Choosing a hoist and slings for lifting people

This factsheet is for advice and guidance only. It is not intended to replace advice from a medical professional. Please ensure you follow manufacturer’s instructions for use and that you carry out appropriate risk assessments.

Hoists provide mechanical means so that less able persons can be moved or transferred from one place/position to another. The aim of using such manual handling equipment is to reduce risk of injury or harm to all individuals to the lowest level possible. Accidents may occur when using hoists e.g. if they are misused or not used with correct slings. Therefore, for any hoists bought or provided to you it is vital you:

• Have your needs assessed from social services.
• Seek advice and training from a ‘moving & handling’ professional e.g. a physiotherapist or occupational therapist.
• Ensure a full risk assessment is carried out.

You can apply for an assessment of your needs/risk assessment from social services via your local authority. Alternatively, you can instruct a private physiotherapist or occupational therapist. 

• A hoist usually has a metal frame which may be fixed or mobile, with a manual or electrical lifting mechanism. The frame has a lifting arm/boom to suspend a sling or a chair.
• Manual hoists may use a winding mechanism or a hand pump to operate a hydraulic cylinder to raise/lower the person. Hydraulics make the lifting easier and smoother.
• Electrical hoists have a power pack/battery and are charged via the mains either in situ or the battery can usually be removed from the hoist and plugged in elsewhere to charge.
• All electrical hoists have emergency stop buttons and manual release mechanisms to allow the person in the hoist to be lowered without battery power.
• Hoists can be active or passive. Active hoists may be used where the person can bear some of their own weight with some trunk stability e.g. standing support. Passive hoists provide full support to lift a person and require no active participation from person being lifted.
• Attached to the boom is a spreader bar. They may have 2,4 or 6 hooks to clip or hook a sling on. A spreader bar that has a padded covering protects the service user from harm if the bar gets too close and accidentally knocks during use of the hoist.

• Static hoists tend to be installed and used for one particular purpose, for example getting in and out of the bath, getting in and out of a swimming pool, riding for disabled people. The metal frame is securely fixed, usually to the floor, with a seat or sling which pivot from the frame and can be raised or lowered. The hoisting mechanism may be manual or electronically powered, controlled with a remote handset.
• Bath/bathroom lifts and hoists are usually static. The hoist usually lifts a rigid, plastic bath chair with simple arm rests/bars which raise and lower on each side. On some models, the seat is detachable from the hoist and will fit onto a mobile chassis frame once out of the bath, allowing the person to be wheeled from the bathroom. The chassis may be designed to allow the seat to be positioned over a toilet.
• Poolside lifts may be static or mobile. They have more range of movement to lift the user into the pool. They may use a rigid, plastic chair, hoists or specialist support systems to lift a person and use a heavy base to counterbalance the weight of the person hoisted.
• Standing hoists/stand-assist hoists support the user with a sling around the back, under the arms and around the thighs. The user positions their feet on a footplate and braces their knees against a pad. While the user holds onto the frame, the hoist gently lifts them to standing, providing support. Depending on the model, such hoists might be used for transfers or to assist with walking. The user must have good upper body strength and control and some weight-bearing ability.
• Mobile hoists have the frame/chassis mounted on castors (with brakes) to allows the hoist to be moved short distances e.g. wheelchair to bed. The chassis legs can usually be spread to gain access around chairs/wheelchairs and under a bed (not divan beds). Mobile hoists need enough space to move when a person is being carried. Relevant areas need to be cleared of furniture/clutter. Castors can catch on uneven surfaces, loose rugs or worn carpets which need removing. Doorways/corridors (if accessed) need to be wide enough to accommodate the hoist. In hospital settings, 3.6m of space is recommended to be available next to a bed to be able to manoeuvre a hoist and the service user effectively.
• Ceiling tracks are an expensive, permanent fitting into a home/setting (requiring a structural survey of the setting prior to fitting) which allows a service user, held in a sling, to be moved along a track/s between locations with little effort.
• Ceiling track hoists provide a powered lift of the service user, but may then be powered or manually moved between locations (traversed). The motor is usually at track height and is charged at a ‘charging station’ when not in use. Other motor units are available from manufacturers which are portable and usable between particular designs of track.
• Gantry system is a heavy frame standing over a chosen location, e.g. a bed. A hoist is suspended from it and is moved along a gantry e.g. moving a person from bed to a chair.
• Portable hoists dismantle to allow for transport, remaining folded or packed into bags. The unit is fairly heavy, which may not be suitable for a less able carer to manage.

