Site safety guide

First Aid on a Construction Site: What the Law Requires

Nicola Dobbie·Founder and CEO, The Site BookLast updated 31 October 2026

TL;DR
Employers must provide first-aid kit, facilities and people that are adequate and appropriate for the site, decided by a needs assessment. HSE treats construction as higher hazard and suggests a starting point: an appointed person below 5 workers, a trained first-aider from 5 to 50, and one FAW first-aider per 50 above that. The self-employed must provide their own kit.

This guide covers Great Britain. Northern Ireland has its own Health and Safety (First-Aid) Regulations (Northern Ireland) 1982, its own CDM 2016 Regulations and guidance from HSENI.

Building work can cause cuts, falls, crush injuries, burns and eye injuries, and a site can be a long way from help. This guide explains what the law asks for, how to work out your first-aid needs, the numbers HSE suggests, what goes in the kit, and how to tell everyone the arrangements. To get a starting point for your own site, use our free first aid needs calculator.

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In this guide

What the law says

The main law is the Health and Safety (First-Aid) Regulations 1981. It applies to every workplace, including a construction site of any size.

Equipment and facilities. An employer must provide the equipment and facilities that are adequate and appropriate in the circumstances for giving first aid to employees who are injured or become ill at work (regulation 3(1)).
First-aiders. An employer must provide an adequate and appropriate number of suitable people to give first aid. A person is suitable only if they have had the training and hold the qualifications that are appropriate in the circumstances (regulation 3(2)).
An appointed person instead. Where the nature of the work, the number of employees and the location make it adequate and appropriate, an employer can appoint a person to take charge of the first-aid arrangements instead of providing a first-aider (regulation 3(4)).
Telling employees. An employer must tell employees about the arrangements, including where the equipment, facilities and first-aid people are (regulation 4).
The self-employed. A self-employed person doing work on a construction site must provide, or make sure there is provided, the equipment to give first aid to themselves at work (regulation 5, read with the Prescribed Undertakings Regulations 2015, Schedule paragraph 3).

CDM 2015 adds a site-wide duty. Where it is necessary for people's health or safety, arrangements must be made for dealing with any foreseeable emergency on a construction site, and everyone they cover must be familiar with them (CDM 2015, regulation 30). First aid is part of those arrangements, and our free emergency plan template puts them in one place. First aid is not one of the CDM Schedule 2 welfare facilities, which our welfare facilities guide covers.

The first-aid needs assessment

“Adequate and appropriate” is decided by you, with a first-aid needs assessment. HSE's guidance on the Regulations, L74 First aid at work (third edition, amended in 2024), says there is no fixed level: each employer assesses the equipment, facilities and people they need. L74 lists what to consider (paragraph 10):

the nature of the work, and its hazards and risks;
the nature of the workforce, and your history of accidents;
the size of the organisation and how the workforce is spread out;
travelling, remote and lone workers, and work patterns such as shifts;
how far the site is from emergency medical services;
whether people work on a shared site with other employers;
annual leave and other absences of first-aiders and appointed persons;
first aid for people who are not your employees.

You do not have to write the assessment down. HSE says keeping a record helps you show a safety representative or an inspector how you decided on your provision (L74 paragraph 9), and L74 Appendix 1 is a record form you can use.

How many first-aiders: HSE's suggested numbers

The law does not give a number. L74 Appendix 3 is a chart of suggested numbers, and it lists construction as an example of higher-hazard work. The table below quotes HSE's higher-hazard column as published in the 2024 amendment of L74.

HSE is clear that these are not a legal table. It says the numbers in Appendix 3 “are suggestions only” and that the employer should take into account all relevant information (L74 paragraph 54). The chart is also for the people who are at work at any one time, so apply it to each shift.

Why you may see different numbers for 5 to 50 workers. Some sources say a site of this size must have a fully trained FAW first-aider. HSE's chart says “at least 1 EFAW or FAW trained first-aider, depending on the type of injuries that may occur”. The choice between EFAW and FAW is for your needs assessment, based on the injuries your work could cause.

Our first aid needs calculator applies the chart to your answers and adds what L74 says about remote sites, shifts, lone workers and shared sites.

