50 years of the Health and Safety at Work Act

Over the past five decades, the health and safety at work act has played a pivotal role in shaping workplace practices and standards.  

Before the health and safety at work act was enacted, workplace deaths and injuries were significant from nearly 168,000 casualties in 1958 to just under 323,000 in 1969 (IOSH 2016). There was no consistent health and safety legislation or inspectorate that covered all workplaces.  

In 1970, Labour’s employment secretary Barbara Castle appointed a committee to take a broad look at health and safety at work. The Robens Committee produced its report in 1972, finding the system unfit for purpose. Its recommendations formed the bedrock of the 1974 health and safety at work act, introduced under a Conservative administration and passed by a Labour government. 

The Act introduced a unified regulator – the Health and Safety Executive (HSE).  There were two more major changes introduced. Coverage was extended to include virtually every worker, bringing some five million additional people under its remit. While previously health and safety had largely been the domain of industrial workplaces, an employer’s duties were also extended to consider the public.

During the months of October and November, we are asking RCN health and safety reps to get active and use their role to inspect their workplaces.  If you are an RCN health and safety rep visit our Reps Hub to find out more. If you are not an RCN health and safety rep you can find out more about the role by visiting our get involved page

The RCN has a long history of campaigning for improvements in health and safety for our members and this timeline highlights key laws introduced over the decades alongside RCN activity to improve health and safety standards for our members.

Explore real-world examples of how RCN members are making a difference across various workplaces, with stories highlighting their impact on staff wellbeing, patient safety, and workplace improvements.

An RCN member for around 13 years, Clinical Practice Educator Lauren Reid became a Health and Safety Rep at Ashford and St Peter’s Hospitals NHS Foundation Trust in Surrey in 2022. Since then, Lauren, who qualified as a nurse in 2015, has worked tirelessly to raise the profile of this key role, working in partnership to accomplish an impressive – and growing – list of achievements.

Lauren's account

I’ve always been interested in health and safety, following in the footsteps of my grandad, who was a health and safety manager, and my dad who was involved in it too. I know some people think it’s box-ticking and boring, but for me, it’s always been incredibly important. Just because something hasn’t happened yet, doesn’t mean it won’t. You must prepare to make sure it never does.

Before I took on the role, there hadn’t been an RCN health and safety rep at the Trust for a while and there’s still just me, so there’s a lot to tackle. From the time I started, I began to develop a good relationship with the Trust’s health and safety manager, Mark Ball, and by working in partnership together, we’ve been able to achieve a lot in a fairly short space of time. We meet regularly, sometimes two or three times a month, and I don’t think I could have achieved as much without his input, as we’ve done everything together.

One of the first issues I took on was improving safety for patients and staff outside one of our buildings, with a new ‘Give way’ sign, which ensures drivers stop and check whether anyone is crossing, preventing collisions. While there had never been an accident, I felt it was a risk we could avoid. At the outset, when I raised it I wondered whether anything would be done, but it was agreed immediately, which made me happy.

Another important issue has been reviewing how we store compressed oxygen gas, which was highlighted when I did a walkabout with our health and safety manager. Afterwards we made certain that cylinders were stored behind locked doors, with the right insulation, appropriate labelling and away from alcohol gel. This makes sure we’re complying with complex regulations, increasing everyone’s safety.

Staff are now starting to bring issues to me. In one example, a receptionist smelt gas and I could smell it too. I escalated our concerns and an investigation showed there was a leak, which was dealt with. I feel I was able to be her voice, making sure her concerns were heard and acted upon.

Although we’re making a difference, I still feel there’s a lot more to do. For instance, I attended Congress this year, where corridor care was a big issue. That’s now on my agenda. Working with the health and safety manager, we’ve been checking fire doors, with our informal inspections allowing us to identify any issues.

I’m also working on providing more fire warden training, now we’ve identified the members of nursing staff who need it. Another issue is looking at staff wellbeing, exploring ways we can help. Health and safety isn’t just about all the things you can see, but supporting people to live the lives they want, whilst working.

I feel I’m the eyes and ears at ground level, as I’m walking around the hospitals every day, so I can identify issues that may otherwise have gone unnoticed. But alongside spotting problems, I also need to come up with solutions too.

Rather than viewing health and safety as a tedious task and a nuisance, I think my role is to educate people about why it’s so important, reminding them they have legal responsibilities and can be held to account as individuals, alongside organisations. Ultimately health and safety is there to protect everyone – both patients and staff.

Donato Tallo, RCN Senior Officer

Our health and safety reps do a lot of work that makes a huge difference to people’s lives, but often it happens behind the scenes, so they don’t always get the recognition they deserve. Lauren has been doing some incredible work that really highlights the contribution health and safety reps are making, raising their profile. She’s championed lots of quick wins and often it’s the smaller things that can have a big impact on people’s lives.

Before Lauren stepped up, the Trust had no health and safety reps at all and hadn’t done for some time. Sadly, we’re aware that many staff feel afraid to speak up about issues, so having someone they know, who they feel safe talking to, can make all the difference.

Initially we had to break down barriers to make sure Lauren had a seat at the table. There was a lack of understanding about her role and how she might improve things for everyone. Lauren has added a questioning voice, holding people to account and behaving as a critical friend. Working in partnership has been essential to her success. Now attitudes have changed completely and there’s widespread appreciation of her achievements.

