Does the Health and Safety Executive regulate health and social care?

Safety is a cornerstone of high-quality health and social care. Whether in care homes, hospitals, GP surgeries, or community settings, providers have a legal duty to protect staff, patients, visitors, and contractors from harm. But when it comes to enforcement, who regulates safety in these care environments?

The Health and Safety Executive (HSE) is the UK’s independent regulator for workplace health and safety in Great Britain. The HSE plays a vital but sometimes misunderstood role in the health and social care sector.

In this comprehensive blog, Dr Richard Dune explains HSE’s remit in health and social care settings, how it works alongside other national regulators, and what providers must do to stay compliant, particularly in light of 2025 priorities and investigation guidance.

What is the HSE, and what does it do in health and social care?

The Health and Safety Executive is the national workplace safety regulator in Great Britain (England, Scotland, and Wales). Sponsored by the Department for Work and Pensions (DWP), the HSE is responsible for:

• Enforcing health and safety law

• Investigating serious workplace incidents

• Prosecuting serious breaches of legislation

• Providing guidance, standards, and alerts

• Working with co-regulators to protect the public and workforce.

In health and social care, the HSE's remit focuses on non-clinical workplace risks, those affecting the environment, staff, and systemic safety controls, such as:

• Manual handling

• Slips and trips

• Fire and electrical safety

• Exposure to hazardous substances

• Unsafe equipment use

• Poor ventilation and infection control practices.

The HSE regulates both private and public providers, including:

• NHS and independent hospitals

• Care homes

• Domiciliary care agencies

• Mental health units

• Day centres

• GP and dental practices.

Key legislation HSE enforces in care settings

The HSE enforces a broad framework of legislation, including:

Health and Safety at Work etc. Act 1974

Requires all employers to ensure the health, safety, and welfare of employees and non-employees.

Management of Health and Safety at Work Regulations 1999

Obligates employers to:

• Carry out risk assessments

• Implement emergency procedures

• Appoint competent persons to manage health and safety.

• Manual Handling Operations Regulations 1992

Essential in care settings for reducing risk during:

• Lifting or moving residents

• Handling hoists or equipment.

Control of Substances Hazardous to Health (COSHH) 2002

Governs the safe handling of:

• Cleaning products

• Clinical substances

• Inhalation or skin exposure risks.

Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013

Mandates reporting of:

• Fractures, burns, scalds, or severe injuries

• Dangerous incidents like gas leaks or equipment failure

• Deaths due to non-clinical causes.

Provision and Use of Work Equipment Regulations (PUWER) 1998

Requires safe use, training, and maintenance of:

• Lifting aids

• Kitchen machinery

• Beds, trolleys, and other equipment.

When does the HSE investigate?

The HSE will only investigate incidents that:

1. Are RIDDOR-reportable AND
2. Fall within HSE’s incident selection criteria OR
3. Involve a systemic failure in health and safety management resulting in fatality or life-threatening harm.

Examples where HSE may investigate include:

• A resident dies following a fall caused by poorly maintained flooring

• A worker suffers severe burns due to a faulty boiler

• A fatal incident results from the failure to train staff in manual handling

• There’s a known breach of a safety alert or industry standard.

When HSE will not investigate

The HSE is not responsible for investigating clinical standards or care outcomes. It will generally not intervene where incidents arise from:

• Poor clinical judgement, such as diagnostic decisions or prescribing errors

• Standards of care, including hydration, nutrition, medication effectiveness, or care planning

• Events that are better handled by another regulator with the powers to improve clinical outcomes or secure justice for service users.

In these cases, the HSE will defer to the appropriate body:

• CQC or Ofsted for care quality and safeguarding in England

• General Medical Council (GMC), Nursing and Midwifery Council (NMC), or Health and Care Professions Council (HCPC) for concerns about professional conduct

• RQIA, CIW, HIS, or the Care Inspectorate in Scotland, Wales, and Northern Ireland

HSE will only act if there is a serious non-clinical safety failure that meets its enforcement criteria.

HSE's collaboration with other UK regulators

The Health and Safety Executive (HSE) collaborates closely with other regulators across the UK to ensure a coordinated and effective regulatory approach, particularly in the health and social care sectors. This collaboration is formalised through Memoranda of Understanding (MoUs), which define roles, referral pathways, and joint working arrangements.

England

• CQC - HSE handles non-clinical safety risks; CQC regulates care quality and safeguarding

• Ofsted - Joint cooperation on safety and environmental risks in children’s social care.

Scotland

• Healthcare Improvement Scotland (HIS) - Safety in hospital and clinical settings

• Care Inspectorate - Coordination on workplace risks in social care

• MWC - Information-sharing for mental health environments.

Wales

• CIW and HIW - Work with HSE on shared concerns and enforcement

• Local authorities and fire services - Joint responsibility for environmental and fire safety.

These partnerships prevent duplication and promote consistent enforcement of regulations.

HSE and fire safety in care homes

The Health and Safety Executive (HSE) plays a distinct role in fire safety within care settings. It is responsible for managing process fire risks, such as those arising from electrical faults, flammable liquids, or gas systems (e.g. LPG). These risks relate to workplace safety and are enforced under health and safety law.

However, general fire precautions, including fire exits, fire doors, alarms, evacuation procedures, and safe escape routes, are typically enforced by local Fire and Rescue Services under the Regulatory Reform (Fire Safety) Order 2005.

The tragic Rosepark Care Home fire in 2004, which led to 14 fatalities, demonstrated the need for robust fire safety policies and joint regulatory enforcement. Providers must ensure coordinated compliance with both HSE and fire service requirements to effectively safeguard residents.

Common health and safety failures in care

HSE inspections in health and social care settings frequently reveal preventable issues that pose significant risks. These include:

• Inadequate or outdated risk assessments

• Poor or irregular staff training in manual handling and safety procedures

• Unsafe use or maintenance of hoists, bed rails, and wheelchairs

• Improper storage or labelling of hazardous substances

• Failure to report incidents under RIDDOR

• Weak infection prevention and control, including poor ventilation and PPE misuse

• Lack of fire drills, emergency plans, or evacuation training.

Such failures often reflect systemic issues in leadership, oversight, or safety culture and may lead to enforcement, prosecution, or reputational damage if unaddressed.

HSE’s priorities in 2025 for the care sector

In 2025, the HSE continues to focus on high-risk issues within health and social care environments. Its strategic priorities include:

• Manual handling injury reduction - Preventing musculoskeletal injuries through training, equipment use, and task redesign

• Workplace mental health and stress management - Promoting psychological safety, supervision, and workload planning

• Safe use of technology - Ensuring proper maintenance and use of hoists, alarms, and digital systems

• Safe staffing - Addressing risks linked to fatigue, low staffing levels, and inadequate supervision

• Fire safety in high-dependency residential settings - Strengthening evacuation procedures and identifying fire hazards

Providers should regularly audit these areas, using HSE guidance to inform proactive risk management strategies.

Best practices for embedding health and safety in governance

Embedding robust health and safety into an organisation's governance is crucial for a strong safety culture and ongoing compliance in health and social care. This section outlines essential practices across policies, training, risk assessments, incident reporting, and leadership oversight, driving better outcomes and regulatory adherence.

Policies and procedures

Comprehensive and up-to-date health and safety policies and procedures form the bedrock of effective safety management in UK care settings. These critical documents provide clear guidelines for staff and ensure adherence to legal requirements and best practices, covering essential areas such as:

• Health and safety, including risk assessments

• COSHH

• RIDDOR

• Fire safety

• Lone working

• Aggression and violence

• PUWER and equipment use. 

Mandatory training

Mandatory health and safety training is indispensable for equipping staff with the essential knowledge and skills to maintain a safe environment and comply with UK health and safety regulations. Investing in regular and relevant training helps to reduce incidents and cultivates a proactive safety culture within your organisation, covering key areas such as:

• Fire drills

• Manual handling

• Infection prevention

• First aid

• RIDDOR awareness

• Mental wellbeing. 

Risk assessments

Proactive and thorough risk assessments are a cornerstone of effective health and safety in health and social care, as they identify and control potential hazards within care environments. To effectively mitigate risks and improve safety, organisations should:

• Conduct risk assessments for all high-risk activities and service user needs

• Involve multidisciplinary input in risk assessments

• Review risk assessments regularly or after incidents.

Incident reporting

Effective incident reporting is crucial for learning from adverse events, preventing their recurrence, and demonstrating compliance with regulations, such as RIDDOR. A robust reporting system enables continuous quality improvement and staff learning in care settings by facilitating the ability to:

• Ensure RIDDOR reporting is timely

• Analyse trends

• Use data for quality improvement and staff learning. 

Leadership and oversight

Strong leadership and diligent oversight are paramount in fostering a positive health and safety culture and ensuring consistent compliance throughout any health or social care organisation. This involves key responsibilities that drive safety from the top down, such as:

• Assigning responsible officers

• Including HSE compliance in board assurance

• Monitoring with dashboards and lead indicators. 

Overview of other key UK health and social care regulators

Alongside the HSE, several regulators ensure the safety, quality, and accountability of health and social care:

England

• CQC - Regulates adult social care, NHS services, and independent healthcare providers

• Ofsted - Oversees children’s social care, fostering, and early education

• GMC, NMC, HCPC, GDC - Regulate health and care professionals, including doctors, nurses, therapists, and dentists.

Scotland

• Healthcare Improvement Scotland (HIS) - Inspects hospitals and clinical services

• Care Inspectorate - Regulates care homes and community care

• Mental Welfare Commission (MWC) - Safeguards mental health rights.

Wales

• HIW - Regulates NHS and private healthcare

• CIW - Oversees social care and early years

• Local authorities - Enforce environmental health and fire safety laws.

Northern Ireland

• RQIA - Regulates hospitals, care homes, and mental health services.

UK-Wide

• MHRA - Oversees medicine and device safety

• Professional Standards Authority (PSA) - Monitors health and care regulators.

Final thoughts

So, does the HSE regulate health and social care? 

Yes, but within clearly defined limits. The HSE does not oversee clinical care standards or professional fitness to practise. Instead, it regulates non-clinical workplace safety, focusing on risks that impact staff, visitors, and service users, including manual handling, hazardous substances, equipment safety, and fire prevention.

Providers that embed HSE principles into their daily operations don’t just meet legal obligations; they help create resilient, well-governed, and safer environments. This not only reduces incidents but also supports staff wellbeing, regulatory compliance, and service continuity.

Understanding where the HSE’s remit begins and ends, and how it overlaps with bodies like the CQC, CIW, HIS, or RQIA, enables providers to respond effectively, manage risk proactively, and deliver better, safer care for all.

Meet HSE standards with confidence using ComplyPlus™

ComplyPlus™ by The Mandatory Training Group is your digital solution for HSE-aligned compliance in health and social care. Whether you manage a care home, clinic, or community service, ComplyPlus™ supports safe and effective operations.

With ComplyPlus™, you can:

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• Align your workforce development with regulatory best practice

Explore ComplyPlus™ today and build a safer, more compliant organisation, because health and safety is everyone’s responsibility.