Normally,I design a H & S or HSE policy with 3 parts:
1. The 1st section is a commitment from the CEO on behalf of the company indicating the principle(s) that are being adopted as far as H & S or HSE is concerned within the controls of the company's operations.
2. The next section lists out this commitment & principle(s) are to going to be achieved. These are basically the objectives that the organisation is planning to achieve. Strategies are then developed to meet these objectives and translated into action plans.
3. The final section lists out who are responsible to achieve the objectives thus fulfilingl the commitment stated in the first section.
The policy is always signed off by the incumbent CEO & reissued whenever the CEO is changed.
Hope it helps. I am attaching a sample from another company.