The chosen hoist and sling/s must be able to lift your accurately measured bodyweight and the working load should be clearly displayed on both hoist and sling.

The hoist should be checked regularly, to ensure that the:

• Lifting arm moves smoothly through its full range.
• Castors on a mobile hoist move freely.
• Brakes are effective when used.
• Emergency stop mechanism works effectively.
• Battery works well (on powered hoists), is kept charged and is correctly installed.
• Electrical connections and leads are not frayed, broken etc.
• Slings are in good order (no broken stitching or frayed or broken material).
• Straps and clips should be secure and in good condition.

Slings should not be used by more than one person to prevent cross-infection and slings should be compatible with the hoist (i.e. usually from the same manufacturer).

Hoists/slings should be serviced every six months (usually provided by the manufacturer or supplier or arranged by the local community equipment service if the hoist is supplied though statutory services).

Mobile hoist brakes (on castors) must not be used in the process of transferring a service user, but may be used when storing the hoist.

Two batteries for a powered mobile hoist are advised, so that one is ready charged for use. If unused for a while, a battery should be recharged. Check the manufacturer’s instructions.

• A correct sling is key to comfort, safety and for effective use of a hoist.
• There is a choice of sling material for the most appropriate fabric for your needs.
• Standard polyester slings have low friction if slid under a person and are easily cleaned.
• Net slings are used for bathing slings to allows water to drain away and easily cleaned.
• Mesh slings are stretchy and adapt to body shapes and may suit best if there are skin integrity concerns or if the sling is left in situ, e.g. if seated in a wheelchair.
• Silk slings can also be left in situ as its fine weave moulds to a person’s shape and is suitable for someone who requires the support of moulded seating.
• General purpose or universal slings are hammock-like slings which fully support the user’s torso, legs and head. They are generally used with passive hoists, where there is no active participation of the service user. Usually, a universal sling has split leg supports, which can be used to hold each leg separately, or can be crossed over to hold the legs together. This design is very good for holding the person in a comfortable/safe position. Slings without split-legs are useful for people with little/no core strength (for total support).
• Toileting slings are designed to allow the service user to be positioned over a toilet or commode. The sling supports the upper back (and head if needed) but splits into two straps at waist level, down each side and under the thighs, leaving the service user’s bottom unsupported and uncovered. Each leg can be supported separately, allowing access for managing the user’s clothes and for personal hygiene. Toileting slings are not suitable for someone with very weak/flaccid core strength, or someone who has no cognitive awareness of what is happening or what is required of them. A certain amount of control, strength and understanding is required to maintain the sitting position.
• Strap slings offer the least support. Usually used in pairs, with one around the trunk and one behind/around the thighs. They can be used in mobile or static hoists for someone with good core strength/control but are more often used with standing hoist use.
• Amputee slings are designed to provide a secure hold around the hips and comfort and protection around the remaining limb/s. Depending on type of amputation, a custom-made sling may be needed (i.e. seek a specialist assessment for needs).
• Washable slings All standard, non-disposable slings are washable, if used for one person only. Washing can be done in a domestic machine but washing will add to sling wear and tear.
• Disposable slings are available. They are not intended for washing and should not be re-used if wetted/soiled. With very frequent use, they will require frequent replacement and should be replaced every six months even with infrequent use.

• Slings sizes are extra small to extra-large, with choice of child sizes and/or custom-made.
• Manufacturers often colour-code the sizes - each size caters for a range of heights.
• Each size will have a weight capacity to suit a person’s weight (accurate weight needed).
• When seated or lying, measure the distance along the spine, from coccyx (base of the spine) to around 4cm above your head. This length is for someone who needs full support along their spine and head. Look at the manufacturer’s guide to find the most appropriate sling. Some manufacturers have measuring tapes which are colour-banded. The sling size required is indicated by the colour band a person fits into when measured.
• It may be useful to measure around the chest, waist and thighs, as a wide-fit sling may be needed for larger girths. If you are a particularly large or small person you must use a sling appropriate for you. Slings are available for people who are taller or heavier than average, or people with a wide girth. Smaller people are at risk of falling from a standard sling, so should use the appropriate size and length for them.
• There are different sling mechanisms to attach to the hoist e.g. loops or clips. A sling usually has a series of fabric loops of different lengths at each suspension point and the length of strap used will change the position of the service user when in the hoist.

It is possible to order special slings for people who have particular needs, e.g. a very tall person. Speak to a range of manufacturers before you buy a hoist to confirm that a compatible custom-made sling can be obtained.

