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Health and safety policy template
A health and safety policy for a business in Great Britain, laid out in the three parts HSE describes. Part 1 is your statement of intent, signed by the most senior person. Part 2 names the people with specific responsibilities. Part 3 records your arrangements topic by topic: who does it, how, where the record is kept and when it is next reviewed. Each arrangement can point to the record behind it, such as your risk assessment, COSHH assessment, DSE assessment, first aid needs assessment, fire risk assessment and incident report. The form ends with the review history, how the policy was brought to your employees' notice, and any gaps as actions. In Ireland the law asks for a safety statement instead.
For owners and managers of small and medium businesses in England, Scotland and Wales, such as builders, joiners, workshops, offices and shops, who need to write or review their health and safety policy and show their staff have seen it.
Written to the law in Great Britain (Health and Safety at Work etc. Act 1974). Employers in Ireland need a safety statement under the Safety, Health and Welfare at Work Act 2005: use the safety statement template.
- Statement of intent with aims for the year, signed and dated by the most senior person
- Responsibilities: each role with a name, position, duties, who covers and their training
- Arrangements by topic, from risk assessment and first aid to COSHH, lone working and welfare, each with who, how, record and review date
- Counts of arrangements in place, needing updating and not yet in place, with gaps carried to actions
- Review history, how it was brought to employees' notice, who still has to sign, and two signatures
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What should a health and safety policy include?
A policy works when it reads like your business, not a template: the statement of intent is signed by the person in charge, every responsibility has a real name, and each arrangement says who does it, how, and where the record is. Gaps are written down as actions, and the staff have actually seen it.
Last updated . Facts checked by the SiteSurvey team on 27 October 2026 against Health and Safety at Work etc. Act 1974, section 2, general duties of employers to their employees, Employers' Health and Safety Policy Statements (Exception) Regulations 1975, HSE, Prepare a health and safety policy: how to write your policy, HSE, Prepare a health and safety policy: overview and Management of Health and Safety at Work Regulations 1999, regulation 5, health and safety arrangements.
How to write a health and safety policy
Write it in your own words. It should say who does what, when and how in your business.
Fill in the business details
Enter the business, what it does, where it works and how many people you employ. The form tells you whether it must be written down.
Write the statement of intent
Say what you commit to and two or three aims for the year. The most senior person signs and dates it.
Name the responsibilities
Add a row for each role: the person, their position, what they are responsible for, who covers, and their training. Name your competent person or adviser.
Record each arrangement
For each topic that applies, say who is responsible, how it is done, where the record is kept and when you will review it. Mark gaps honestly.
Share it and sign it off
Record how you told your employees and when, who still needs to see it, the review history, and actions for any gaps. Both signers sign.
What makes a health and safety policy work
Arrangements: how it is done
First aid. T. Penrose (bench joiner) is the first aider; box by the workshop office door checked on the first Monday of the month; each fitting van carries a kit. Record: first aid needs assessment and kit checks in SiteSurvey. Gap: no cover when T. Penrose is on site, so S. Marley is booked on a course. Review by 11 Oct 2027.
Fictional example. Record the actual evidence and approved arrangements for your job.
A common recording mistake
Copying a long generic policy that names arrangements the business does not have, such as a safety committee or a health surveillance programme, and leaving every responsibility as "the manager".
What happens next
Brief the policy to staff, record who has signed it, and turn every arrangement marked not yet in place or needing updating into an action with an owner and a date.
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Every question in the health and safety policy template
A health and safety policy for a business in Great Britain, in the three parts HSE describes: a statement of intent signed by the most senior person, responsibilities with names, positions and roles, and the arrangements by topic (risk assessment, consultation, training, first aid, accidents and RIDDOR, fire and emergencies, equipment, COSHH, work at height, display screen equipment, lone working, contractors and visitors, welfare, monitoring) with who, how, where the record is kept, status and a review date. Then the review history, how it was brought to employees' notice, gaps as actions and sign-off. Notes cite section 2(3) of the Health and Safety at Work etc. Act 1974 and the exception for fewer than five employees. 6 sections and 76 questions. Follow-up questions and guidance appear only when an answer calls for them, so the person on site never sees the ones that do not apply.
Make it your own: every question is editable
This is a starting point, not a fixed form. Once it is in your SiteSurvey account you can reword any question, add or remove questions, sections and answer options, and add your own logo, so it fits the way your team works and the jobs you do.
