Accident Report Form (England & Wales)
WORKPLACE ACCIDENT REPORT FORM
Report Reference: [Report Reference]
Date of Report: [Report Date]
Report Completed By: [Report Completed By]
CONFIDENTIAL — This report contains personal data and is subject to the Data Protection Act 2018 (UK GDPR). Access should be restricted to authorised personnel only.
SECTION 1 — ORGANISATION DETAILS
Organisation / Employer: [Organisation Name]
Workplace Address: [Organisation Address], [Organisation City], [Organisation Postcode]
Health and Safety Responsible Person: [HS Responsible Person]
Note: Under the Employers' Liability (Compulsory Insurance) Act 1969, all employers with one or more employees must hold a valid Employers' Liability insurance policy with a minimum indemnity of £5,000,000. The certificate must be displayed at each workplace.
SECTION 2 — INJURED PERSON DETAILS
Name: [Injured Person Name]
Job Title / Role: [Injured Person Job Title]
Status: [Injured Person Type]
Home Address: [Injured Person Address], [Injured Person City], [Injured Person Postcode]
Data Protection Notice: Personal data collected in this report is processed under Article 9 UK GDPR (special category health data) for the purpose of managing workplace health and safety obligations under the Health and Safety at Work etc. Act 1974. This data will be held securely and retained for a minimum of 3 years in accordance with RIDDOR 2013 requirements.
SECTION 3 — ACCIDENT DETAILS
Date of Accident: [Accident Date]
Time of Accident: [Accident Time]
Location: [Accident Location]
Description of How the Accident Occurred:
[Accident Description]
SECTION 4 — INJURY AND TREATMENT
Nature of Injury or Illness:
[Injury Description]
Severity Classification: [Injury Severity]
Treatment Given at Scene:
[Treatment Given]
Hospital Treatment Required: [Hospital Required]
SECTION 5 — WITNESSES
Witnesses Present: [Witnesses Present]
SECTION 6 — RIDDOR 2013 REPORTING
The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (SI 2013/1471) require employers to report certain accidents to the Health and Safety Executive (HSE). Specified injuries and fatalities must be reported immediately; over-7-day injuries within 15 days; and injuries to members of the public requiring hospital treatment as soon as practicable.
RIDDOR Report Required: [Riddor Report Required]
SECTION 7 — IMMEDIATE ACTION TAKEN
[Immediate Action]
Formal Investigation Required: [Further Investigation Required]
SECTION 8 — CAUSATION ANALYSIS
Immediate Cause:
[Immediate Cause]
Underlying Cause(s):
[Underlying Cause]
Corrective and Preventive Actions:
[Corrective Actions]
SECTION 9 — LEGAL OBLIGATIONS SUMMARY
This report has been completed in accordance with the following legislation: Health and Safety at Work etc. Act 1974; Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR 2013, SI 2013/1471); Management of Health and Safety at Work Regulations 1999 (SI 1999/3242); Health and Safety (First Aid) Regulations 1981; Employers' Liability (Compulsory Insurance) Act 1969; Data Protection Act 2018 (UK GDPR). All accident records must be retained for a minimum of 3 years from the date of the accident (RIDDOR 2013, reg. 12). Health records related to work-related disease or injury should be retained for 40 years. This document is governed by the laws of England and Wales.
DECLARATION
I declare that to the best of my knowledge the information contained in this Accident Report Form is true and accurate. I understand that this report may be disclosed to the Health and Safety Executive, insurers, legal advisers, or other authorised parties in connection with investigation or legal proceedings arising from this accident.
Person completing this report: [Report Completed By]
Organisation: [Organisation Name]
Person Completing Report
________________
Signature
Date: ________________
Health and Safety Manager / Supervisor
________________
Signature
Date: ________________
What Is a Accident Report Form (England & Wales)?
An Accident Report Form in the United Kingdom puts facts on the record under a formal declaration so they can be relied on by a court, registrar, or third party, with its requirements set by the Data Protection Act 2018.
