Reporting an Incident

The following section provides guidance for the completion of an incident report form. An incident report form should be completed and submitted for all incidents and near misses, regardless of seriousness and impact.

Section 1 - Your Details

1. Your Name?

This section requires reporting individuals to confirm the name of the individual who is reporting the incident. As much as is reasonably practicable, the reporting individual should be the member of staff who is completing the Incident Report Form. In instances where this is not the case, the name of the individual originally reporting the incident should be entered. This field will automatically populate with the information of the individuals whose details have been used to log into the incident reporting system.

2. Your Contact Details?

This section requires reporting individuals to confirm their contact details. The information provided should include an email address and telephone number. This field will automatically populate with the information of the individuals whose details have been used to log into the incident reporting system.

3. Your Department?

This section requires reporting individuals to confirm the name of the Department reporting the incident. This will be the Department of the Reporting Individual. This field will determine to whom the incident investigation for the incident will be sent.

Section 2 - Date, Time and Location

4. Date of Incident?

This section requires reporting individuals to confirm the date of the incident. Users should select the appropriate option from the calendar view, ensuring that the date entered is the date on which the incident took place, rather than the date on which the reporting individual is completing the Incident Report Form.

The month can be changed through the use of the toggling arrows, and the relevant date selected from the resulting calendar layout by clicking that date from the options available.

5. Time of Incident

This section requires reporting individuals to confirm the time of the incident. Reporting individuals should document the time of the incident in the format of hh:mm using the twenty four hour clock i.e. Quarter past nine in the evening would be given as 21:15. When the exact time of the incident is unknown, reporting individuals should endeavour to provide the best approximate time, or input ‘unknown’ if it is not possible to provide an estimate.

6. Location of Incident (Building)?

This section requires reporting individuals to confirm the location of the incident. Users should select the appropriate building from the predetermined options. Users should click the dropdown arrow to view and select from the options.

7. Exact location of the incident?

This section requires reporting individuals to confirm the exact zone where the incident took place. Users should endeavour to be as specific as possible in relation to the Campus, Building, Room (if applicable) and exact location where the incident took place. This field is for free text, therefore reporting individuals should click in the designated box and manually enter the exact location of the incident.

Section 3 - Incident Details

8. Please provide a brief description of the circumstances i.e. what happened

This section requires reporting individuals to provide information relating to events before, during and following the incident. Reporting individuals should attempt to summarise the circumstances, and include as much relevant details as possible. This field is for free text, therefore reporting individuals should click in the designated box and manually enter a summary of the incident.

The information to be included should include, but should not be limited to:

  • A summary of the conditions;
  • Details of the tasks or work being undertaken at the time of the incident;
  • A summary of the events leading to and culminating in the incident;
  • A summary of events and responses immediately following the incident;
  • Any additional information that the reporting individual considers relevant.

9. Did the incident result in harm (to person, property or the environment)?

This question requires reporting individuals to confirm whether the incident resulted in harm, which can either be interpreted as personal harm or damage to property, equipment or the environment. In this context, harm is considered physical and/or other injury or damage. Users should select the appropriate information from the predetermined options. Users should click the dropdown arrow to view and select from the options.

The options available to reporting individuals are:

No – This option should be selected when the incident has not resulted in personal harm or damage to property, equipment or the environment. Such incidents with no resulting harm are considered near misses.

Yes - This option should be selected when the incident has resulted in personal harm or damage to property, equipment or the environment.

10. What category best describes the type of incident?

This question asks reporting individuals to confirm the type of incident being reported. Reporting Individuals should use this field to note the immediate primary cause of the incident. Please note that this is different to the underlying cause of the incident which should be established during the investigation process. Users should select the appropriate information from the predetermined options. Users should click the dropdown arrow to view and select from the options. The options available to reporting individuals are:

