https://www.england.nhs.uk/wp-content/uploads/2017/04/pol-1002-health-safety-policy.pdf
This policy covers all the 5 elements, which include statement of intent, objectives, organization, arrangements, and information on review. However, there are some details and key points that are not covered in this policy.

The statement of intent is written in simple and clear language. It contains the aims and the objectives of the organization. It also includes performance targets. However, it is not dated and signed by the senior member of the organization. As seen below:

The objectives are clear. However, I believe that they could have been stated better by following the SMART protocol. There are no indication of KPI’s (key performance indicators.)
As for the organization, everyone seems to have a role to play and have their own set of responsibilities. It seems pretty clear as to what each person is responsible for.

There are arrangements for emergency protocols, training procedures, risk assessments, and so forth.
The only information regarding review is mentioned in the statement of intent. It states that the policy will be reviewed every two years or in the light of legislative or organizational change.