RIDDOR 2013 requires employers, self-employed persons, and persons in control of premises to report specified categories of workplace accidents, occupational diseases, and dangerous occurrences to the Health and Safety Executive (HSE). The main reportable categories are specified injuries to employees (regulation 4), including fractures, amputations, and loss of consciousness; over-7-day incapacitating injuries (regulation 6), which must be reported within 15 days; injuries to non-workers (members of the public) requiring hospital treatment (regulation 5); and dangerous occurrences listed in Schedule 2.
The Health and Safety at Work etc. Act 1974 places a general duty on employers under section 2 to confirm so far as is reasonably practicable the health, safety, and welfare of all their employees. This is supplemented by the Management of Health and Safety at Work Regulations 1999 (SI 1999/3242), which require employers to carry out suitable and sufficient risk assessments, implement appropriate preventive measures, and review those measures following accidents or incidents.
Employers are also required under the Employers' Liability (Compulsory Insurance) Act 1969 to maintain employers' liability insurance of at least £5 million and to display the current insurance certificate at each workplace. A properly completed accident report form is essential for notifying insurers of a potential claim and for establishing the facts of any personal injury action.
The Data Protection Act 2018 (UK GDPR) governs the processing of personal data contained in accident reports, including the injured person's health information (special category data under Article 9 UK GDPR) and witness contact details. Employers must handle this data securely, provide appropriate privacy notices, and retain records for the minimum required period (3 years under RIDDOR 2013, regulation 12).
The legal framework governing the Accident Report Form (England & Wales) in United Kingdom draws on several key statutes and regulatory bodies. Under the Employment Rights Act 1996, the Employment Tribunal adjudicates workplace disputes. Section 94 of the Employment Rights Act 1996 provides the right not to be unfairly dismissed. The Advisory, Conciliation and Arbitration Service (ACAS) provides early conciliation under Section 18A of the Employment Tribunals Act 1996. The UK GDPR and Data Protection Act 2018 govern personal data handling. HM Revenue and Customs (HMRC) administers PAYE and National Insurance contributions under the Income Tax (Earnings and Pensions) Act 2003. Parties executing a Accident Report Form (England & Wales) in United Kingdom should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Employment Rights Act 1996 sets the foundational requirements.
When Do You Need a Accident Report Form (England & Wales)?
A Workplace Accident Report Form should be completed as soon as practicable after every workplace accident, injury, near miss, or dangerous occurrence, regardless of whether the incident appears minor at the time. The benefits of prompt and accurate reporting are legal, practical, and organisational.
From a legal perspective, the RIDDOR 2013 reporting obligation is triggered immediately for specified injuries and fatalities, and within 15 days for over-7-day injuries. Failure to report a RIDDOR-reportable incident is a criminal offence under the Health and Safety at Work etc. Act 1974 and may result in prosecution by the HSE, potentially leading to significant fines and, in serious cases, imprisonment.
From a practical perspective, contemporaneous accident records are invaluable if the injured person subsequently brings a personal injury claim. Under the Limitation Act 1980, a personal injury claim must generally be brought within three years of the date of knowledge, so records may be required for up to three years or longer. A contemporaneous accident report that accurately captures the facts is far more compelling evidence than a reconstructed account prepared months or years later.
From an organisational perspective, maintaining thorough accident records enables an employer to identify patterns and trends in workplace accidents, assess the effectiveness of existing risk control measures, demonstrate due diligence in the event of an HSE investigation, and fulfil their obligations under the Management of Health and Safety at Work Regulations 1999 to review and update risk assessments in light of new information.
The United Kingdom Accident Report Form (England & Wales) form should be completed in all situations including: an employee slipping, tripping, or falling at work; a work-related injury caused by manual handling, machinery, or hazardous substances; a road traffic accident in the course of employment; a violent incident at work; a member of the public being injured on the employer's premises; and any dangerous occurrence or near miss, even where no injury resulted.
