Third Party Health & Safety Incident Reporting

Explanation

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  5. If you have questions or feedback regarding the incident form please email procurement@acc.co.nz.

This is required.
× As a non-contracted provider, you do not have to report incidents to us via this form. If you are a health provider you can contact the Provider Helpline (0800 222 070). Other suppliers can email procurement@acc.co.nz
Explanation

A 'health provider' means an ACC supplier who has been awarded a contract to deliver rehabilitation or treatment goods or services to ACC clients in accordance with ACC's Standard Terms and Conditions on our external website.

A 'non-health' provider means a supplier who has been awarded a contract to deliver any other goods or services to ACC under the terms and conditions of a negotiated services agreement (or similar).

This is required.
Explanation

Contracted suppliers must report Notifiable Event's, Threats and Other Risks to Health and Safety that occur while delivering goods or services to us or on our behalf (i.e. to ACC clients) in accordance with the terms of our contract.


A 'Notifiable Event' is:


  • The death of a person;
  • A Notifiable Injury or Illness; or
  • A Notifiable Incident.

Use WorkSafe's Notifiable Event tool to help you with understanding which events are notifiable, what you need to do and when.


Threats are defined as either Personal or Organisational. A 'Personal Threat' means any written or verbal threat made to a staff member or subcontractors staff either in person or remotely, for example over the phone or via email. An 'Organisational Threat' means any written or verbal threat made to your organisation or your subcontractors, for example a bomb threat or damage to property.


'Other Risks to Health and Safety' means hazards, risks, accidents, incident or near misses that may result or could have resulted in a Notifiable Event. The level of reporting of these events will depend on the severity and management controls already documented and agreed with ACC.

This is required.
× If you have any questions regarding the requirement to report to us please email procurement@acc.co.nz. Alternatively, contact a Supplier Manager (Health Providers) or the Contract Manager (Non-Health Providers) specified in your contract.

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Use this form to report:

Any hazards, risks, accidents, incidents or near misses to the Supplier's or a subcontractors staff arising from any ACC Client's behaviour or condition.

Use this form to report:

Any hazards or risks that you or your sub-contractors identify or create and all accidents, incidents and near misses relating to the Services on ACC's premise or otherwise within ACC's control.

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Notifiable events must also be reported to WorkSafe.
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Incident Details

The date is required.
Explanation

Please do not include personal information (e.g. the name or address of members of the public or ACC clients) in the Description field unless it’s absolutely necessary for ACC to know this information in order to manage risks to health and safety. Any personal information supplied will be collected only for the purpose of ACC meeting its obligations under the Health and Safety at Work Act to ensure that risks to health and safety are effectively managed so far as reasonably practicable and within ACC’s influence and control.

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A brief description is required.
Explanation

Please do not include personal information (e.g. names or addresses of members of the public or ACC Clients) in the Investigation field unless it’s absolutely necessary for ACC to know this information in order to manage risks to health and safety. Any personal information supplied will be collected only for the purpose of ACC meeting its obligations under the Health and Safety at Work Act to ensure that risks to health and safety are effectively managed so far as reasonably practicable and within ACC’s influence and control.

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The incident address is required.
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Contact Details

The company name is required.
Add company address.
A contact person is required.
An email address is required. A valid contact email address is required.
A valid phone number is required including area code.
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