HSE's suggested first-aid personnel for higher-hazard work, including construction (L74 Appendix 3)
Employees at work	HSE's suggested starting point
Fewer than 5	At least 1 appointed person
5 to 50	At least 1 EFAW or FAW trained first-aider, depending on the type of injuries that may occur
More than 50	At least 1 FAW trained first-aider for every 50 employed (or part thereof)

Source: HSE L74 First aid at work, third edition (amended 2024), Appendix 3, higher-hazard column. HSE says the numbers are suggestions only (para 54); your needs assessment decides.

Appointed person, EFAW or FAW?

Appointed person. Takes charge of the first-aid arrangements, including looking after the equipment and facilities and calling the emergency services. They do not need first-aid training, though HSE says they may benefit from an EFAW course (L74 paragraphs 78 to 80).
EFAW first-aider. Trained in emergency first aid at work: giving emergency first aid to someone who is injured or becomes ill at work, including CPR and using a defibrillator (L74 paragraph 5 and Appendix 6).
FAW first-aider. Trained in first aid at work, which includes EFAW and also covers specific injuries and illnesses, such as injuries to bones, muscles and joints, burns and scalds, eye injuries and major illness (L74 paragraph 5 and Appendix 5).

HSE no longer approves first-aid training providers, so check that the provider you choose is competent. L74 also lists extra training that may be relevant after your assessment. It names construction, and working in remote areas, as examples where training in haemostatic dressings, wound packing and tourniquets for life-threatening bleeding may be relevant (L74 Appendix 4).

Plan cover for absences. HSE says annual leave does not count as an exceptional absence: if your assessment says you need first-aiders, one should be on duty whenever the need arises (L74 paragraph 81).

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The first-aid kit

The minimum is a suitably stocked first-aid container for each work site, marked with a white cross on a green background. Large sites may need more than one (L74 paragraphs 36 and 37).

No set contents. HSE gives a suggested minimum for low-hazard work and points to British Standard BS 8599, but the contents should reflect your needs assessment (L74 Appendix 2).
Extra items. Your assessment may show you need foil blankets, haemostatic dressings, tourniquets, wound packing or shears that can cut through clothing (L74 paragraph 39).
Water for washing wounds and eyes. If mains tap water is not readily available, HSE says to provide at least one litre of sterile water or sterile saline in sealed, disposable containers (L74 paragraph 40).
Looking after it. Keep containers easy to reach, near hand washing where possible, protected from dust and damp. Check them often and restock soon after use (L74 paragraphs 37 and 38).

On a large construction site, HSE says a first-aid room will usually be necessary (L74 paragraph 48).

Remote sites, shifts and lone workers

Remote sites. Arrange suitable transport, check the kit copes if the emergency services are delayed, and tell the emergency services in writing where the site is and about any specific hazards (L74 paragraph 24).
Shifts and out of hours. First-aid provision must be available whenever employees are at work. You may need separate arrangements for each shift (L74 paragraph 22).
Lone and travelling workers. Decide whether people who travel should carry a personal first-aid kit, and make sure anyone working alone can call for help, for example with a mobile phone. For remote areas, consider personal communicators and extra training (L74 paragraph 21). See our guide to lone working in construction.

Shared sites, subcontractors and the self-employed

First-aid duties sit with each employer for its own employees. On a shared site, one employer can take responsibility for first-aid cover for all the workers. HSE says all the employers should agree the arrangements, share information about the hazards so the shared cover is adequate, and tell their workers. It strongly recommends a written agreement (L74 paragraph 25).

Self-employed people who work on an employer's premises, or alongside other self-employed people, are each responsible for their own first-aid provision, but can agree joint arrangements (L74 paragraph 85).

Write down who provides what before work starts, and brief it at the site induction. If you are a subcontractor, ask the principal contractor what has been agreed for the site.

Telling everyone the arrangements

Arrangements only work if people know them. The law requires you to tell employees where the equipment, facilities and first-aid people are (regulation 4). HSE suggests at least one first-aid notice in a prominent place on each site, and first aid in the induction for new starters (L74 paragraph 83).