What to Include in Your Accident Report Form (England & Wales)
A legally effective Workplace Accident Report Form for use in England and Wales must capture all information relevant to the accident, the injuries sustained, the actions taken, and the RIDDOR reporting status.
The organisation details section establishes the legal identity of the employer and the workplace where the accident occurred. It should include the name and address of the organisation and identify the person responsible for health and safety. Under regulation 5 of the Management of Health and Safety at Work Regulations 1999, employers must appoint one or more competent persons to assist in meeting their health and safety obligations.
The injured person section captures the personal details of the injured individual. Given that health information about injuries constitutes special category personal data under Article 9 of the UK GDPR (implemented by the Data Protection Act 2018), the form must be handled securely and access must be restricted to those with a legitimate need to know.
The accident details section is the core of the report and must provide a clear, factual, and objective description of what happened — where, when, and how. It should describe what the injured person was doing at the time, what went wrong, and the sequence of events leading to the injury. Vague or incomplete descriptions significantly reduce the evidential value of the report.
The injury and treatment section classifies the injury by reference to the RIDDOR 2013 categories (specified injury, over-7-day, non-worker injury, dangerous occurrence) and records the treatment given at the scene and any hospital attendance. This classification is critical for determining the reporting obligation and deadline.
The RIDDOR reporting section confirms whether the incident has been or will be reported to the HSE and records the HSE reference number. All RIDDOR-reportable incidents should be reported via the HSE online portal or, for fatalities and specified injuries, by telephone.
The causation and corrective actions section drives learning and prevention. It distinguishes between the immediate cause (the physical event that caused the injury) and the underlying causes (the management or organisational failures that allowed the hazard to exist). Corrective actions should be SMART (specific, measurable, achievable, realistic, and time-bound) and should be tracked through the organisation's safety management system.
Additional compliance elements for a Accident Report Form (England & Wales) used in United Kingdom include: Under the Employment Rights Act 1996, the Employment Tribunal adjudicates workplace disputes. Section 94 of the Employment Rights Act 1996 provides the right not to be unfairly dismissed. The Advisory, Conciliation and Arbitration Service (ACAS) provides early conciliation under Section 18A of the Employment Tribunals Act 1996. The UK GDPR and Data Protection Act 2018 govern personal data handling. HM Revenue and Customs (HMRC) administers PAYE and National Insurance contributions under the Income Tax (Earnings and Pensions) Act 2003. Forms-legal.com provides this template as a starting point for United Kingdom-compliant documentation.
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Reference this free template in an article, syllabus, or research note:
Forms Legal. (2026). Accident Report Form (England & Wales) (United Kingdom) [Legal document template]. Forms Legal. https://forms-legal.com/uk/employment/health-safety/accident-report-form-uk
"Accident Report Form (England & Wales) (United Kingdom)." Forms Legal, 2026, https://forms-legal.com/uk/employment/health-safety/accident-report-form-uk.
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author = {{Forms Legal}},
title = {Accident Report Form (England & Wales) (United Kingdom)},
year = {2026},
howpublished = {\url{https://forms-legal.com/uk/employment/health-safety/accident-report-form-uk}},
note = {Free legal document template. Based on Employment Rights Act 1996}
}Also available for these jurisdictions:
Frequently Asked Questions
The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (SI 2013/1471) require employers, self-employed persons, and persons in control of premises to report specific categories of workplace incidents to the Health and Safety Executive (HSE). The main reportable categories are: specified injuries to employees (regulation 4), which include fractures (other than to fingers, thumbs, or toes), amputations, injuries likely to require over 24 hours in hospital, crush injuries causing damage to internal organs, loss of consciousness, and serious burns; injuries to workers that result in incapacitation for more than 7 consecutive days (regulation 6, excluding the day of the accident) — these must be reported within 15 days; injuries to non-workers (members of the public, visitors, or pupils at educational establishments) that result in them being taken from the scene to a hospital for treatment (regulation 5); and dangerous occurrences (Schedule 2), which are near-miss events such as the collapse of a scaffold or failure of a lifting machine, even where no-one is injured. Certain occupational diseases (Schedule 1) must also be reported. Reports are made online at www.riddor.hse.gov.uk. Fatal and specified injuries must be reported immediately (also by phone: 0345 300 9923).