  1. Alcohol - This option should be selected when alcohol is considered the immediate primary cause of the incident.
  2. Animal (including insects) - This option should be selected when animals are considered the immediate primary cause of the incident. This may include but may not be limited to incidents such as bite, strike, sting and crush occurrences from animals.
  3. Anti-social behaviour - This option should be selected when anti-social behaviour is considered the immediate primary cause of the incident. This may include but may not be limited to incidents such as criminal damage, aggressive behaviour and noise disruption.
  4. Electricity - This option should be selected when electricity is considered the immediate primary cause of the incident. This may include but may not be limited to incidents such as electrocution and electrical fires.
  5. Environmental - This option should be selected when spillages or contamination is considered the immediate primary cause of the incident.
  6. Failure of device - This option should be selected when the failure of a device being used at the time of the incident is considered the immediate primary cause of the incident.
  7. Fall from height (including stairs) - This option should be selected when falling from height is considered the immediate primary cause of the incident. This may include but may not be limited to incidents such as falling down stairs and falling from a ladder.
  8. Fire related - This option should be selected when issues relating to fire safety are considered the immediate primary cause of the incident. This may include but may not be limited to incidents such as failure to evacuate during fire alarm activations, fire doors wedged open, and tampering with fire detection and fighting equipment.
  9. Fire/Explosion - This option should be selected when fire or explosion is considered the immediate primary cause of the incident.
  10. Gas - This option should be selected when gas is considered the immediate primary cause of the incident. This may include but may not be limited to incidents such as gas leaks and combustion of gas.
  11. Hand tools - This option should be selected when the use of hand tools is considered the immediate primary cause of the incident.
  12. Handling, lifting or carrying - This option should be selected when manual handling is considered the immediate primary cause of the incident. This may include but may not be limited to incidents involving physical lifting, pulling, pushing and carrying.
  13. Harmful substance - This option should be selected when harmful substances are considered the immediate primary cause of the incident. This may include but may not be limited to incidents such as chemical spills, substance leakages, and inhalations.
  14. Horseplay – This option should be selected when boisterousness is considered the immediate primary cause of the incident.
  15. Machinery / equipment - This option should be selected when contact with moving machinery is considered the immediate primary cause of the incident. This may include but may not be limited to incidents caused by moving equipment parts, or associated with the operation or use of a machine or priece of equipment.
  16. Maintenance - This option should be selected when a lack of or a greater demand for improved maintenance is considered the immediate primary cause of the incident.
  17. Moving or falling object - This option should be selected when contact with moving or falling objects is considered the immediate primary cause of the incident. This may include but may not be limited to incidents caused by impacts with object which are moving at the time of the impact, or objects which have fallen from their fixings.
  18. Natural hazard - This option should be selected when natural hazards are considered the immediate primary cause of the incident. This may include but may not be limited to incidents caused by flooding, snow and adverse weather conditions.
  19. Non-work related ill-health (e.g. faint, unwell) - This option should be selected when non-work related ill-health is considered the immediate primary cause of the incident. This option should be selected when an illness was not the result of the work activity or the work environment.
  20. Occupational ill Health - This option should be selected when work related ill-health is considered the immediate primary cause of the incident. This option should be selected when an illness was the result of the work activity or the work environment.
  21. Prohibited/illegal item(s) - This option should be selected when prohibited or illegal items are considered the immediate primary cause of the incident. This may include but may not be limited to incidents such as drug use and incidents caused by objects that are not permitted on Aberystwyth University property.
  22. Road traffic accident - This option should be selected when road traffic accident is considered the immediate primary cause of the incident. This may include but may not be limited to incidents such as accidents involving a vehicle and any other object such as vehicles, buildings, land and pedestrians.
  23. Sharp object (glass needles, etc.) - This option should be selected when contact with sharp objects is considered the immediate primary cause of the incident. This may include but may not be limited to incidents caused by glass, needles and metals.
  24. Slip, trip or fall on same level - This option should be selected when a slip, trip or fall on level ground (excluding stairs and steps) is considered the immediate primary cause of the incident.
  25. Sports/Exercise - This option should be selected when participating in sports activities or exercise is considered the immediate primary cause of the incident.
  26. Stationary object (e.g. furniture, fittings) - This option should be selected when contact with stationary objects is considered the immediate primary cause of the incident. This may include but may not be limited to incidents caused by fixed fittings and stationary objects (e.g. furniture).
  27. Very hot or cold substance or object - This option should be selected when contact with either extremely hot or extremely cold substances is considered the immediate primary cause of the incident. This may include but may not be limited to incidents such as burns and scalds.
  28. Violence (physical assault) - This option should be selected when violence is considered the immediate primary cause of the incident. This may include but may not be limited to incidents involving signs of aggression and/or physical assault.

For any guidance or clarification relating to the appropriate option, please contact the Health, Safety and Environment Team.