Mark Ball, Interim Assistant Director of Facilities Support Services

As the Trust’s Health and Safety Lead, it’s been my great pleasure to work with Lauren. Her enthusiasm and determination to make improvements has helped push through some real changes, in the wards and beyond.

We’ve worked together on a number of targeted walkabouts, changing our colleagues’ understanding of the risks in their areas - whether safe storage of compressed oxygen, fire safety, or good practice in signposting hazards. Lauren has also contributed significantly to various Trust committee meetings on fire, health and safety, and medical gases, giving practical advice. I look forward to continuing our work together.

Bill and Scott (names have been changed to protect identities) have been RCN health and safety reps for several years, supporting staff at an NHS Foundation Trust in England. When a complex situation arose, which was seriously impacting members’ health and wellbeing, they worked closely with RCN officers, both locally and nationally, to find solutions.

Bill's account

A 10-storey hospital block was being re-cladded, but unfortunately this exacerbated existing difficulties for staff working on the building’s top floor. The consensus is that the cranes used in the building work disturbed the roof. During a storm, around a quarter of the ceiling was affected, with some coming down, and water coming in, affecting work stations below. These leaks continued every time it rained.

But as we began to uncover, this was just the latest in a long line of problems. As the windows were old, metal-framed and single-glazed, the whole floor was either freezing or boiling hot, depending on the season. In the winter, staff were bringing in their own heaters because they were so cold.

There had also been a lot of staff sickness, which we felt was related to the poor working environment, with some experiencing respiratory problems, including chest infections, persistent colds and worsened asthma. Several staff had been subjected to sickness absence reviews and we sought help from our local RCN officers in these cases. Following their representations, the trust has now agreed to cancel anything that may be related to these environmental factors.

Since Scott wrote a detailed report, things are beginning to improve and staff are feeling better. I think they felt a little ignored and that they had to just get on with it, no matter how bad things had become. Now work has happened to repair the roof and stop the water ingress, and the ceiling has been repaired. Funding has also been agreed to upgrade the windows, and there are air conditioning units and dehumidifiers. There’s still more to be done, but there is definite progress.

Scott's account

After Bill told me what was happening, we decided I should carry out a full workplace inspection with the Trust, including their risk manager and estate staff. 

We discovered there were a lot more issues than water coming through the ceiling, many of which were long-standing. These included the fluctuating temperatures; windows that didn’t shut properly which allowed bird faeces to come into the building; and some windows that were unsafe. There was also spaghetti wiring underneath desks, which is a trip hazard. All in all, it was a very unpleasant place for staff to work.  

After highlighting all these issues, we said remedies needed to be put in place as a matter of urgency, and we agreed an action plan. This included repairing or replacing the windows, with recommendations for cooling and heating the office in summer and winter.

First and foremost I’m a nurse, not a health and safety inspector, so the expert guidance I received from the RCN’s national officer to carry out the inspection and write the report was invaluable. They pointed me in the direction of specific things I should look out for, the kinds of follow-up questions I should ask, and the legislation that would support us.

Generally, we have a very good relationship with the Trust and they have responded in a helpful way.

Nicola Browning, RCN Regional Officer

As local RCN officers, we represented two members who were being taken through a sickness absence process by the Trust. The members also told us of other staff whose health was being adversely affected by damp. Clearly there was an impact on people’s emotional wellbeing and mental health too, including those with underlying health conditions, who were having to work in these difficult circumstances, day in, day out.

Once we delved into the details, we found water had been coming into their office following building work. I did a site visit too and it was obvious that there were some significant health and safety concerns, including a persistent smell of damp, loose windows that were mouldy, cabling trip hazards and poor heating.

Working with the health and safety reps on site, who were extremely dedicated and thorough, and with expert input from the RCN’s national officers, we managed to get these proceedings cancelled and start the ball rolling on the necessary work to improve life for everyone. For the staff working there, our involvement has already made a big difference.

Andrew Christaki, RCN Senior Officer

After we’d highlighted all of these issues to the Trust’s executive team and they had the full picture, they took things seriously, were very responsive and concerned in the wellbeing of their staff.

The RCN’s approach is always to try and find practical solutions, rather than pursuing unnecessary grievances. By working in partnership, we were able to help the organisation create a more active risk register, which benefits both staff and the Trust. We also have an agreement that if things deteriorate, the Trust will consider moving staff elsewhere or allowing them to work from home, which is reassuring.

Louise Church, RCN Health, Safety and Wellbeing National Officer

Our role has been to provide technical knowledge and expertise that supports both the local officers and our health and safety reps on the ground. From my side, I was able to support our health and safety reps with advice on completing the investigation, alongside more specific health and safety issues and legislation.  I also worked with the reps and officers to frame some follow-up questions and discussed expectations for action by the employer.

There has been some significant movement on these serious issues, and it is a great example of how workplace inspections and the power of legislation can influence real and beneficial changes for our members. Now I’m very much looking forward to more progress over the coming weeks and months.

Kim Sunley, RCN Head of Health, Safety and Wellbeing

This is a great example of the vital role RCN health and safety reps play in preventing work-related ill health.  Not only will these actions lead to an improved working environment for our members, they will also benefit the employer and ultimately patients, in terms of keeping nursing staff well and at work. 

Which resources helped guide the RCN’s response?

The RCN Reps hub, health, safety and wellbeing page has briefings on key topics and templates for workplace inspections.

The Health and Safety Executive (HSE) has guidance on inspections of the workplace, including forms, guidance on good practice, and a case study.

The HSE also has free guidance for managers on the workplace health, safety and welfare regulations.