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Moving and
handling
Basic back
care
APRIL 08
AR/AD Apr08
Aims and outcomes
AIM
 To give you the skills and knowledge to
provide safe and effective care in line with
Trust Policy, legislation and current best
practice
OUTCOMES
 To understand how moving and handling
impacts on you and your practice
 To understand employers and employees
responsibilities in line with Trust policies
and legislation
 To understand structure and function of the
spine, causes and prevention of injury
 To demonstrate awareness of correct
posture and practical application of this in
load handling
 To develop the ability to risk assess and
relate it to working practice
 Demonstrate ability to carry out appropriate
load handling techniques and follow the
principles of safer moving and handling
AR/AD Apr08
Back facts
It is estimated that 4 out of 5 adults (80%) will have
back pain at some stage in their lives (Pain 2000)
The NHS spends more than £1 billion on back pain
related costs
£512 million on hospital costs
£141 million on GP consultations
£150.6 million on physiotherapy
(Pain 2000)
5million working days lost in 2003/2004 due to back
pain. On any one day 1% of the population in the UK
were on sick leave due to a back problem (HSE
2005)
The number of people with back pain increases with
advancing age, starting in school children and
peaking in adults 35 to 55 years of age. Back pain is
just as common in adolescents as it is in adults
(Eur Spine J 2006)
Back pain is the number 2 reason for long term
sickness in the UK (DWP 2002)
AR/AD Apr08
Definition of moving
and handling
Manual handling
‘Any transporting or supporting of a load including the lifting,
putting down, pushing, pulling, carrying or moving thereof by
hand or bodily force’ (MHOR, 1992)
Role of the adviser also considers
• The way we sit, stand, work, move
• Storage
• Design of workplace and workstation
• The purchase and hire of appropriate equipment
AR/AD Apr08
Effects of poor moving
and handling
Replacing
staff
Financial loss
to employer
Lost hours
Financial loss
to injured
person
Psych.
effects on
Client
EFFECTS
Family life
litigation
Reputation
of
employer
Physical
effect
on Client
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Benefits of safer moving
and handling
BENEFITS
TO STAFF
• makes the job
easier
• reduces accidents
• reduces physical
injury
• reduces sick leave
• avoids financial loss
• complies with policy
TO
ORGANISATION
• reduces
accidents
• reduces injuries
• complies with law
• avoids litigation
• financial savings
• protects
reputation
• improves staffing
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TO CLIENT
• reduces
accidents
• reduces injuries
• increases
confidence
• reduces anxiety
Legislation
AR/AD Apr08
Legislation
Legal requirements

Health & Safety at Work Act 1974

Management of the Health & Safety at Work Regulations 1999

Manual Handling Operations Regulations 1992

Workplace (Health, Safety & Welfare) Regulations 1992

Reporting of Injuries, Diseases and Dangerous Occurrences
Regulations 1995 (RIDDOR 1995)

Provision & Use of Work Equipment Regulations 1998 (PUWER)

Lifting Operations & Lifting Equipment Regulations 1998 (LOLER)

Human Rights Act 1998

Health & Safety (Display Screen Equipment) Regulations 1992
AR/AD Apr08
Health and Safety at Work
Act 1974
Employers’ duties
Employees’ duties
Section 2 imposes a duty on every
employer to ensure so far as is
reasonably practicable, the health,
safety and welfare at work of all it’s
employees. The scope of the duty
for manual handling includes:
Under section 7 the employee
is under a corresponding duty
to:
Provision and maintenance of
plant work systems that are safe
and without health risks
 Arrangements for ensuring safety
and absence of health risks in the
use, handling, storage and
transport of articles and
substances
 Provision of information,
instruction, training and supervision
necessary to ensure health and
safety.
 to have a written policy detailing
health and safety measures and to
have it communicated to
employees

Take reasonable care of
his/her own health and safety
and the health and safety of
other people affected by
his/her acts or omissions.
 Co-operate with the
employer in performing the
duties under the Act

AR/AD Apr08
Manual handling operations
regulations 1992
Employers’ duties
Employees’ duties
Regulation 4 (1) (a) - Each
employer shall, so far as
reasonably practicable, AVOID
the need for its employees to
under take any manual handling
operations at work which involve
a risk of injury.
Reg 4 (1) (b) (i) – When it is not
reasonably practicable to avoid
manual handling a suitable and
sufficient ASSESSment of the
task should be made including,
task, individual capability, load
and environment.
(ii) Appropriate steps should be
taken to REDUCE the risks if
hazards are found.
(iii) Provide employees with
details of the weight and the
heaviest side of the load.
Reg (2) REASSESSment as
required

