Free RIDDOR incident report template

• The MapTrack RIDDOR incident report template contains 22 checks across 7 sections. Sections covered: Injured Person Details, Incident Description, Location and Time, Injury/Condition Details, Witness Details, Investigation Findings, Corrective Actions.
• Report details: report reference number, date of report, responsible person (name, position, contact details).
• Injured person details: full name, date of birth, occupation, employer (if different from the reporter), employment status (employee, self-employed, member of the public).
• Incident details: date, time, exact location (site, building, area), what the injured person was doing at the time.

Learn more about compliance and inspections in MapTrack.

• Regulatory compliance: meet RIDDOR 2013 reporting obligations to the HSE and demonstrate due diligence in incident management.
• Timely reporting: the structured template prompts the responsible person to capture all required information quickly, helping meet the reporting deadlines (without delay for deaths and specified injuries, within 15 days for over-7-day incapacitation).
• Accurate categorisation: clear prompts for RIDDOR incident categories (specified injury, over-7-day, dangerous occurrence, occupational disease) reduce the risk of mis-classification or under-reporting.
• Investigation support: the detailed incident description, witness statements and immediate actions section feeds directly into follow-up incident investigations.
• Audit trail: completed RIDDOR reports provide documented evidence for HSE inspections, insurance claims and internal safety reviews.
• Continuous improvement: tracking RIDDOR-reportable incidents over time helps identify patterns, high-risk activities and areas where controls need strengthening.

• Report details: report reference number, date of report, responsible person (name, position, contact details).
• Injured person details: full name, date of birth, occupation, employer (if different from the reporter), employment status (employee, self-employed, member of the public).
• Incident details: date, time, exact location (site, building, area), what the injured person was doing at the time.
• RIDDOR category: specified injury (with type), over-7-day incapacitation, dangerous occurrence (with Schedule 2 reference), occupational disease (with disease type), or death.
• Description of incident: what happened, how it happened, what went wrong, equipment or substances involved.
• Injury or condition details: nature of injury, body part affected, first aid or medical treatment given, hospital attended.
• Immediate actions taken: first aid, area secured, equipment isolated, witnesses identified, supervisor notified.
• Witness details: names, contact details, statements (attach separately if needed).
• HSE notification: method of reporting (online portal), date submitted, HSE reference number (when received).
• Follow-up actions: investigation assigned to, corrective actions identified, target completion dates.

1. As soon as a reportable incident occurs, secure the scene, administer first aid and call emergency services if needed. Begin completing the template while details are fresh.

   The immediate priority is the safety of the injured person and bystanders. Administer first aid, call 999 if the injury is serious, and secure the scene to prevent further harm. Do not disturb the scene unnecessarily, as it may need to be preserved for investigation. Once the scene is safe and the injured person is receiving care, begin completing the template. Recording details while they are fresh produces a more accurate and complete report than relying on memory hours or days later.

2. Fill in the report details and injured person information. Record the date, time and exact location of the incident.

   Enter the report reference number (from your internal incident log), the date the report is being compiled, and the responsible person details (name, position, contact number). Record the injured person full name, date of birth, occupation, employer (if different from the reporting organisation) and employment status (employee, self-employed or member of the public). Note the exact date and time of the incident and the precise location, including the site name, building, floor, area and any grid reference or what3words location if applicable.

3. Determine the correct RIDDOR category. For specified injuries and deaths, the report must be submitted without delay. For over-7-day incapacitation, report within 15 days of the incident.

   Review the injury details against the RIDDOR 2013 categories. Specified injuries include fractures (other than fingers, thumbs and toes), amputations, permanent loss of sight, crush injuries, scalping, burns covering more than 10% of the body, and injuries leading to hypothermia, unconsciousness or requiring resuscitation. If the worker is incapacitated for more than seven consecutive days (not counting the day of the accident), it is an over-7-day incapacitation. For dangerous occurrences, check Schedule 2 of RIDDOR 2013. For occupational diseases, a medical diagnosis from a doctor is required. Record the category on the template, as it determines the reporting deadline.

4. Write a clear, factual description of what happened, how it happened, what equipment or substances were involved, and what went wrong. Avoid speculation or blame.

   Describe the sequence of events leading up to the incident in plain, factual language. State what the injured person was doing at the time, what task was being performed, what equipment or substances were involved, and what deviated from normal. Include specific details such as the make and model of equipment, the chemical name of any substance, the height of a fall or the weight of an object. Do not include opinions, blame or conclusions about fault at this stage; those belong in the subsequent investigation. The HSE needs a clear, objective account to assess the incident.

5. Record witness details and gather statements. Note any CCTV footage or photographs of the scene.

   Record the name, contact details and role of every person who witnessed the incident. Ask each witness to provide a written statement as soon as practical, while their recollection is fresh. Note whether CCTV cameras cover the incident location and arrange for the footage to be preserved before it is overwritten. Take photographs of the scene, the equipment involved, any damage and the surrounding area. These records support the RIDDOR report, the internal investigation and any potential enforcement or insurance proceedings.

6. Submit the report to the HSE via the online RIDDOR reporting portal (www.hse.gov.uk/riddor/report.htm). Record the HSE reference number on the template.

   For deaths and specified injuries, submit the report to the HSE without delay. You can report online via the RIDDOR portal or by telephone to the Incident Contact Centre on 0345 300 9923. If reported by telephone, a written report must follow within 10 days. For over-7-day incapacitation, submit the online report within 15 days. Once submitted, the HSE issues a reference number. Record this reference number on the template and in your incident register. Retain a copy of the submitted report as proof of compliance.

7. Assign follow-up actions: initiate a formal incident investigation, identify corrective actions and set target completion dates. Retain the completed report for a minimum of three years.

   Assign a lead investigator and initiate a formal incident investigation to determine the root cause. Identify corrective and preventive actions, assign responsible persons and set target completion dates. Track these actions to close-out in your safety management system. File the completed RIDDOR template, witness statements, photographs and HSE reference number together as a single incident record. Under RIDDOR 2013, records must be retained for a minimum of three years. Best practice is to retain records for at least six years to align with the Limitation Act 1980 for personal injury claims.

Practical answers about the form, record keeping and using MapTrack.

This form is a starting point. Check the current requirements that apply to your equipment, work and location. The form alone does not establish compliance.

• RIDDOR 2013 - Reporting of Injuries, Diseases and Dangerous Occurrences Regulations
• HSWA 1974 - Health and Safety at Work etc. Act, Section 2 (general duties of employers)
• Management of Health and Safety at Work Regulations 1999, Regulation 3 (risk assessment)

• Health and Safety at Work etc. Act 1974
• Management of Health and Safety at Work Regulations 1999

MapTrack publishes this template. The linked authorities publish their own guidance; they haven't endorsed this form.

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