COVID-19 and individual risk assessments

Some individuals are recognised as being at an increased risk of contracting or developing more severe complications, from exposure to SARs CoV-2 (coronavirus). There are other factors which can increase your risk including gender, ethnicity and age, as well as underlying health conditions such as type 1 or 2 diabetes. Pregnancy, especially when over 28 weeks is also recognised as a risk factor. The more risk factors you have the greater your risk. 

The RCN expects all employers to follow their legal duties under health and safety legislation in ensuring the health, safety and welfare of all their employees when they are at work including the carrying out of suitable and sufficient risk assessments, by a person with the competency to do so; this includes both workplace and individual risk assessments. Following assessment of risk your employer should take steps to reduce your risk, so far as is reasonably practicable.  This may include working from home, working in non-patient facing areas or improvements to your personal protective equipment (PPE). Whatever steps are taken they should discuss the issues with you and come to an agreement. If you are concerned with the results of the risk assessment or feel you are being bullied into accepting the findings, then you should escalate your concerns through your Occupational Health Department, your RCN workplace representative or contact us for advice. 

If you work for an agency, your agency should liaise with the host organisation where you are being placed and ensure that both individual and environmental risk assessments are being carried out and that any risk of harm is being reduced so far as is reasonably practicable.

Outside of the extremely clinically vulnerable group, other factors can increase your risk and are listed below: 

• you are over 60 (your risk increases as you get older) 
• you are from a Black, Asian or minority ethnic background 
• having an existing lung condition (such as asthma, COPD, emphysema or bronchitis) 
• having heart disease (such as heart failure) 
• having type 1 or type 2 diabetes 
• having chronic kidney disease 
• having liver disease (such as hepatitis) 
• having a condition affecting the brain or nerves (such as Parkinson's disease, motor neurone disease, multiple sclerosis or cerebral palsy) 
• having a health condition that means you have a higher risk of getting infections 
• taking medicine that can affect the immune system (such as low doses of steroids) 
• you are very obese (a BMI of 40 or above).

See Public Health England's (PHE) report COVID-19: review of disparities in risks and outcomes for more information which identifies a number of risk factors that any individual risk assessment will need to consider. The background research on risk assessments for healthcare workers working with COVID-19 can be found here.

If you have one or more of the characteristics listed above, then you may be more at risk and should ask for an individual risk assessment to be carried out. You can use this letter to help you. Even if you do not have one of the above risk factors but are anxious about your risk then you can still ask for an individual risk assessment to be carried out and use our letter to help you.   

Please also see the guidance from the Society of Occupational Medicine to support staff who are returning to work.

Under the Management of Health and Safety at Work Regulations employers are legally required to assess the risk of harm to new and expectant mothers. This includes exposure to COVID-19 but also other risks such as chemical exposure, radiation and violence. Please see our pregnancy and maternity toolkit for more information.

If you work for an agency, they should liaise with the host organisation where you are being placed and ensure that both individual and environmental risk assessments are being carried out and shared, ensuring that any risk of harm is reduced, so far as is reasonably practicable.

If your employer hasn’t carried out a pregnancy risk assessment you can use this letter to request an assessment. If after receiving the letter the situation is not resolved, please consider raising your concerns and contact us for support. 

Following your pregnancy risk assessment, your employer should take reasonable steps to reduce the risk of harm to you and your unborn child. They should consider the information from the NHS on Pregnancy and coronavirus (COVID-19) and in particular, the section on, pregnancy and your risk. If you are concerned with the results of the risk assessment, you should escalate to your Occupational Health Department, your RCN workplace representative, or contact us for advice. Your midwife or GP may also be able to support you.

The government guidance is available using the links below.
England: The Department of Health and Social Care and the UK Health Security Agency has issued Guidance for people previously considered clinically extremely vulnerable from COVID-19
Northern Ireland: Coronavirus (COVID-19): guidance for people at higher risk from COVID-19 – NI direct
Scotland: Coronavirus (COVID-19): advice for people on the Highest Risk List – gov.scot
Wales: People at increased risk from coronavirus 

Our COVID-19 FAQs also contain information on pregnancy.

Your employer should have suitable policies and procedures in place to support all their employees who are working from home, whether this is permanently or because they have been asked to do so as a consequence of the pandemic.

If your individual or pregnancy risk assessment has indicated that you should be working from home, your employer has a legal duty to carry out a suitable and sufficient risk assessment of home working. This should include the provision of suitable work equipment and secure storage if confidential documents are being held at home. 

If you are an NMC registrant, you will also need to be aware of your professional responsibilities and accountability in line with the NMC Code. 

If you have not had a home working risk assessment you can use this letter to request one. If it is still not completed then you should escalate your concerns to your Occupational Health Department, your RCN workplace representative or contact us for advice.  

Useful information is also available from NHS Employers and from ACAS.