Lockout Tagout Risk Assessment Form for the United Kingdom

Lockout Tagout Risk Assessment Form Template for England and Wales

A Lockout Tagout Risk Assessment Form is a legally required document under England and Wales health and safety legislation that evaluates the hazards associated with machinery and equipment maintenance. It documents the identification of energy sources, assessment of risks, and establishment of control measures to prevent unexpected energization during maintenance or servicing. The form ensures compliance with the Health and Safety at Work Act 1974 and related regulations while providing a systematic approach to machinery safety.

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What is a Lockout Tagout Risk Assessment Form?

The Lockout Tagout Risk Assessment Form is a critical safety document required by UK health and safety legislation to protect workers from hazardous energy during equipment maintenance and servicing. This document is essential for compliance with the Health and Safety at Work Act 1974 and associated regulations in England and Wales. It provides a structured approach to identifying potential hazards, evaluating risks, and implementing appropriate control measures. The assessment should be conducted before any maintenance work begins and must be regularly reviewed to ensure continued effectiveness of safety measures.

What sections should be included in a Lockout Tagout Risk Assessment Form?

1. Assessment Information: Basic details including date, assessor name, location, and equipment identification

2. Hazard Identification: Comprehensive list of potential energy sources and associated risks requiring lockout/tagout

3. Control Measures: Detailed LOTO procedures, isolation points, and specific safety measures to be implemented

4. PPE Requirements: List of required personal protective equipment for performing LOTO procedures

5. Authorization: Required signatures, approval processes, and responsible persons

What sections are optional to include in a Lockout Tagout Risk Assessment Form?

1. Emergency Procedures: Special procedures for emergency situations, required for complex machinery or high-risk operations

2. Training Requirements: Specific training needs and competency requirements for personnel performing LOTO

3. Contractor Requirements: Additional requirements and procedures when external contractors are involved in LOTO activities

What schedules should be included in a Lockout Tagout Risk Assessment Form?

1. Equipment-specific LOTO Procedures: Detailed step-by-step procedures for specific machinery and equipment

2. Energy Source Checklist: Comprehensive checklist of all potential energy sources requiring isolation

3. PPE Checklist: Detailed checklist of required PPE and inspection criteria

4. Training Records: Documentation template for recording completed LOTO training and authorizations

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Jurisdiction

England and Wales

Publisher

Genie AI

Sector

Sales

Cost

Free to use
Industries

Health and Safety at Work etc. Act 1974: Primary legislation that forms the foundation of workplace health and safety law in the UK, establishing general duties for employers to ensure workplace safety

Management of Health and Safety at Work Regulations 1999: Key regulations that mandate requirements for risk assessments, establish principles of prevention, and outline necessary health and safety arrangements

Provision and Use of Work Equipment Regulations 1998 (PUWER): Regulations specifying requirements for work equipment safety, including maintenance, inspection, and training requirements for equipment operation

The Electricity at Work Regulations 1989: Legislation covering safety requirements for electrical systems and requirements for working on or near electrical equipment

Personal Protective Equipment at Work Regulations 1992: Regulations governing the provision and use of personal protective equipment in the workplace

Control of Substances Hazardous to Health Regulations 2002 (COSHH): Regulations controlling exposure to hazardous substances in the workplace

Workplace (Health, Safety and Welfare) Regulations 1992: Regulations covering basic workplace conditions including ventilation, temperature, lighting, and facilities

BS EN 1037:1995+A1:2008: British and European Standard for Safety of machinery - Prevention of unexpected start-up

HSE Guidance Documents: Official guidance documents from the Health and Safety Executive providing practical advice on implementing safety regulations

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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