Under regulation 12 of the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (SI 2013/1471), every employer and self-employed person who is required to report an incident under RIDDOR must keep a record of that incident for at least 3 years from the date on which the record was made. This record must include the date and method of reporting, the date, time, and place of the event, the personal details of those involved, and a brief description of the nature of the event or disease. For health records relating to work-related disease or injury, the Health and Safety Executive recommends a retention period of 40 years in some circumstances (for example, asbestos exposure records). Accident books (previously required under the Social Security (Claims and Payments) Regulations 1979) are no longer mandated, but most employers maintain them as a practical record-keeping tool, particularly to confirm GDPR compliance through anonymisation.
Under the Health and Safety at Work etc. Act 1974, employers have a general duty under section 2 to confirm, so far as is reasonably practicable, the health, safety, and welfare of all their employees. Following a workplace accident, this general duty is supplemented by specific obligations under the Management of Health and Safety at Work Regulations 1999 (SI 1999/3242), which require employers to carry out a suitable and sufficient risk assessment (regulation 3), implement appropriate preventive and protective measures (regulation 4), and review and update risk assessments in light of new information — including information arising from an accident. The employer must also comply with any RIDDOR 2013 reporting obligation, notify their insurers in accordance with their Employers' Liability insurance policy, and investigate the accident to prevent recurrence. Failure to investigate a workplace accident that reveals a systemic safety failure may expose the employer to prosecution by the HSE under section 33 of the 1974 Act, which can result in unlimited fines and, in the most serious cases, imprisonment.
Yes. An accident report form completed shortly after an incident is contemporaneous documentary evidence and may be highly significant in personal injury litigation. Under the Civil Procedure Rules 1998 (CPR), parties to civil proceedings must disclose all documents in their control that are or may be relevant to the issues in dispute. An accident report completed by the employer is likely to be disclosable in any personal injury claim brought by the injured worker. If the report contains admissions of fault, failure to follow risk assessments, or acknowledgment of known hazards, it may significantly affect the outcome of a claim. Employers should confirm that accident reports are accurate and factual, and should seek legal advice before making any admissions in the report. The Limitation Act 1980 provides that a personal injury claim must generally be brought within three years of the date on which the injured person had knowledge of the injury — so records may be relevant for several years.
Accident report forms contain personal data about the injured person and, potentially, witnesses. This data is subject to the Data Protection Act 2018, which implements the UK General Data Protection Regulation (UK GDPR) in domestic law following the UK's departure from the EU. Health information about injuries constitutes 'special category' personal data under Article 9 UK GDPR and is subject to heightened protection. Employers processing this data must: have a lawful basis for processing (typically legal obligation under Article 6(1)(c) — compliance with RIDDOR 2013 and health and safety legislation — and a special category condition under Article 9(2)(b) — obligations and rights in employment); provide the data subject with a privacy notice explaining how their data will be used; store accident records securely with restricted access; and not retain the data for longer than necessary. Witness details should only be used for the purpose of accident investigation and should not be disclosed to third parties without a lawful basis.
Yes, these terms have distinct meanings under RIDDOR 2013. An 'accident' is an undesired event that leads to injury or ill health. An 'incident' is a broader term that includes accidents and near misses. A 'dangerous occurrence' is a defined category of event listed in Schedule 2 to RIDDOR 2013 that must be reported even where no-one was injured — because the event had the potential to cause serious injury or death. Dangerous occurrences include: collapse of a lifting machine or hoist; explosion or fire; collapse of a scaffold over 5 metres high; and unintended contact with overhead power lines. Near misses that do not fall within Schedule 2 are not reportable under RIDDOR 2013 but should still be recorded internally as part of an effective health and safety management system. The separate Incident Report template covers near misses and dangerous occurrences in greater depth.
This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer
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