The British Healthcare Trades Association (BHTA) and Driving Mobility have published interim guidance for BHTA members about the UK Government’s spring 2024 update called ‘Using mobility scooters and powered wheelchairs’.
This interim guidance has been published by the BHTA and Driving Mobility following a notable (and somewhat confusing) update to the government document around “not in a class” mobility scooters and powerchairs.
“Not in a class” mobility scooters and powerchairs are a new class of mobility vehicle that was introduced in the government’s spring 2024 update. This new class has raised a lot of questions and concerns by BHTA members.
BHTA and Driving Mobility’s interim guidance is designed to help member companies understand the latest government update and outline clearly what the new ‘not in a class’ classification means.
This is followed by a series of questions (as identified by the by BHTA, Driving Mobility, and several member companies) that seek clarification from the government following its most recent update to ‘Using mobility scooters and powered wheelchairs’. The guidance will be updated in due course as the BHTA and Driving Mobility seek answers from relevant government stakeholders.
Download the BHTA guidance document in full here.
Written by experts from the BHTA First Aid Medical Equipment (FAME) and Defibrillator Section.
Download the BHTA guidance document as a PDF here.
Written by experts from the BHTA Beds and Support Surfaces and Pressure Care and Seating Sections.
The ISO 20342 series of standards covers various aspects of safety, performance, and technical information relating to mattresses and related products, products described in the standards as “Assistive Products for Tissue Integrity” or “APTIs”. Part 1 of the series covers General Requirements, and these are applicable to all APTIs. The information set out within the general requirements standard is intended to help ensure the safety of users.
The devices covered by this standard include all pressure redistributing mattresses and overlays manufactured using a range of materials including foam, gel, air, and foam in combination with air (i.e. hybrid mattresses). Products within the scope of this standard also include all reactive (non-powered) and active (powered) mattresses and overlays. This standard does NOT include wheelchair cushions.
Aspects relating directly towards the clinical efficacy of a product (and therefore the safety-related properties in prevention or management of pressure injuries, for example) are not addressed in this standard, but are topics covered by tests prescribed in other parts of the ISO 20342 series.
The aim of this article is to give the reader a feel as to why they should be aware of the standard’s content and provide an overview of what the standard covers in depth, and therefore its importance in the design, selection, and use of an APTI.
BS EN ISO 20342-1 is the first mattress and related device international safety standard. It sets the minimum threshold a device should reach in order to protect the safety of users.
BS EN ISO 20342-1 covers the key safety elements from an APTI-specific standpoint. These include management of potential hazards and addresses specific areas of mechanical, electrical, and materials safety. Table 1 contains a summary of the areas covered by the standard.
| Clause | Content |
|---|---|
| 4. General requirements and safety | 4.1 General; 4.2 Intended use; 4.3 Risk management; 4.4 Usability; 4.5 Design controls; 4.6 Clinical evaluation; 4.7 Foreseeable misuse; 4.8 Test conditions; 4.9 Lifting and carrying means |
| 5. Safety requirements | 5.1 Information supplied by the manufacturer; 5.2 APTI that can be dismantled; 5.3 Resistance to corrosion; 5.4 Noise and vibration; 5.5 Sound audible acoustic energy; 5.6 Default indicators; 5.7 Feedback |
| 6. Flammability | 6.1 General; 6.2 Flammability; 6.3 Moulded parts used as enclosures for electrical equipment |
| 7. Mechanical safety | 7.1 Prevention of traps; 7.2 Moving and folding parts; 7.3 V-shaped openings; 7.4 Surfaces, corners, edges and protruding parts; 7.5 Folding and adjusting mechanisms; 7.6 Instability hazard; 7.7 Temperature of parts in contact with skin; Ergonomic principles; Additional considerations |
| 8. Safety of electrical equipment | 8.1 General; 8.2 Electromagnetic compatibility; 8.3 Liquid ingress; 8.4 Interruption of power supply; 8.5 Hold to run activation; 8.6 Emergency stop functions |
| 9. Biocompatibility | 9.1 Biocompatibility and toxicity; 9.2 Animal tissue |
| 10. Contamination | 10.1 Liquid ingress; 10.2 Cleaning and disinfection; 10.3 Cross infection and microbial contamination |
| Annex A. General Information | A.1 General; A.2 Design controls; A.3 Packaging; A.4 Noise and vibration; A.5 Flammability; A.6 Ergonomic principles; A.7 (EMC) immunity; A.8 Cleaning and disinfection; A.9 Moisture vapour permeability/microclimate management |
| Annex B. Environmental and consumer related guidance | Covers Hazardous Substances in an APTI. B.1 General; B.2 All materials; B.3 Textiles; B.4 Plastic materials; B.5 Metals; B.6 Wooden parts |
| Annex C. Periodic inspection |
This standard clearly sets out the expected safety requirements for all mattress surface devices, irrespective of which medical device classification they fall into. To deliver safe, effective, harm-free care to patients, it is not unreasonable to assume the use of devices which meet the required level of safety and do not inadvertently introduce any additional risks to users.