Details you only enter once
Add this form to a project in SiteSurvey and it fills in what the project already knows, so nobody on site retypes it and every form on the job uses the same names. Anything filled in can still be changed.
- Project: the project name
- Main business address: the site address, from the space or the project
- Prepared for (business or site): the project's customer
Business and scope
- ProjectShort answer
Filled in from the project in SiteSurvey.
Fills in from the project name - Main business addressShort answerFills in from the site address, from the space or the project
- Prepared for (business or site)Short answerFills in from the project's customer
- Location (GPS)Short answer
- Date of this version*Date
- Prepared by*Short answer
- Business name*Short answer
- What the business doesShort answer
For example joinery and shop fitting, with work in customers' premises.
- Number of employees*Number
Everyone you employ, including part-time staff. Do not count self-employed subcontractors.
- VersionShort answer
For example version 4.
- Premises and work locations this policy coversNotes
For example workshop and office at the unit, plus fitting work at customers' sites.
- Where you employ peopleChoose one
Sets which short note you see. It does not change the questions.
- Great Britain (England, Scotland, Wales)
- Ireland
- Other country
- Written policyWorked out by the formShown when “Number of employees” is answered
- GuidanceThe law in Great Britain. Every employer must prepare a written statement of their general policy on health and safety at work, and the organisation and arrangements for carrying it out; revise it as often as is appropriate; and bring it, and any revision, to the notice of all employees (Health and Safety at Work etc. Act 1974, section 2(3)). Employers with fewer than five employees are excepted (Employers' Health and Safety Policy Statements (Exception) Regulations 1975). HSE says every business must still have a policy for managing health and safety, and that writing it down is useful.Shown only when the answers above make it relevant
- CheckIreland. Irish law asks for a safety statement, not this policy. Use the Safety Statement (Ireland) form instead.Shown when “Where you employ people” is “Ireland”
- CheckThis form records your own policy. It does not certify anything, and having a policy does not on its own show that risks are controlled: the arrangements have to work in practice.
Part 1: Statement of intent
- GuidanceHSE says this part states your general policy on health and safety at work, including your commitment and aims, and that the employer or most senior person should sign it and review it regularly. Write it in your own words.
- Statement of intent*Notes
What you commit to, in plain words. For example: we will assess the risks of our work, consult our staff, provide training, equipment and safe premises, and review this policy every year or sooner if things change.
- Aims for the coming yearNotes
Two or three things you mean to improve, so you can check them at the next review.
- Signed by (most senior person)*Short answer
- Position*Short answer
For example managing director, owner.
- Signature*Signature
- Date signedDate
Part 2: Responsibilities
- GuidanceHSE says to list the names, positions and roles of the people in your business with specific responsibility for health and safety. Add one row per role.
- Overall responsibility for health and safety*Short answer
The person with overall responsibility, usually the owner or a director.
- Day-to-day responsibilityShort answer
- People with specific responsibilitiesRepeat for each role. Each one asks:
- Role*Short answer
For example overall responsibility, workshop supervisor, first aider.
- Name*Short answer
- PositionShort answer
- What they are responsible for*Notes
- Who covers when they are awayShort answer
- Trained for this role?Yes or No
- Training and dateShort answer
For example first aid at work, refreshed March 2026.
Shown when “Trained for this role?” is Yes
- Roles namedWorked out by the form
- Roles not yet trainedWorked out by the form
- Competent health and safety assistance*Choose one
Employers must appoint one or more competent persons to help them meet their health and safety duties (Management Regulations 1999, regulation 7).
- Someone in the business
- An external adviser
- Both
- Not yet arranged
- Name of the competent person or adviserShort answerShown only when the answers above make it relevant
- What all employees are asked to doNotes
For example follow training and safe methods, use the equipment provided, report hazards, accidents and near misses.
Part 3: Arrangements
- GuidanceHSE says this part gives the practical arrangements that show how you will achieve the aims of your policy. Add one row per topic. Topics often covered: risk assessment, consultation, training, first aid, accidents and RIDDOR, fire and emergencies, equipment, COSHH, work at height, display screen equipment, lone working, contractors and visitors, welfare and monitoring. Leave out topics that do not apply, or mark them not applicable.
