Aim To identify and explore the manual handling risks for patients and caregivers using bariatric patient pathways in health and social care.

Method A mixed methodological approach, including focus groups and questionnaires, was used in this study. Participants were recruited for the focus groups from the National Back Exchange (NBE) Special Interest Group on Bariatrics and the National Ambulance Risk and Safety Forum (NARSF). The questionnaire was distributed to all members of the NBE and NARSF in 2006.

Results The data sets were analysed thematically (focus groups: n = 25) and descriptively (questionnaires: n = 230). Patient pathways were mapped for medical (acute), community and maternity admissions resulting in five generic themes: patient factors; building and vehicle space and design; equipment and furniture; communication; and organisational and staff issues. A total of 59% (n = 136) of respondents reported that their organisation did not have a bariatric manual handling policy. Of all responding organisations (n = 230), 77% (n = 177) had access to specialist equipment, but only 32% (n = 68) of NBE respondents (n = 212) provided specialist bariatric manual handling training for staff. Lack of formal communication systems between and within organisations contributed to manual handling risks at admission and discharge.

Conclusion There is a need to review and design more appropriate buildings, vehicles, furniture and equipment to reduce the manual handling risks to health professionals and bariatric patients. More research is required to examine the implementation of policies, in particular focusing on the use of equipment and the communication between care-providing agencies.