Construction sites carry a different level of risk to a typical office or shop floor, and construction site first aid requirements reflect that. Falls from height, contact with machinery, embedded objects and manual handling injuries mean that when something goes wrong, it tends to go wrong quickly and seriously. Getting first aid provision right is not just good practice, it is a legal duty that principal contractors and employers cannot afford to get wrong.
This guide sets out what UK law actually requires for first aid on construction sites, how many first aiders you need, what should be in your kit, and how construction sites differ from lower-risk workplaces.
The Legal Basis for First Aid on Construction Sites
The core legal duty comes from the Health and Safety (First-Aid) Regulations 1981, which apply to every workplace in Great Britain, including construction sites. The regulations require employers to provide "adequate and appropriate" first aid equipment, facilities and personnel, based on the specific circumstances of the workplace.
Since October 2013, the old Approved Code of Practice was withdrawn and replaced with HSE guidance document L74 (First Aid at Work), now in its third edition. This is an important point that many guides get wrong: L74 does not set out a fixed ratio of first aiders to workers. Instead, it requires employers to carry out a first aid needs assessment and use that to decide what "adequate" provision looks like for their site. Following the guidance in L74 is not compulsory, but the HSE confirms that if you do follow it, you will normally be doing enough to comply with the law.
On a construction site, this needs assessment sits alongside your duties under the Construction (Design and Management) Regulations 2015 (CDM 2015). CDM 2015 does not replace the 1981 Regulations, but it does require your construction phase plan to set out emergency procedures, including first aid arrangements, the location of first aid equipment, and how injuries will be reported. The principal contractor holds overall responsibility for ensuring this is in place before work starts and reviewed as the workforce changes.
Carrying Out a First Aid Needs Assessment for Construction
A first aid needs assessment does not need to be a lengthy document, but it should be recorded and kept under review. For a construction site, HSE guidance points to several factors you need to consider.
Nature of the work. High-risk activities such as steelwork, demolition, work at height, or work involving hazardous substances need more first aid provision than lower-risk finishing trades. A groundworks or steel-fixing phase carries different risks to snagging and decoration at the end of a project.
Number of workers on site. More people on site means more potential casualties and a greater need for trained cover, particularly where multiple contractors are working simultaneously.
Site layout and access. A spread-out site, a multi-storey build, or a site with restricted access may need first aid points in more than one location, rather than a single kit in the site office.
Shift patterns and lone working. If work continues across shifts, or if individuals are working alone or in isolated parts of the site, first aid cover needs to be available whenever people are on site, not just during core hours.
History of incidents. Previous accidents or near misses on site or on comparable projects should inform how much provision is genuinely adequate.
How Many First Aiders Do You Need on a Construction Site?
There is no single number written into law, but HSE guidance and widely used industry benchmarks give a practical starting point for higher-risk environments like construction:
- Fewer than 5 workers: at least one appointed person, someone designated to take charge of first aid arrangements, look after equipment, and call the emergency services when needed. An appointed person does not need a first aid qualification.
- 5 to 50 workers, higher risk: at least one first aider trained to Emergency First Aid at Work (EFAW) or First Aid at Work (FAW) level, depending on the outcome of your needs assessment.
- More than 50 workers, higher risk: provision typically scales at roughly one FAW-trained first aider for every 50 workers, with additional cover built in for shift patterns and multi-contractor working.
These figures are a benchmark, not a legal minimum. Many principal contractors set their own standards above HSE guidance, particularly on larger or higher-risk sites, and it is common for dedicated first aiders to be appointed who are not also performing trade duties, so they can respond immediately without downing tools elsewhere on site.
EFAW or FAW: Which Training Do You Need?
Emergency First Aid at Work (EFAW) is a one-day course covering life-threatening emergencies such as CPR, choking, severe bleeding and shock. First Aid at Work (FAW) is a three-day course that covers everything in EFAW plus additional injuries and illnesses relevant to higher-risk workplaces, including fractures, burns and extended casualty care before emergency services arrive. Which one your site needs depends on the outcome of your needs assessment, but FAW is the standard expectation for larger construction sites, supervisors and principal contractors. First aid certificates are valid for three years, and the HSE recommends an annual refresher to keep skills current between requalification courses.
What Should Be in a Construction Site First Aid Kit?
There is no single mandated contents list for a workplace first aid kit. Instead, the HSE expects kit contents to be based on your needs assessment, with BS 8599-1:2019+A1:2026 used as the recognised British Standard benchmark for workplace kit contents and sizing.
For construction, this typically means going beyond a standard kit:
- A BS 8599-1 compliant kit sized to your workforce, stocked with dressings, eye wash, plasters and burns dressings appropriate to site hazards.
- A critical injury or bleed control kit where work involves power tools, machinery, sharp materials or embedded object risk. Standard plasters and dressings are not designed to manage major traumatic bleeding, and the HSE's guidance on higher-risk environments points to additional trauma provision alongside the general kit.
- Eye wash provision, particularly relevant where cutting, grinding, or work with dust, cement or chemicals is taking place.
- Multiple, clearly signed first aid points on larger or multi-storey sites, rather than a single central kit that may be a long walk from an active work area.
Kits should be checked and restocked regularly, kept dry and protected from site conditions, and clearly signed so every worker, including subcontractors and visitors, knows where to find them.
Is a First Aid Room Required on a Construction Site?
A dedicated first aid room is not automatically required by law. HSE guidance suggests one should be considered where the site has a higher accident rate, a large workforce, or is a significant distance from emergency medical services. On many construction sites this translates into a designated space within the site welfare cabin, kept clean, accessible and stocked appropriately, rather than a standalone clinical room. The decision should be recorded as part of your first aid needs assessment.
Recordkeeping and RIDDOR
Every construction site should maintain an accident book to record injuries and incidents, regardless of severity. Some injuries and dangerous occurrences on site will also meet the threshold for reporting under RIDDOR (the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013), and construction's higher incident rate for reportable injuries makes accurate recordkeeping a genuine compliance priority, not just an administrative task. Records should note who administered first aid, what was provided, and any follow-up action taken.
Practical Takeaways
- Base your first aid provision on a documented needs assessment, not a copied ratio table.
- Budget for at least an appointed person on the smallest sites, scaling to FAW-trained first aiders as workforce size and risk increase.
- Stock a BS 8599-1 compliant kit as standard, with a critical injury or bleed control kit where machinery, power tools or embedded object risks are present.
- Review provision whenever the workforce, site layout or work phase changes significantly, not just at project kick-off.
- Keep an accident book on site and know your RIDDOR reporting obligations for anything more serious than minor first aid treatment.
How MedWare Can Help
Getting construction site first aid requirements right starts with the right kit, in the right place, kept properly stocked. MedWare supplies BS 8599-1 compliant first aid kits, dedicated bleed control and trauma kits, and eye wash stations suited to higher-risk sites, alongside the storage and signage to keep them accessible where your teams need them. If you are setting up provision across multiple sites or need trade pricing for ongoing supply, get in touch with our team to talk through what your site needs.