To make full and proper use of any
system of work provided
 to inform the employer of any
physical condition suffered which
could affect one’s ability to undertake
manual handling operations safely
AR/AD Apr08
Risk
assessment
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MHOR(92)– Requirements for
risk assessment
AVOID
ASSESS
REASSESS
REDUCE
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Risk assessment factors
There are four factors to be
considered in all handling
assessments
TASK
ENVIRONMENT
INDIVIDUAL
CAPABILITY
LOAD
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Risk factors
Task
Individual
• load held away from trunk
• twisting/bending/stretching/stooping
• excessive lifting/lowering/carrying
• excessive pushing/pulling
• sudden movement
• frequent or prolonged handling
• handling whilst seated
• team handling
• unusual strength/capability
needed
• specialist knowledge/training
needed
• pose risk to staff who are
pregnant/in poor health
AR/AD Apr08
Risk factors
Load
Environment
• heavy
• bulky
• unwieldy
• difficult to grasp
• potentially dangerous
• awkward
• large
• space constraints
• uneven/unstable floors
• slipping/tripping hazards
• extremes of temperature
• poor lighting
• obstacles
AR/AD Apr08
Structure
and
function of
the spine
AR/AD Apr08
Structure of the spine
The spine is made up of 33
bones or VERTEBRAE.
Each pair of adjacent
vertebrae are connected at
the rear by a FACET JOINT.
Each vertebrae is separated
by a pad of cartilage called a
DISC. Discs are made up of
an outer layer of fibrous
material called the
ANNULUS and an inner gel
like substance called the
NUCLEUS. They only have a
minimal nerve & blood
supply.
LIGAMENTS hold the bones
together & MUSCLES control
movement.
AR/AD Apr08
Key structures and their function
MUSCLES AND
LIGAMENTS
DISCS
Act as spacers between
vertebrae.
Help to hold bones
together.
Act as shock absorbers
Support bodies of
vertebrae.
Control & guide
movement.
VERTEBRAE
FACET JOINTS
Provide central support
for skeleton.
Control and limit range
of movement between
each pair of vertebrae
Largest bones at base to
support body weight
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Potential damage to key
structures of the spine
Prolapsed disc




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Often referred to as
‘slipped disc’
Cumulative in nature –
sometimes over a
number of years
Repeated stresses to
the outer layer of the
disc due to poor posture
eg. bending, twisting,
stretching, stooping – or
a combination of these.
Nucleus can bulge or
rupture through the
outer layer of the disc,
causing stimulation of
the surrounding nerve
and subsequent pain.
Potential damage to key
structures of the spine
VERTEBRAE AND
JOINTS
NERVES
Usually fractures due to
direct trauma or pathological
or age related conditions.
Spinal cord damage due
to trauma or nerve root
irritation.
MUSCLES
LIGAMENTS
Sprains and strains due
to over stretching
of tired muscles. Poor or
static postures
contribute to this.
Can be torn due to
trauma or over
stretching. Pregnancy
hormones can cause
weakening of ligaments
AR/AD Apr08
Contributory factors to back
pain and injury
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Poor posture – twisting, bending, stretching, stooping,
reaching or a combination of these
Unaccustomed work/ work that is heavier or more difficult
than usual
Exceeding own capabilities
Physical illness/ unfit for work
Fatigue/ emotional stress/ tense, rigid movements
Previous injury or trauma
Cumulative stress
Repetitive stress
Lack of training/ knowledge/ information/
equipment/ resources
Psychological attitudes
Inappropriate practice/ clothing/ footwear
Static posture/ progressing from static to activity
Lack of communication
Environmental factors
Ageing process/ pregnancy/ congenital factors
AR/AD Apr08
Principles
of safer
moving and
handling
AR/AD Apr08
Principles of safer moving
and handling
• Is it necessary? Can it be avoided?
• Assess and reduce risk.
• Select method, plan and prepare.
• Keep spine in line.
• Keep load close to body.
• Get a good grip.
• Establish a wide base for stability. Keep one foot in front of the
other if possible.
• Get help if needed.
• Bend at the hips and knees, keep head upright.
• Avoid stooping, twisting, bending, stretching and prolonged
holds.
•Wear appropriate clothing and footwear.
•Know your own capacity and don’t exceed.
• Use clear, precise instructions. Use ‘ready, steady, go’.
• Use clear communication to client and colleagues.
• Follow safety procedures relevant to the task and if in doubt seek
guidance.
• Follow policies.
• Inform your manager of pregnancy or ill health.
• Follow manufacturers guidance when using equipment.
AR/AD Apr08
Contact
details
AR/AD Apr08
Who to contact for moving and
handling advice
Ann Drinkwater
Education Centre
Fieldhead
Wakefield
WF1 3SP
01924 328617
07789710420
Alison Roper
Yearn 2 Learn
St Luke’s hospital
Huddersfield
HD4 5RQ
01484 343995
07881 785183
AR/AD Apr08