With pressure ulcers recognised as a preventable harm and pressure ulcer incidence metrics typically reported at board meetings as a key indicator or care quality, it is prudent for providers to use products that meet the required levels of safety.
Clinicians will benefit from clear statements around the intended use, intended users, and any device claims around performance and safety, including minimum and maximum user weight on the device.
Furthermore, supporting documents, such as the clinical evaluation and instructions for use, will give additional information about the suitability of the device for local patients/residents. Requesting relevant evidence as part of a tender process will help ensure that claims of device performance are substantiated with appropriate levels of evidence and supporting documentation. This can be particularly helpful when looking to substantiate claims for self-certified, Class I medical devices, which are otherwise externally-unregulated devices.
Where manufacturers’ products align with this standard, it demonstrates that the manufacturers are seeking to attain minimum levels of device safety and that their claims around device performance can be supported by suitable data and evidence, thereby giving clinicians peace of mind when prescribing the products for patients.
Medical device manufacturers typically strive to deliver the safest, most effective products to the market. Since elements of BS EN ISO 20342-1 will apply to every APTI sold in the UK it would be a concern to understand why a manufacturer would not want their products to comply with this standard.
Healthcare providers can help encourage uptake of these standards by listing compliance as a prerequisite on mattress tender submissions. If manufacturers need to comply with specific elements of the ISO 20342 series of standards (e.g. Part 1, General Requirements) to be considered for the tender, this would greatly encourage this area of the medical device industry to meet the requirements for BS EN ISO 20342-1:2002.
BS EN ISO 20342-1:2022 – TC | 31 Aug 2022 | BSI Knowledge (bsigroup.com)
For a broader background to the ISO 20342 series of APTI standards, see the BHTA article: ‘New standards for testing mattresses and related products – An Introduction’
Personal issue kits should be issued to individual first aiders and other employees where appropriate to their role, e.g. security personnel, cleaners, maintenance, etc. as a supplementary resource to small, medium and large first aid kits being available in the workplace.
If your business has people working offsite, in vehicles or lone workers in an isolated environment, kits will need to be issued amongst persons that fall within those categories.
This convenient kit can be worn on the person; it contains essential first aid products enable basic first aid to be provided quickly and easily. The personal issue kit is designed to enable effective CPR and deal with common minor injuries, such as breaks and sprains to arms and small bleeding injuries.
It is recommended that one personal issue kit is issued to each first aider and any other employee and required, following a needs assessment.
Contents:
1 x Guidance leaflet
1 x Contents list
1 x Large sterile dressing
1 x Triangular bandage
10 x Sterile adhesive dressings
4 x Alcohol free cleansing wipes
2 x Pairs of nitrile gloves
1 x Resuscitation face shield
1 x Foil blanket
1 x Pair of universal shears
The critical injury pack contains advanced first aid products, designed to stem catastrophic blood loss and treat life threatening injuries. It is recommended that the critical injury pack is provided wherever a substantial risk of injury has been identified and to supplement first aid kits conforming to the British Standard (BS 8599-1:2019).
A critical injury pack should be provided in any workplace where there is risk of critical injury. A critical injury pack should be available to each employee exposed to these risks.
Examples include: work with dangerous machinery or sharp instruments, cutting equipment, power tools, construction, agriculture, forestry, etc.
It is highly recommended that employees responsible for the delivery of first aid in the workplace be trained in the use of the critical injury pack and its contents, specifically the haemostatic dressings and tourniquet.
Critical injury packs can also be stored in large quantities for distribution in an emergency. Following a risk assessment, an employer should consider storing appropriate quantities of critical injury packs to treat injuries to employees or the public, resulting from acts of terrorism or other mass casualty incidents.
Appropriate numbers of the critical injury pack should be stored, in line with the risks assessed. Employers should take into consideration the maximum number of people on site at any one time, each pack is designed to treat one person.
