First aid on site means having the equipment, facilities and trained people in place to give immediate help to anyone who is injured or taken ill at work, until professional medical help arrives. Under the Health and Safety (First-Aid) Regulations 1981, employers must provide adequate and appropriate first-aid arrangements, and what counts as adequate depends on the risks on the site. This guide explains the duties, the difference between a first aider and an appointed person, and how provision is decided.
Key takeaways
- Employers must provide adequate and appropriate first-aid equipment, facilities and people for their workers.
- What is adequate depends on the risks of the work and the site, so it comes from an assessment of first-aid needs, not a fixed formula.
- A first aider holds a recognised first-aid qualification, whereas an appointed person takes charge when someone is injured or ill and looks after the equipment.
- An appointed person should not attempt first aid they have not been trained to give.
- On construction sites, the high-risk nature of the work means first-aid provision needs particular care (general knowledge).
- First-aid arrangements should be explained at induction, so everyone knows where help is and how to get it.
What the law requires
The Health and Safety (First-Aid) Regulations 1981, regulation 3(1), require equipment and facilities for first aid to employees who are hurt or become ill. The Health and Safety (First-Aid) Regulations 1981 require employers to provide adequate and appropriate equipment, facilities and personnel. The regulations apply to all workplaces, including construction sites. They do not ask for a particular number of people or items. Instead, the amount and type of provision must match the needs of the workplace.
For self-employed workers, the duty is to provide first aid for themselves, so check the HSE page if you work for yourself. On a shared construction site, it is common for the principal contractor to arrange site-wide cover and for other contractors to rely on it, and that arrangement should be agreed and communicated rather than assumed. Where you are unsure how the duties are split, ask the site manager and check the HSE guidance.
First-aid needs assessment
The key idea in the HSE guidance is that employers carry out an assessment of first-aid needs. This is not a separate system from the risk assessment, but follows from it. On a construction site, the questions normally include:
- What are the hazards on this site and how likely and how serious are the injuries or illnesses they could cause?
- How many people are working here, and does this change as the project goes on?
- Are there people with particular needs, for example workers with health conditions, young workers, or members of the public who could visit?
- How far is the site from emergency medical services, and how easy is it to get an ambulance to the work area?
- Are there lone workers, shift patterns or out-of-hours working that mean help is not always close by?
- Are different parts of the site far apart, or on different levels, so that one point of first aid is not enough?
- What injuries are most likely, such as cuts, burns, eye injuries, falls or crush injuries, and what equipment do they need?
The answers decide what to provide, and the assessment should be reviewed as the site changes. A site that adds new hazards, a larger workforce or a remote work area may need more.
First aider or appointed person
These two roles are often confused, and the difference is a common exam point.
| Role | What they do | Key point |
|---|---|---|
| First aider | Gives first aid, using a recognised first-aid qualification | Trained and holds a valid certificate |
| Appointed person | Takes charge when someone is injured or ill, including calling the emergency services, and looks after the first-aid equipment and facilities | Not necessarily trained in first aid, and should not give first aid they have not been trained for |
As general practice, where the assessment shows it is needed, a first aider should be provided. In lower-risk situations, an appointed person may be enough (regulation 3(2) to (4) of the 1981 Regulations covers appointed persons). For most construction work, the risks of the job and the possible severity of injuries mean the assessment is likely to call for trained first aiders, but the assessment of the particular site decides. HSE's page on first aid at work gives the full guidance, including training and how to choose a provider.
Equipment and facilities
First-aid provision includes more than people. The assessment should consider:
- First-aid containers. Suitably stocked and marked, kept where they can be reached quickly, and checked regularly so that items are in date and replaced after use.
- Where it is kept. On a larger site, containers may be needed in more than one place, including in site vehicles or at remote work areas.
- Facilities. Some workplaces need a first-aid room, depending on the assessment. Washing facilities and clean water for treating minor injuries are part of the picture too, which links to site welfare facilities.
- Information. Everyone on site should know who the first aiders or appointed persons are, where the first-aid kit is and how to get help. This is normally covered at induction and by notices on site.
The stock of a first-aid container should reflect the assessment. Do not assume that a standard box is enough for every site. Check the HSE page for the details on what to keep, and do not add medicines to a kit unless the guidance allows it.
What to do if someone is hurt
The exact steps depend on your training and on the site's emergency arrangements, which you should learn at induction. As a general guide:
- Make sure the area is safe for you and for others, and do not become a second casualty.
- Raise the alarm and get the trained first aider or the appointed person to the scene.
- Call the emergency services if the injury is serious, or if you are in any doubt.
- Give only the help you are trained to give.
- Keep the person warm and as calm as possible, and stay with them.
- Make sure someone meets the ambulance and guides it to the right place.
- Tell your supervisor, and make sure the incident is recorded.
Afterwards, the incident may need to be reported to HSE as well as recorded internally. See RIDDOR reporting on site for which injuries and events must be reported and who does it. Recording and reporting help the site learn from what went wrong.
Common mistakes
- Assuming first aid is someone else's job. Everyone should know how to raise the alarm and who to call.
- Confusing the appointed person with a first aider. An appointed person is not a replacement for a trained first aider where the assessment calls for one.
- Using a fixed formula. The right provision is set by the assessment of the site, not by a rule of thumb.
- Letting stock run out. An empty or out-of-date kit does not meet the duty.
- Forgetting out-of-hours and remote work. Provision needs to cover the times and places where people are actually working.
- Not telling new starters. If workers do not know where help is, the provision cannot do its job.
Practice check
These are original questions for revision. They are not official CITB questions and a score here is not an official result. This site is independent and is not affiliated with CSCS or CITB.
Question 1. What is the main role of an appointed person?
- A. To give advanced medical treatment
- B. To take charge when someone is injured or ill, including calling the emergency services, and to look after first-aid equipment
- C. To replace the need for any first-aid kit
- D. To decide who is at fault for the accident
Answer: B. An appointed person takes charge in an emergency and looks after the equipment. They are not automatically trained to give first aid.
Question 2. What should decide how much first-aid provision a site has?
- A. A standard number used on every site
- B. The cheapest option available
- C. An assessment of first-aid needs based on the site's risks
- D. Whatever the previous site had
Answer: C. Provision must be adequate and appropriate, which means it comes from an assessment of the needs of the particular site.
For more practice, try the free practice questions.
FAQ
What is the difference between a first aider and an appointed person?
A first aider has a recognised first-aid qualification and can give first aid. An appointed person takes charge when someone is injured or ill, calls the emergency services and looks after the first-aid equipment, but should not give first aid they have not been trained to give.
How many first aiders does a construction site need?
There is no single answer to quote. The number depends on the assessment of first-aid needs, which considers the risks, the size and layout of the site and how many people are working there. The HSE first aid at work page explains how to make that assessment, and your site manager will know the arrangements for your site.
Who is responsible for first aid on a construction site?
Employers must provide first aid for their workers, and self-employed people must provide for themselves. On a multi-contractor site, the principal contractor usually arranges shared cover, which should be agreed and communicated to everyone. If you are unsure, ask the site manager.
Do I have to report every injury to HSE?
No. Many minor injuries only need to be recorded on site. Some serious injuries and events must be reported under RIDDOR, so check RIDDOR reporting on site and the HSE page.
Sources
- HSE: First aid at work
- HSE: Construction
- Legislation.gov.uk: Health and Safety (First-Aid) Regulations 1981
Independent guide, not affiliated with, authorised by, approved by or endorsed by CSCS or CITB. Last updated 2026-10-08.