A variety of hoists and slings are available, please consider:

• Your level of ability and those of your carer/s.
• What you want to achieve with the hoist.
• The environment/s in which you are planning to use it.

Where a moving and handling need has been recognised, this falls under the relevant moving and handling legislation, as it is defined as a risk assessment. Risks are identified and a plan is developed to reduce risks, involving provision of equipment such as hoists or other items. 

Your local authority can identify and provide the appropriate option for you and your carer/s, from within the range that they are able to provide.

If you are looking to obtain a hoist without involvement of statutory services, you are advised to seek an assessment by a qualified moving and handling advisor. They might be from a nursing, physiotherapy or occupational therapy background. This should provide you with a moving and handling plan and advice on any training necessary for you and your carer/s. The assessment and plan should look at any risks and how they will be managed and inform you about appropriate equipment and where to obtain it.

Your physical shape and ability should guide your choice of equipment:

• Consider your strength. If you are able to take some of your own weight through your legs, you may be able to manage with a standing hoist which gives enough support to keep you safe as you stand up and sit down. You can then be moved when in a standing position, or supported as you walk to help maintain this function and general health.
• If you need full hoisting, look at your requirement for support along your spine and whether you have strength to hold your head and neck up independently. Otherwise, consider a sling that supports you all the way up your back, including your head.
• If you have good body stability and core strength, you may manage with strap slings, which only give support around the torso, under the arms and under the thighs. These slings must not be used with people who have reduction in their core strength, any uncontrolled movement or reduced cognitive ability.
• If you have uncontrolled movements/spasms, you need more support when hoisted. It is likely that a full sling keeping you in a flexed position will help to reduce spasm.
• If you have reduced cognitive abilities, you may benefit from a full sling which provides a feeling of security and will keep you safe as you are moved.
• Consider your weight as hoists and slings have weight limits identified on each piece of equipment. You must use equipment that is suitable for your weight. Special equipment (such as bariatric slings) can be available for those with excess weight or girth.
• Consider your height and use slings suitable for your height. If you are tall you may need to look at extra-long slings. Look for a model of hoist which gives more knee/leg space when you are suspended in the hoist, and you may need to be in a very upright position when suspended. If you are small, you may need to use smaller slings, or you risk falling.
• If you are an above-knee amputee, you need to consider using a specific sling designed to hold you safely.
• If you have fragile or broken skin, consider using a silk sling which offers more protection.

The range of activities you want to use the hoist for will partly determine the kind of hoist you need and the nature of sling you require:

Consider your daily routine. When do you need to be moved and what for? For example: from your bed to a chair which will allow you to be showered and toileted or into a comfy chair or a wheelchair, or from your comfy chair or wheelchair to the toilet or commode, or into bed and positioned in bed.

If you are simply looking for assistance with particular activities, such as getting in and out of the bath, a static hoist is likely to meet your needs. If you need fuller assistance, a standard mobile hoist may suit. You need to ensure the base can fit under the bed and around your seat or chair. You also need to ensure that there is adequate access to all areas of the house that you need to reach, e.g. bedroom, bathroom and living room.

• A standard mobile hoist will enable the activities listed above. Most can also lift a person from floor level if required. Providing there is enough room for access, a mobile hoist has the benefit of being usable almost anywhere. Its disadvantages are that it takes up space when in use and when stored, and it requires more effort from the carer.
• A ceiling track hoist can also carry out all of the activities listed above, but the activity is limited to the location of the hoist. If you want a ceiling track hoist you must have a structural survey of the house before one is installed. It does not use floor space and requires less effort from the carer, but is less flexible in where it can be used.
• General purpose slings are available for standards transfers. Toileting and bathing slings are available for personal care activities. If you wish to remain seated for significant periods of time, with a sling in situ, you will need to consider the fabric used in the sling.

• If using a mobile hoist you need to check that all necessary areas can be accessed, including corridors, corners and room entrances (especially turning from a narrow corridor into a doorway).
• It is easier to manoeuvre a mobile hoist along a smooth hard-floored surface. Carpets can make it very hard work. All access routes need to be kept clear of clutter. The legs of a mobile hoist need to go under or around any furniture used by the service user, including bed, seating, toilet facilities etc.
• Some mobile hoists can be used outdoors depending on design and outdoor surface.
• A ceiling track hoist can be linear, curved, or have intersecting tracks. This allows it to access all the areas of the house that you require.
• Consider privacy and dignity to ensure that both can be maintained as much as possible when the hoist is being used. This is especially important when the hoist is being used for toileting and bathing purposes. 