1 x guidance leaflet
1 x contents list
2 x pairs of nitrile disposable gloves
1 x foil blanket
1 x pair of universal shears
2 x large trauma dressings
2 x haemostatic dressings
1 x emergency tourniquet
The personal issue kit is intended to be issued to first aiders and other employees where appropriate to their role (e.g. security personnel, cleaners, maintenance, etc). This kit should be provided in addition to an appropriate number of British Standard compliant first aid kits being available in the workplace.
This convenient kit contains essential first aid products to enable basic first aid to be provided quickly and easily.
It is recommended that one personal issue kit be issued to each first aider and any other employee as required, following a needs assessment.
1 x guidance leaflet
1 x contents list
1 x large sterile dressing
1 x triangular bandage
10 x sterile adhesive dressings
4 x alcohol free cleansing wipes
2 x pairs of nitrile gloves
1 x face shield
1 x foil blanket
1 x pair of universal shears
Click here and search for “First Aid Medical Equipment” for further information on reputable brands, manufacturers, and suppliers.
Road accidents are common in the UK with 181,384 injuries reported in 2016.
It is an employer’s legal responsibility to ensure all employees have access to a first aid kit, appropriate to the level of risk in their workplace, including employees who work away from the office and on the road.
A vehicle first aid kit, designed with associated risks in mind, contains essential equipment to provide early treatment at the roadside.
Ambulances are targeted to reach an emergency in eight minutes, though it can often be longer due to traffic and volume of calls. An untreated casualty with a severe enough injury can bleed out in a much shorter time, without treatment. A trauma dressing can be used by any bystander to potentially save someone’s life.
Kits that meet British Standard 8599-2 are designed for professionals and untrained bystanders. Items carried in the kit are designed to be useful and practical for professional first aiders, but they are also simple and intuitive enough to be used by anyone in an emergency situation.
While there are many vehicle first aid kits on the market, the British Standard 8599-2 compliant first aid kit is the first to be designed by a panel of industry experts who were invited to help the BHTA design the new vehicle first aid kits. The kits have been created to treat the most common roadside injuries.
Examples of products include:
Employers must provide first aid suitable to risks identified in the workplace. Company vehicles should be considered a workplace. It is for employers to decide if the first aid kit carried by their employees is sufficient for the risks employees are exposed to. A British Standard 8599-2 compliant first aid kit is the ideal solution for vehicle first aid.
| Number of passengers | Vehicle examples | Number of first aid kits required |
|---|---|---|
| 1-3 | Mopeds, motorcycles, motor tricycles, and quadricycles | 1 |
| 1-8 | Cars, taxis, and commercial vehicles | 1 |
| 1-16 | Minibuses and small buses | 1 |
| 17+ | Buses and coaches | 2* |
*Multi-level vehicles might require more than two kits
1 x Triangular Bandage
1 x Dressing, Adhesive 7.5cm x 7.5cm
1 x Dressing, Sterile Medium 12cm x 12cm
1 x Dressing, Sterile Medium Trauma 10cm x 18cm
2 x Hydrogel Burn Dressings 10cm x 10cm
1 x Foil Blanket 130cm x 210cm
2 x Nitrile disposable gloves (pair)
1 x Guidance Leaflet
10 x Plasters, Washproof Assorted Sizes
1 x Resuscitation Face Shield
1 x Shears (suitable for cutting clothing, including leather)
10 x Alcohol Free moist cleaning wipes
1 x Contents List
Please contact BHTA on 020 7702 2141 to find your nearest First Aid Supplier to you.
Copies of the document are available to purchase from the BSI here or by telephone on 0345 086 9001.
The BHTA has worked with the Don’t Call Me Mum campaign initiative to produce this article. We want to help professionals and companies working with carers and families of adults and children with additional needs to demonstrate their respect of parents as partners.
When you enter a family’s house, it is also their home, their place of comfort, and a safe space. Whilst keeping this in mind, professionals should understand the potential anxieties and fears families may have around outsiders entering their home and the decisions that may be made. Working with parents/carers and involving them at every stage of a meeting/assessment will help gain their respect and trust.
Companies, professionals, and parents are all the experts in their own right. Bringing together everyone’s skills, knowledge and resources creates the best outcome because when parents are partners; everyone, especially the person with the disability, wins.
Every family has a story. Every interaction is part of an ongoing journey littered with complications, emotions and challenges.
Every person has a different set of priorities and expectations. When each party openly communicates their agenda and priorities, progress can be made.
We have established some top tips to help when working with families.
The BHTA is one of the UK’s oldest and largest healthcare trades association. To find out more about the BHTA and see other useful guidance articles, click here.