11. Please provide names and contact details of any witnesses

This section requires reporting individuals to provide information relating to any witnesses or parties to an incident. This field is for free text, therefore reporting individuals should click in the designated box and manually enter the name(s) and contact details for any witnesses. Reporting Individuals should provide as much contact information as possible, such as names, telephone numbers, addresses and email addresses, in the event that further information is required. For incidents where there were no witnesses, the field should be completed as ‘None’.

12. Was anyone affected by or involved in the incident?

This section requires reporting individuals to confirm whether any individuals were affected or could have been affected by the incident. For this purpose, affected individuals should be considered as being subjected to harm or the potential for harm, or to injury or the potential for injury, as a direct result of the incident.

Users should select the appropriate information from the predetermined options. Users should click the dropdown arrow to view and select from the options.

The options available to reporting individuals are:

Yes – This option should be selected when individual(s) were subjected to harm or the potential for harm, or to injury or the potential for injury, as a direct result of the incident. When this option has been selected, Reporting Individuals will be required to complete the ‘Affected Person(s)’ and ‘Injuries’ sections.

No – This option should be selected when individual(s) were not subjected to harm or the potential for harm, or to injury or the potential for injury, as a direct result of the incident. When this option has been selected, Reporting Individuals will not be required to complete the ‘Affected Person(s)’ and ‘Injuries’ sections.

13. Supporting Evidence / Documents

This section allows reporting individuals to upload supporting evidence or documents to accompany the incident report. Documents can be uploaded as any supported file type. This may include, but will not be limited to documents such as photographs, witness statements, email correspondence, risk assessments, etc. To upload a document, click ‘Upload Document’, select the relevant document from the correct folder using ‘Browse’, before clicking ‘Upload’. Multiple documents can be uploaded for each incident report if required.

Section 4 - Affected Person(s)

In this section, click ‘Add Person’ in order to record details for each affected person. Note: Multiple affected individuals can be recorded for each incident submitted.

14. Name of person affected

This section requires reporting individuals to confirm the name of the affected person. This field is for free text, therefore reporting individuals should click in the designated box and manually enter the full name of the affected person. An affected person is considered as being subjected to harm or the potential for harm, or to injury or the potential for injury, as a direct result of the incident.

15. Address and contact details of person affected

This section requires reporting individuals to confirm the address and contact details of the affected person. This field is for free text, therefore reporting individuals should click in the designated box and manually enter the address, and any other details available e.g. email address, telephone number, etc.

16. Person Capacity

This section requires reporting individuals to confirm the affected person’s capacity and purpose for their presence at the University at the time of the incident. Users should select the appropriate information from the predetermined options. Users should click the dropdown arrow to view and select from the options.

The options available to reporting individuals are:

Postgraduate – Postgraduate Student(s) at Aberystwyth University.

Undergraduate – Undergraduate Student(s) at Aberystwyth University.

Contractor – External suppliers who have been outsourced to conduct work on behalf of the University.

Member of Staff – Aberystwyth University member(s) of staff. Please note that when selecting this option, the incident should have occurred during the affected individual’s hours of work. When this option has been selected, users will also be required to complete an additional question with their area of work. Please note that when an incident occurs outside the hours of work (e.g. when using the Sports Centre during the evening), the member of staff should be considered a ‘Visitor’ for the purposes of reporting.

Visitor – All other individuals who were not on Aberystwyth University premises for the purposes of study or work.

17. If Staff

This section requires reporting individuals to confirm the area of work for any affected person who are Aberystwyth University members of staff. This question will only appear if ‘Member of Staff’ has been selected in the previous question. Users should select the appropriate information from the predetermined options. Users should click the dropdown arrow to view and select from the options.

The options available to reporting individuals are:

  1. Academic / Academic Related
  2. Caretaker / Porter
  3. Catering
  4. Cleaning / Domestic
  5. Clerical / Secretarial
  6. Farm Staff
  7. Grounds / Gardens
  8. Maintenance
  9. Other
  10. Security
  11. Technical

Users whose primary role is not available from the options should contact the Health, Safety and Environment Team for further guidance.

18. Did the person affected suffer an injury?

This section requires reporting individuals to confirm whether the affected person sustained an injury as a direct result of the incident. In this instance, an injury is considered actual physical harm. Users should select the appropriate information from the predetermined options. Users should click the dropdown arrow to view and select from the options.

