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Dangerous incident reporting (Accident or Near Miss)

Reporting a Dangerous Occurrence (Accident or Near Miss)

Definitions:

Dangerous Occurrence

An unexpected event occurring during normal activity that falls under the following headings.

Accident

An unplanned event which causes injury to persons, damage to property or a contribution of both.

Near Miss

An event not causing harm, but has the potential to cause material damage, injury or ill health.

Procedure:

In the event of a dangerous occurrence the Part A of the reporting form should be completed. This allows the occurrence to be investigated and any necessary changes made to codes of practice, instructions or equipment.  If possible, identify any witnesses to the occurrence to help the Health and Safety committee during their review.

Clicking on SUBMIT REPORT will send the report automatically to incident@marconi-sc.org.uk

Any Dangerous Occurrence will be reviewed by the Health and Safety Committee at the following committee meeting.  The Committee will decide upon any additional actions to be taken and will complete Part B of the form and disseminate any requirements or follow-up actions that are required.

The person submitting Part A of the form will be kept informed of progress by the H & S Committee.

    Part A    Click applicable box for either reporting an Accident or Near Miss

    An unplanned event which causes injury to persons, damage to property or a contribution of both

    An event not causing harm, but has the potential to cause material damage, injury or ill health

    Injured Party Details

    Name:

    Address:

    Location, time and date of occurrence

    Location:

    Date:*

    Time:

    Details of occurrence

    Details of any injury and treatment provided (if applicable)

    Witnesses

    Name:

    Address:

    Name:

    Address:

    Person completing the report

    Name:*

    Email:*

    Address:

     

    Part B    Health and Safety Committee review

    Details of any actions planned or taken to prevent re-occurrence

    Is there a risk assessment covering this occurrence?  

    Reference Number:

    Were codes of practice followed?   

    Review Date:

    Signature of Health and Safety Officer: