Safety representative report form

When your staff safety representatives want to inform managers of problems they have observed in the workplace it’s good practice for them to put their findings in writing. Use our form to record and report these observations.

Safety representatives

Under the Safety Representatives and Safety Committees Regulations 1977 (SRSCR), recognised trade unions may appoint safety representatives within a workforce. One of their functions is to carry out health and safety inspections. They may also make observations and receive reports from colleagues between formal inspections.

As a result, these representatives will occasionally have concerns which they wish to raise with managers. This is when our Safety Representative Report Form can be used.

The form is based on an example provided by the HSE in its official guidance to the SRSCR “Consulting workers on health and safety (L146)”.

What should the employer do on receipt?

According to the HSE, employers who receive reports from safety representatives should:

• take appropriate remedial action and publicise what has been done throughout the workplace, or
• explain in writing why action is not considered appropriate or must be delayed, and
• give the representatives the opportunity to re-inspect the area and to record their views, and
• table the matter at the next health and safety committee meeting, if one exists.