The options available to reporting individuals are:

No - This option should be selected when the individual did not sustain an injury as a direct result of the incident. When this option has been selected, Reporting Individuals are not required to complete the ‘Injuries’ section.

Yes - This option should be selected when the individual did sustain an injury as a direct result of the incident. When this option has been selected, Reporting Individuals are required to complete the ‘Injuries’ section.

Section 5 - Injuries

In this section, click ‘Add Injury’ in order to record details for each injury sustained. Note: Multiple injuries can be recorded for each affected person. Injuries can only be allocated against affected individuals who have been confirmed as having suffered an injury in the ‘Affected Person(s)’ section.

19. Part(s) of body affected

This section requires reporting individuals to provide information relating to the part(s) of the body injured as a direct result of the incident. Reporting Individuals should endeavour to be as specific as possible in their description of the areas affected. This field is for free text, therefore reporting individuals should click in the designated box and manually enter the relevant details.

20. Nature of the injury(ies)

This section requires reporting individuals to provide information relating to the nature of the injury(ies) sustained as a direct result of the incident. Reponses should refer to the type and specific nature of injury sustained to the part(s) of the body noted in the previous field. This field is for free text, therefore reporting individuals should click in the designated box and manually enter the relevant details.

21. Was first aid administered?

This section requires reporting individuals to confirm whether the affected person received first aid assistance for the injury(ies) sustained as a direct result of the incident. Users should select the appropriate information from the predetermined options. Users should click the dropdown arrow to view and select from the options.

The options available to reporting individuals are:

No - This option should be selected when the individual did not receive first aid assistance for the injury(ies) sustained as a direct result of the incident.

Yes - This option should be selected when the individual did receive first aid assistance for the injury(ies) sustained as a direct result of the incident. When this option has been selected, Reporting Individuals are also required to complete an additional question with details of the individual who administered first aid support.

22. First Aid Administered by

This section requires reporting individuals to confirm the name(s) of the individual(s) who administered first aid for the affected person. This question will only appear if first aid was administered. This field is for free text, therefore reporting individuals should click in the designated box and manually enter the full name of the first aid provider.

23. Was time off required from work as a result of the incident?

This section requires reporting individuals to confirm whether the affected person required time from work due to the injury(ies) sustained as a direct result of the incident. Users should select the appropriate information from the predetermined options. Users should click the dropdown arrow to view and select from the options.

The options available to reporting individuals are:

No - This option should be selected when the individual did not require time off from work due to the injury(ies) sustained as a direct result of the incident.

Yes - This option should be selected when the individual did require time off from work due to the injury(ies) sustained as a direct result of the incident. When this option has been selected, Reporting Individuals are required to complete an additional question with details of the number of consecutive days absence.

This information is relevant as incidents which result in an employee being away from work, or unable to perform their normal work duties as a result of their injury, for a period of more than seven consecutive days, may be reportable under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013. The reporting under RIDDOR will be undertaken by the Health, Safety and Environment Team. For further guidance relating to whether an incident is reportable under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013, please contact the Health, Safety and Environment Team.

24. If yes, how many consecutive days were they away for?

This section requires reporting individuals to confirm the number of consecutive days the affected person was away from work due to the injury(ies) sustained as a direct result of the incident. This question will only appear if the affected individual required time away from work. This field is for free text, therefore reporting individuals should click in the designated box and manually enter the number of days in a number format. Please note that any value greater than seven is reportable under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013. The reporting of all incidents under RIDDOR will be undertaken by the Health, Safety and Environment Team. For further guidance relating to whether an incident is reportable under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013, please contact the Health, Safety and Environment Team.

25. Did the persons affected go directly to hospital?

This section requires reporting individuals to confirm whether the affected person was taken directly to hospital for treatment due to the injury(ies) sustained as a direct result of the incident. Users should select the appropriate information from the predetermined options. Users should click the dropdown arrow to view and select from the options.

The options available to reporting individuals are:

No - This option should be selected when the individual was not taken directly to hospital for treatment to the injury(ies) sustained as a direct result of the incident.

Yes - This option should be selected when the individual was taken directly to hospital for treatment to the injury(ies) sustained as a direct result of the incident.

Please note that incidents involving non-workers or members of the public which result in an injury requiring the individual to be taken directly from the scene of the incident to hospital for treatment may be reportable under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013. For further guidance relating to whether an incident is reportable under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013, please contact the Health, Safety and Environment Team.