To become a supporter of ‘Don’t Call Me Mum’ and show that your company, department, or school acknowledges the essential contribution parents make, order your supporters pack and contact us to add our logo to your website. Email us: info@dontcallmemum.com or visit the Don’t Call Me Mum website.
With thanks to Born at the Right Time bringing a family’s perspective to professional practice and pioneer of the Don’t Call Me Mum initiative.
The Health and Safety (First Aid) regulations 1981 states: “An employer shall provide, or ensure that there are provided, such equipment and facilities as are adequate and appropriate in the circumstances for enabling first-aid to be rendered to his employees if they are injured or become ill at work.”
The Health and Safety Executive (HSE) provides a code of practice and guidance to help you meet your obligations under the law. Whilst this is guidance and not law, following this will ensure that you meet your legal obligations regarding first aid in the workplace and will demonstrate, if ever questioned, that your first aid provision has been considered against a risk assessment and is appropriate.
This code of practice and guidance covers all manner of topics relating to first aid, like first aid training, where it gives some practical guidance about how many trained first aiders you need in a workplace. With the contents of first aid kits, it only gives a list of the type of products that you might include in a first aid kit, and points to the BSI for further guidance.
The HSE guidance focuses on the importance of a needs assessment. All employers should conduct a needs/risk assessment in order to decide on which first aid kits are needed and where they should be sited. The British Standard BS 8599-1 provides some very useful guidance to help employers match their needs with BS8599-1 compliant kits.
A range of workplace first aid kits are detailed in British Standard BS 8599-1. These kits have been professionally designed to help you fully comply with the HSE code of practice and guidance, and hence fully meet your obligations under the law. The standard is regularly reviewed to keep it up to date.
The BS 8599 range comprises:
Since the HSE guidance is not binding, some workplace first aid kits are available that fall well short of the British Standard. By using these kits, an employer is not breaking the law. If, however, there is an incident, and an employee suffers harm that could have been prevented should a British Standard kit have been available, it might be difficult for employers to legally defend themselves.
Some kits are called HSE first aid kits; there is no such standard. Some kits quote British Healthcare Trades Association (BHTA) standard; this standard was withdrawn in 2012 and replaced with the BSi standard.
Choosing the right first aid kit is now even easier. Decide if your work environment is low hazard or high hazard by reading the table (below). Then how many employees there are in your workplace and finally which of the three sizes of kit you will need, e.g. small, medium or large. It’s that simple!
e.g. shops, offices, libraries etc.
| Number of employees | Size of first aid kits |
|---|---|
| Fewer than 25 | Small |
| 25-100 | Medium |
| More than 100 | Large (1 per 100 employees) |
e.g. light engineering and assembly work, food processing, warehousing, extensive work with dangerous machinery or sharp instruments, construction, chemical manufacture etc.
| Number of employees | Size of first aid kits |
|---|---|
| Fewer than 5 | Small |
| 5-25 | Medium |
| More than 25 | Large (1 per 25 employees) |
| Contents | S | M | L | Off-site |
|---|---|---|---|---|
| Sterile adhesive dressings | 40 | 60 | 100 | 10 |
| Nitrile disposable gloves (pairs) | 6 | 9 | 12 | 2 |
| Burn dressing Min 100cm2 | 1 | 2 | 2 | 0 |
| Resuscitation face shield | 1 | 1 | 2 | 1 |
| Guidance leaflet | 1 | 1 | 1 | 1 |
| Contents list | 1 | 1 | 1 | 1 |
| Shears (suitable for cutting clothing, including leather) | 1 | 1 | 1 | 1 |
| Sterile finger dressing | 2 | 3 | 4 | 0 |
| Sterile eyepad dressing | 2 | 3 | 4 | 0 |
| Sterile medium dressing | 2 | 4 | 6 | 0 |
| Sterile large dressing | 2 | 3 | 4 | 1 |
| Conforming bandage (min 7.5cm width and 4m stretch length) | 1 | 2 | 2 | 0 |
| Triangular bandage | 2 | 3 | 4 | 1 |
| Foil blanket (130cm x 210cm) | 1 | 2 | 3 | 1 |
| Adhesive tape rolls (Individually wrapped, min 2.5cm width, 5m length) | 1 | 2 | 3 | 0 |
| Alcohol-free moist cleansing wipes | 20 | 30 | 40 | 4 |
Please contact BHTA on 020 7702 2141 to find your nearest first aid supplier.
Copies of the document are available to purchase from the BSI web shop or by telephone on 0345 086 9001.