- ArrangementsRepeat for each arrangement. Each one asks:
- Topic*Choose one
- Risk assessment
- Consultation with employees
- Information, instruction and training
- First aid
- Accidents, incidents and RIDDOR reporting
- Fire and emergencies
- Work equipment and maintenance
- Hazardous substances (COSHH)
- Work at height
- Display screen equipment
- Lone working
- Contractors and visitors
- Welfare facilities
- Monitoring, inspection and review
- Other
- Other topic*Short answerShown when “Topic” is “Other”
- GuidanceEmployers must make a suitable and sufficient risk assessment, and with five or more employees record the significant findings (Management of Health and Safety at Work Regulations 1999, regulation 3).Shown when “Topic” is “Risk assessment”
- GuidanceEmployees not represented by safety representatives must be consulted in good time on matters relating to their health and safety at work (Health and Safety (Consultation with Employees) Regulations 1996, regulation 3).Shown when “Topic” is “Consultation with employees”
- GuidanceTraining is required when people are recruited and when they are exposed to new or increased risks, repeated periodically where appropriate (Management Regulations 1999, regulation 13(2)).Shown only when the answers above make it relevant
- GuidanceEmployers must provide adequate and appropriate first-aid equipment and facilities (Health and Safety (First-Aid) Regulations 1981, regulation 3). A first aid needs assessment helps you decide what is adequate.Shown when “Topic” is “First aid”
- GuidanceSay who records accidents and near misses, and who decides whether a report is needed under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR).Shown only when the answers above make it relevant
- GuidanceThe responsible person for the premises must make a fire risk assessment (Regulatory Reform (Fire Safety) Order 2005, article 9). Say who does it, and who runs drills and checks escape routes.Shown only when the answers above make it relevant
- GuidanceWork equipment must be maintained in an efficient state, in efficient working order and in good repair (Provision and Use of Work Equipment Regulations 1998, regulation 5).Shown only when the answers above make it relevant
- GuidanceWork that may expose employees to a substance hazardous to health needs an assessment first (Control of Substances Hazardous to Health Regulations 2002, regulation 6).Shown when “Topic” is “Hazardous substances (COSHH)”
- GuidanceWork at height is covered by the Work at Height Regulations 2005. Say who plans it and who checks ladders, steps and access equipment.Shown when “Topic” is “Work at height”
- GuidanceEmployers must analyse the workstations of display screen users (Health and Safety (Display Screen Equipment) Regulations 1992, regulation 2).Shown when “Topic” is “Display screen equipment”
- Status*Choose one
- In place
- In place: needs updating
- Not yet in place
- Not applicable
- Who is responsible*Short answerShown only when the answers above make it relevant
- How it is done*Notes
What actually happens: the steps, how often, and what equipment or training is used.
Shown only when the answers above make it relevant - Linked record and where it is keptShort answer
For example risk assessments in SiteSurvey, project folder; accident book in the office.
Shown only when the answers above make it relevant - Review this arrangement byDateShown only when the answers above make it relevant
- What needs doing*NotesShown only when the answers above make it relevant
- Why not applicableShort answerShown when “Status” is “Not applicable”
- PhotosPhotos
Optional. For example the first aid box, the fire point, the safety data sheet file.
Shown only when the answers above make it relevant
- Arrangements recordedWorked out by the form
- In placeWorked out by the form
- Need updatingWorked out by the form
- Not yet in placeWorked out by the form
- WarningSome arrangements are not yet in place. Add each one as an action on the last page with an owner and a date.Shown only when the answers above make it relevant
Review history and bringing it to employees' notice
- GuidanceThe Act requires the statement and every revision to be brought to the notice of all employees (section 2(3)). HSE says you must share the policy, and any changes, with your employees. Record how you did it.
- Review historyRepeat for each review. Each one asks:
- Version*Short answer
- Date reviewed*Date
- Reviewed byShort answer
- Why reviewedChoose one
- Planned review
- New work, premises or equipment
- After an accident or near miss
- Change in the law or guidance
- Staff or role changes
- First issue
- Other
- What changedNotes
- How this version was brought to employees' notice*Tick all that apply
- Explained at induction
- Copy given to each employee
- On the notice board
- Sent by email or on the intranet
- Briefed at a team meeting or toolbox talk
- Translated or explained for people with limited English
- Employees signed to say they read it
- Date shared with employees*Date
- Where the current copy is keptShort answer
For example office notice board and shared drive.
- Employees who signed to say they read itNumberShown when “How this version was brought to employees' notice” includes “Employees signed to say they read it”
- Employees still to signWorked out by the formShown when “How this version was brought to employees' notice” includes “Employees signed to say they read it” and “Employees who signed to say they read it” is answered
- Who still needs to see it, and whyNotes
For example two fitters on a site in Bristol until Friday.
