In Your Opinion, The Corrective Measures That Could Be Taken|
|Please List Witnesses (With Consent Only)|
|Completed By. (Optional)|
Please Retain A Copy Of This Report As Health & Safety is Everybody's Responsibility.
To be completed by department heads/supervisors
Please consider the following when completing this form, and attach where possible, any witness statements, and a copy of the original "Near Miss Report"
1 Names of substances involved
2 The roles played by other employees
3 Any Machinery Involved
4 The Events that led to the incident
5 Had instruction been given for the task
6 Were these known to and understood by the personnel
7 The training & experience of the personnel
8 Is there a risk assessment for this task
9 Had the correct equipment been issued
10 Had the equipment been used correctly
11 The environmental condition (heat, cold etc.)
|Describe The Incident|
|List Any Actions Taken|
|List Any Further Corrective Action Needed, And To Whom This Has Been Recommended|
|Near Miss Report Attached||Witness Statements Attached|
|Risk Assessment Attached||Copy Retained|
|Copy To Relevant Manager/Director||Copy To H&S Officer|
|Investigating department head/supervisors signature|
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Tel: 01803 814522 | Fax: 01803 814533 | email: email@example.com
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