• Putting a sling in the right place under and/or around a service user can be difficult, depending on their ability and size. If the service user has some function (such as to roll or lean safely) it can help. Learning techniques and using equipment such as slide sheets can make the process easier and quicker. 
• A standard mobile hoist requires the carer to push it from place to place, both with and without the service user being suspended in the hoist. This is physically demanding, made harder by carpeted floors and narrow access routes. The lifting mechanism used on the hoist varies in the demands it makes of the carer, with a winding mechanism being most demanding, a powered lifting being the easiest.
• A ceiling track hoist does the moving for you and requires much less effort from the carer. You must have a structural survey carried out before one is installed.
• Historically, two carers were often needed to be present for hoisting, but with improved product design and techniques, the provision of safe single-handed care is now commonly possible. The number of carers needed is based on the assessment of need and the ability of the service user and their carer/s within their usual environment.

• If you are assessed by hospital or social care staff, in order to provide you with moving and handling equipment they will carry out assessment of needs and a risk assessment.
• When you are at home, if your care is provided from a care agency, the employer of the care agency is responsible for carrying out their own risk assessment and staff training.
• If you, as the service user, privately employ your own care staff, including paying a family member or neighbour, you, as the employer, are responsible for carrying out your own risk assessment and training of the carer/s. 
• If the hoist is obtained from the local authority, they may provide family carers with training on the safe use of the hoist. Some local authorities provide formal training courses. If not, organisations are available who provide such training. Ask your local authority for advice.
• If you use direct payments to employ a carer/s, risk assessment can be carried out by the local authority, with you and your carer/s. Direct payment can be used to pay for training.

• Manual handling (also referred to as moving and handling) is strictly regulated by the Manual Handling Operations Regulations (MHOR) 1992 and, in the work setting, the Management of Health and Safety at Work Regulations 1999. 
• In an employment situation, hoists and slings also need to meet the requirements of the Provision and Use of Work Equipment Regulations 1998 (PUWER) and the Lifting Operations and Lifting Equipment Regulations 1998 (LOLER). In addition to routine maintenance and servicing, LOLER requires lifting equipment to be inspected and thoroughly examined by a ‘competent person’ either at six-monthly intervals or in accordance with a written scheme of examination drawn up by a ‘competent person’.
• The Health and Safety at Work Act 1974 also has provisions to ensure that, so far as reasonably practicable, systems of work are safe and without risks to health. These regulations are underpinned by the general duties of the Management of Health and Safety at Work Regulations 1999, for a worker to take reasonable care of their own health and safety and that of others who may be affected by their acts and omissions; and to co-operate with their employers, complying with their health and safety duties.
• The primary aim of these regulations is to reduce the risk of harm to the employee/carer and the individual being cared for. The MHOR provides a hierarchy of actions to be taken to do this, from completely avoiding hazardous manual handling where possible, to assessing and reducing the risk of injury where it can’t be avoided. A risk assessment of any proposed moving and handling activity MUST be made. The regulations require a record of the risk assessment and how any risk will be managed. This should be reviewed on a regular basis.
• The MHOR do not prohibit manual handling. In fact, organisations are not allowed to have blanket policies. Each situation has to be assessed and managed individually. It is seen as a balance between protecting carers and workers and meeting the needs and wishes of the person cared for, enabling their independence and autonomy as much as possible.
• Many retailers are members of the British Healthcare Trades Association (BHTA), which means that they adhere to the organisation’s code of practice. You can search the BHTA website for local retailers.
• The British Standard for hoists is ISO 10535:2021. ‘Assistive products — Hoists for the transfer of persons. Requirements and test methods’. 

• If you are assessed by your local authority, they will provide you with a suitable hoist and slings from the local community equipment service. Equipment from this service will be on loan and be maintained and inspected by them.
• If you are in receipt of direct payments or a personal budget from the council, it may be possible to use this to purchase the hoist of your choice if it has been identified as needed in your health and social care assessment. However, local authority policies vary. Check with your local authority before making purchases on this assumption. Confirm also who is responsible for the required inspection and maintenance of the hoist.

If you wish to buy equipment privately, there are numerous moving and handling equipment suppliers, with information available online. Your assessor may be able to make recommendations for you. Be sure of your preferences and requirements before you look at equipment, so you get something that meets your needs. You are advised to try a number of models before purchase and ask supplier about maintenance/repair

Demonstration Centres

• If you need advice before you buy, contact your local equipment demonstration centre where you will have the opportunity to try out a range of equipment. There are several of these around the country where you can go for impartial advice. Your local authority will also be able to supply information about where your nearest centre is located.

