The health care setting presents particular risks from manual handling and it is known that training in manual handling techniques is ineffective in reducing these risks when used as a stand-alone measure. The 'Manual Handling Operations Regulations 1992' requires employers to consider hazardous manual handling, advising the use of an ergonomics approach. However, it is not known how well-equipped non-ergonomists in the health care setting are to deal with this approach. Therefore, the ability of non-ergonomists to make manual handling risk assessments, with or without additional training, and to implement changes to the work environment was investigated. Twenty-five pairs of subjects from a broad cross section of departments in a busy teaching hospital were studied; training and a guide book were provided for one of each pair and the guide book only for the other. Subjects then independently prioritised three tasks in their department and undertook a full assessment of a specified task. All work was repeated by an ergonomist and the subjects' assessments were scored in comparison with the ergonomist. Each department was followed up after six months to assess progress with implementing recommendations. Trends in the data indicated that both groups appeared able to identify hazards though not necessarily to prioritise the tasks. The trained group tended to score better in assessments although wide variation existed within both groups and inter-group differences were not significant at the 5% level. Approximately half of staff assessments were considered 'adequate' to 'very good', in comparison with the ergonomist. Implementation of assessment recommendations ranged from nil to almost full compliance. Incomplete implementation seemed to be related to an apparent confusion in some departments over who was responsible for making changes, a lack of finances for changes and overstretched managers having other priorities.