Critical Incident Report Form

Critical Incident Report Form Template for England and Wales

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Key Requirements PROMPT example:

I need a Critical Incident Report Form for our manufacturing facility that specifically addresses machinery malfunctions and includes detailed sections for equipment inspection history, with extra focus on RIDDOR compliance as we've had several reportable incidents in the past month.

Document background

The Critical Incident Report Form is a crucial document required under English and Welsh law for documenting and investigating significant events that may impact safety, operations, or compliance. This form is essential for organizations to maintain accurate records of incidents, comply with regulatory requirements, and implement preventive measures. It should be completed as soon as possible after an incident occurs, typically within 24 hours, and must include detailed information about the event, parties involved, immediate actions taken, and recommended follow-up measures. The form helps organizations meet their obligations under various regulations, including RIDDOR 2013 and the Health and Safety at Work Act 1974.

Suggested Sections

1. Incident Details: Date, time, location, and type of incident, including incident reference number

2. Persons Involved: Details of affected individuals, witnesses, and reporting person, including contact information and roles

3. Incident Description: Detailed narrative of what occurred, including sequence of events and immediate impact

4. Immediate Actions Taken: Response measures implemented immediately after incident, including emergency responses and notifications made

5. Risk Assessment: Evaluation of incident severity, potential consequences, and likelihood of recurrence

Optional Sections

1. Medical Information: Details of injuries sustained, first aid administered, and any subsequent medical treatment

2. Equipment Involved: Details of any equipment or machinery involved, including maintenance records and safety checks

3. Environmental Impact: Assessment of environmental consequences and any remedial actions required

4. Financial Impact: Assessment of any financial losses or costs associated with the incident

5. Security Implications: Analysis of any security breaches or vulnerabilities exposed by the incident

Suggested Schedules

1. Witness Statements: Formal written statements from all witnesses to the incident

2. Photographic Evidence: Photos, videos, or other visual documentation of the incident scene and any damage

3. Risk Assessment Forms: Completed risk assessment documentation and safety analysis forms

4. Medical Reports: Relevant medical documentation, certificates, and treatment records

5. Investigation Findings: Detailed findings from any internal or external investigations conducted

Authors

Alex Denne

Head of Growth (Open Source Law) @ ��ֱ�� | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Healthcare
Manufacturing
Education
Construction
Retail

Relevant Teams

Health and Safety
Human Resources
Operations
Legal
Quality Assurance

Relevant Roles

Health and Safety Manager
Department Supervisor
Risk Manager
Compliance Officer
Operations Manager

Industries

Health and Safety at Work etc. Act 1974: Primary legislation governing workplace health and safety in England and Wales. Sets out general duties employers have towards employees and members of the public.

Management of Health and Safety at Work Regulations 1999: Details specific risk assessment requirements and management procedures for workplace safety incidents.

RIDDOR 2013: Reporting of Injuries, Diseases and Dangerous Occurrences Regulations - specifies mandatory incident reporting requirements to the Health and Safety Executive.

UK General Data Protection Regulation (UK GDPR): Post-Brexit data protection regulation governing how personal information must be handled, including incident reports containing personal data.

Data Protection Act 2018: UK's implementation of data protection standards, working alongside UK GDPR to regulate personal data processing and protection.

Privacy and Electronic Communications Regulations (PECR): Specific rules about privacy and electronic communications, relevant when incident reports are transmitted electronically.

Health and Social Care Act 2008 Regulations: Regulated Activities Regulations 2014 - Specific requirements for health and social care providers regarding incident reporting and management.

Care Standards Act 2000: Legislation setting standards for care homes and care services, including requirements for incident reporting and documentation.

Education and Skills Act 2008: Relevant for incident reporting in educational settings, including specific requirements for safeguarding incidents.

Financial Services and Markets Act 2000: Governs incident reporting requirements in financial services sector, including mandatory reporting of certain types of incidents.

Employment Rights Act 1996: Relevant for incidents involving employees, including protection for whistleblowers and employee rights during incident investigations.

Equality Act 2010: Must be considered when handling incidents involving discrimination or harassment, ensuring equal treatment in incident reporting and investigation.

Public Records Act 1958: Governs record-keeping requirements for public sector organizations, including retention of incident reports.

Limitation Act 1980: Sets statutory time limits for legal actions, influencing how long incident reports must be retained.

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Let's create your Critical Incident Report Form

Authors

Alex Denne

Find the exact document you need

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