• Consider asking for a health and social care needs assessment if you or your carer/s are struggling to provide care. Since the Care Act 2014 came into power in 2015, anyone who appears to need care and support can request an assessment from their local council, irrespective of income/savings. The Act places a statutory duty on local authorities and NHS to support individuals to take steps to prevent their ill health or care requirements from worsening. These prevention strategies can include early provision of equipment and services to help prevent, delay or reduce development of need for care and support. A care and support assessment aims to identify difficulties you might have in caring for yourself and how this impacts your wellbeing. If you have someone who helps you, they can have a carers assessment to see if they also need support to continue in the role.
• If you have a diagnosed long-term condition, you should be able to claim VAT relief when purchasing a hoist. Ask the supplying company or check their website for further information. More information is available on the GOV.UK website.
• Access to Work provides grants for practical assistance if you have a disability, health or mental health condition, in order to help you gain employment, stay in employment, or even become self-employed. Access to Work may provide funding for a hoist if it is required for the purposes of your work and there is no more cost-effective alternative. 
• Some charities might fund hoists where other funding streams have been denied.

British Healthcare Trades Association (BHTA). Available at: https://www.bhta.com/ (Accessed: 01.04.2024).

Chartered Society of Physiotherapy. (2023) Find a Chartered Physiotherapist. Available at: https://www.csp.org.uk/public-patient/find-physiotherapist/find-physio (Accessed: 12.04.2024).

Department for Work and Pensions. (2023) Access to Work: Factsheet for customers. Available at: https://www.gov.uk/government/publications/access-to-work-factsheet/access-to-work-factsheet-for-customers (Accessed: 01.04.2024).

Health and Safety Executive. (2011) Getting to grips with hoisting people. Available at: https://www.hse.gov.uk/pubns/hsis3.pdf  (Accessed: 01.04.2024).

HM Government. Apply for a needs assessment by social services. Available at: https://www.gov.uk/apply-needs-assessment-social-services (Accessed: 12.04.2024).

HM Revenue and Customs. (2015) Get VAT relief on certain goods if you have a disability. Available at: https://www.gov.uk/guidance/vat-relief-on-certain-goods-if-you-have-a-disability (Accessed: 01.04.2024).

International Organization for Standardization. (2021) ISO 10535:2021. Assistive products — Hoists for the transfer of persons. Requirements and test methods. Available at:    https://www.iso.org/obp/ui/#iso:std:iso:10535:ed-3:v2:en (Accessed: 01.04.2024). 

Manual Handling Operations Regulations (MHOR) 1992. Available at: https://www.legislation.gov.uk/uksi/1992/2793 (Accessed: 01.04.2024).

Medicines and Healthcare products Regulatory Agency. (2014) Patient hoists and slings – ensure you follow manufacturer’s instructions for use and that you carry out risk assessments. Available at: https://www.gov.uk/drug-device-alerts/medical-device-alert-patient-hoists-and-slings-ensure-you-follow-manufacturer-s-instructions-for-use-and-that-you-carry-out-risk-assessments (Accessed: 01.04.2024).

NHS England. (2015) Patient Safety Alert: Risk of death and serious harm by falling from hoists. Available at: https://www.england.nhs.uk/patientsafety/wp-content/uploads/sites/32/2015/10/psa-falling-from-hoists-1015.pdf (Accessed: 01.04.2024).

Royal College of Occupational Therapists. Find an occupational therapist near you. Available at: https://www.rcot.co.uk/about-occupational-therapy/find-occupational-therapist (Accessed: 12.04.2024).

The Care Act 2014. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents/enacted/data.htm (Accessed: 01.04.2024).

The Health and Safety at Work Act 1974. Available at:  https://www.legislation.gov.uk/ukpga/1974/37/contents (Accessed: 01.04.2024).

The Lifting Operations and Lifting Equipment Regulations 1998 (LOLER). Available at: https://www.legislation.gov.uk/uksi/1998/2307/contents (Accessed: 01.04.2024).

The Management of Health and Safety at Work Regulations 1999. Available at:   https://www.legislation.gov.uk/uksi/1999/3242/contents (Accessed: 01.04.2024).

The Provision and Use of Work Equipment Regulations 1998 (PUWER). Available at: https://www.legislation.gov.uk/uksi/1998/2306/contents (Accessed: 01.04.2024).