On site, that means the names of the first-aiders or appointed person, where the kit is, the site address for an emergency call, and the route to the nearest A&E. Put them in the emergency section of the job's RAMS, on the notice board, and in the induction. RAMS made in The Site Book include a first-aid statement for you to review and complete for each job.

Toolbox talks

Common questions

How many first aiders do I need on a construction site?

The law does not set a number. The Health and Safety (First-Aid) Regulations 1981 require first-aiders in an adequate and appropriate number, decided by your needs assessment. HSE's guidance L74 gives suggested numbers in its Appendix 3, and lists construction as higher-hazard work. For higher-hazard work it suggests at least 1 appointed person for fewer than 5 employees; at least 1 EFAW or FAW trained first-aider for 5 to 50, depending on the type of injuries that may occur; and at least 1 FAW trained first-aider for every 50 employed (or part thereof) above 50. HSE says these numbers are suggestions only.

Do I need a trained first aider if I have fewer than 5 workers?

Not always. The Regulations allow an employer to appoint a person to take charge of first-aid arrangements instead of a first-aider, but only where the nature of the work, the number of employees and the location make that adequate and appropriate (regulation 3(4)). HSE's suggested starting point for higher-hazard work with fewer than 5 employees is at least 1 appointed person. HSE also points out that an accident or sudden illness can still happen, so you may wish to provide a qualified first-aider.

Should my first aider do EFAW or FAW?

It depends on the injuries your work could cause. EFAW (emergency first aid at work) covers giving emergency first aid to someone injured or taken ill at work. FAW (first aid at work) includes EFAW and also covers specific injuries and illnesses, such as injuries to bones, muscles and joints, burns, eye injuries and major illness. For higher-hazard work with 5 to 50 employees, HSE's chart says at least 1 EFAW or FAW trained first-aider, depending on the type of injuries that may occur. Above 50, it says FAW.

I am self-employed. Do I need a first aid kit?

Yes, on a construction site. A self-employed person doing work on a construction site must provide, or make sure there is provided, the equipment adequate and appropriate to give first aid to themselves at work (regulation 5, read with the Prescribed Undertakings Regulations 2015). HSE's guidance says that where self-employed people work on an employer's premises or alongside others, each is responsible for their own first-aid provision, but joint arrangements can be made.

Can one contractor provide first aid for the whole site?

Yes, if everyone agrees. HSE's guidance says that on a shared site one employer can take responsibility for first-aid cover for all the workers. All the employers should agree the arrangements, swap information about the hazards so the cover is adequate, and tell their workers. HSE strongly recommends a written agreement between the employers.

What should be in a construction site first aid kit?

There is no mandatory list. HSE's guidance gives a suggested minimum for low-hazard work and refers to British Standard BS 8599, but says the contents should reflect your needs assessment. On a construction site, think about the injuries your work could cause. HSE suggests extra items may be needed, such as foil blankets, haemostatic dressings, tourniquets or shears for cutting through clothing, and sterile water if there is no mains tap water for washing wounds and eyes.

Do I need a defibrillator on site?

HSE's first aid FAQs say health and safety legislation does not require you to have an automated external defibrillator (AED) in your workplace. You can still decide to provide one as part of your needs assessment. CPR and AED use are part of the EFAW and FAW course content.

What HSE's suggested numbers do, and what they cannot do

Pros

Give you a starting point for your headcount, from HSE's own guidance.
Treat construction as higher-hazard work, so the starting point fits a building site.
Show when a trained first-aider, not just an appointed person, is likely to be needed.
Make it easy to explain your decision to a client, principal contractor or inspector.

Cons

HSE says the numbers are suggestions only, not a legal table.
They do not tell you whether EFAW or FAW suits a 5 to 50 person site.
They do not cover remote sites, shifts or lone workers: your assessment has to.
A number on paper does not help if the first-aider is on holiday. Plan cover.

“The numbers quoted in Appendix 3 are suggestions only. The employer should take into account all relevant information to make a valid judgement.”

Health and Safety Executive, UK health and safety regulator · Source

“There is no mandatory list of items to be included in a first-aid container.”