At my last job we had criteria and did basically 3 levels: 1- the basic open and shut things that you describe Level-2-more serious issues requiring a bit of an investigation as to how they happened, they might involve some sort of operational failure; person not trained to do particular task or not wearing the correct PPE etc. some RIDDORS most first aid cases. Level-3 we need to go to town on this because it’s a RIDDOR and HSE may follow this up, the person has suffered  a serious injury and may sue  or its something that has the potential to really damage the business or has gone horribly wrong and we better investigate thoroughly and produce a serous looking report which goes into detail and clearly sets out corrective actions. The criteria were a bit more objective than that but I can’t remember the details of what we did but you need some flexibility so not every RIDDOR is a Level 3  and not all near misses are Level 1.

Hi Mike 

I have always taken the view that the level of in house investigations should generally be determined by the reasonably forseeable potential outcome (NOT the worst case scenario which is almost invariably at least one dead body) rather than what the ACTUAL outcome was.

There ARE the "open and shut" cases where it is obvious that action is needed and it is perhaps not worth bothering with an in depth investigation - particularly if that action is to sort out an unsafe CONDITION. Sort the problem and perhaps leave identifying the underlying (usually management failings) for another day.

So, you can have a relatively serious outcome such as a RIDDOR where the outcome was more serious than could have been anticipated if NOT applying hindsight. Example, man working in final stages of refurbishment of a block of flats, necessarily lifted a single floor board and fell a maximum of 340mm - then a series of other things happened and he ended up dead 10 days later, but with a clear cause and effect between incident and outcome.

BUT, you can quickly establish that there were no reasonably practicable precautions to prevent the incident, so not worth spending any more time than needed to show compassion on the investigation.

Conversely, someone falls 6m from e.g. a scaffold and twists their ankle, no time lost - this merits an in depth investigation due to the easily foreseeable potential consequence.

I completely agree with Peter. 

All good training on accident investigation, including the section in the NEBOSH General Cert states the level of investigation should be proportional to the potential consequences, not the actual outcome. This is particularly important for identifying the need for 'near miss' investigation. The only difference between a 'near miss' and an potentially serious accident is luck, and that can't be listed on a risk assessment as a control!

There is also a benefit to 'over investigating' some accidents or 'near misses' when accidents are a rare event, just to maintain the skills of investigators.

Hope it helps.

Originally Posted by: andybz

Mike

I know you were being a bit flipant in your second post but you have (inadvertently) highlighted at least two reasons to investigate:

1. If it is "always the apprentice" you want to investigate why that is the case. Are you achieving the right balance between allowing people new to work to experience it whilst managing the risks they are exposed to? What could have been done differently to allow the apprentice to use a grinding disc but with less likelihood of injury.

2. The accident was definitely not caused by failure to wear gloves. That may have led to more significant consequences, but there was obviously a loss of control that allowed contact to take place. Your investigation has to get beyond "injury to failure to wear PPE".

What others have said about potential rather than actual outcomes is spot on.

Oh I totally get what you're saying. You're right, I was just being a bit flipant, this is the first accident this apprentice has had since I have worked here, the comment was more based on experience of working with many apprentices and having been one myself, they're young and invincible.

The main issue wasn't that he was wearing gloves, but that he was holding the workpiece with one hand, and the grinder with the other. His work wasn't secured and the grinder wasn't fully controlled. Gloves would have helped, but the accident still would have occurred.

Time to go ask some questions, I think.