Shown only when the answers above make it relevant - Photo of the notice board or briefing recordPhotos
- Next planned review of the whole policyDate
No law sets a fixed interval. Review it when things change, after an accident, and on a date you choose.
Gaps, actions and sign-off
- Gaps to closeWorked out by the form
- ResultWorked out by the form
- ActionsRepeat for each action. Each one asks:
- Action*Notes
- PriorityChoose one
- Now
- Within a month
- Before the next review
- Who will do it*Short answer
- Due byDate
- Status*Choose one
- Open
- In progress
- Done, checked
- Photo when donePhotosShown when “Status” is “Done, checked”
- Actions still openWorked out by the form
- Decision*Choose one
- Policy in force: no actions
- Policy in force: actions listed
- Draft: not yet in force
- Date to check the actions are doneDate
- Summary of this versionNotes
- Most senior person nameShort answer
- Most senior person signature*Signature
- Person responsible for health and safety nameShort answer
- Person responsible for health and safety signatureSignature
See it filled in
A completed health and safety policy report, made by SiteSurvey from a fictional site visit: every answer, the photos, the guidance that applied and the sign-off, ready to send as a PDF.
Health and safety policy FAQs
Do I need a written health and safety policy?
Yes, if you have five or more employees. Section 2(3) of the Health and Safety at Work etc. Act 1974 requires employers to prepare a written statement of their general health and safety policy and the organisation and arrangements for carrying it out, to revise it as often as appropriate, and to bring it and any revision to the notice of all employees. Employers with fewer than five employees are excepted by the Employers' Health and Safety Policy Statements (Exception) Regulations 1975. HSE says every business must still have a policy, and writing it down is useful.
Sources: Health and Safety at Work etc. Act 1974, section 2, general duties of employers to their employees, Employers' Health and Safety Policy Statements (Exception) Regulations 1975 and HSE, Prepare a health and safety policy: overview.
Who should sign the health and safety policy?
HSE says the employer or the most senior person in the company should sign the statement of intent and review it regularly. The form asks for their name, position, signature and date, and a second signature from the person responsible for health and safety day to day.
Source: HSE, Prepare a health and safety policy: how to write your policy.
How often should a health and safety policy be reviewed?
The Act says to revise it as often as may be appropriate; no law sets a fixed interval. Set a review date that suits your business, and review it sooner when something changes, such as new premises, new work, new equipment or after an accident. The form keeps a review history with the date, the reason and what changed, and a date for the next review.
Source: Health and Safety at Work etc. Act 1974, section 2, general duties of employers to their employees.
What goes in the arrangements section?
Your practical arrangements, one topic at a time: risk assessment, consultation, training, first aid, accidents and RIDDOR reporting, fire and emergencies, work equipment, hazardous substances, work at height, display screen equipment, lone working, contractors and visitors, welfare and monitoring. The Management of Health and Safety at Work Regulations 1999 require employers to have arrangements for planning, organising, controlling, monitoring and reviewing their protective measures, and to record them if they have five or more employees.
Do I need a competent person for health and safety?
Employers must appoint one or more competent persons to help them meet their health and safety duties (Management of Health and Safety at Work Regulations 1999, regulation 7). That can be someone in the business, an external adviser, or both. The responsibilities page records who it is.
Source: Management of Health and Safety at Work Regulations 1999, regulation 7, health and safety assistance.
Is a health and safety policy the same as a risk assessment?
No. The policy says how you manage health and safety and who does what. The risk assessment looks at the hazards of your work and the controls. The policy's risk assessment arrangement points to your assessments, which you can do on the risk assessment form in SiteSurvey. Completing the policy form does not make a business compliant on its own: the arrangements have to work in practice.
Related
Related templates
Templates that go with the health and safety policy form
Hazards, who might be harmed, controls and risk scores, with a briefing record and review date.
A safety statement for employers in Ireland under section 20 of the Safety, Health and Welfare at Work Act 2005: policy, the section 19 risk assessment rated Low, Medium or High, protective and preventive measures, emergency plans, named responsible people, consultation and the safety representative, how it is brought to employees’ attention, and review. Optional construction section with the PSDP, PSCS, Safe Pass and Safe System of Work Plans.
A first aid needs record covering work hazards, staffing and shifts, absence cover, remote work, equipment, facilities and agreed provision.
Risk assessment for someone working alone: the work and place, violence, health, high risk tasks, check-in arrangements, what happens if contact is lost and scored hazards.
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