Learners on our Paediatric First Aid Courses in Cumbria and elsewhere are often confused by the rules around First Aid. It can be a little confusing, so hopefully we can shed some light…
[Disclaimer: What follows is intended to be a rough guide only, and should not be relied upon by itself. If you are responsible for First Aid provision in your organisation, it is your responsibility to make sure that you are complying with the necessary regulations.]
The first thing to say is that if you are also an employer, then you will need to follow the guidelines for employers as well as the guidelines around adults who work with children and young people. Even if you’re not an employer, it’s a good idea to look at these guidelines anyway as they’re a very comprehensive framework. We’ve written what follows on this page assuming that you’ve read that page, so we won’t repeat the bits about First Aid kits, Risk Assessment, and so on.
Citing our Sources
First Aid regulations for employers are laid down by the Health & Safety Executive (HSE) while regulations around looking after young people are laid down by the Department for Education.
The important documents are:
- The Early Years Foundation Stage Statutory Framework (EYFS) (DFE)
- First Aid in Schools (DFE)
- Incident Reporting in Schools (HSE)
There are also a few other useful sources:
- Gov.uk has a useful section on Health, safety, and well-being in schools. It’s not all relevant to First Aid, however.
- Emergency Asthma Inhalers for Use in Schools (DHSC/ Gov.uk)
- Advice for Schools on Anaphylaxis (Anaphylaxis Campaign)
First Aid Courses for those who work with Children and Young People
As we noted in the page aimed at employers, there are basically three First Aid qualifications (for lack of a better word) recognised by the HSE: Appointed Person (AP), Emergency First Aid at Work (EFAW) and First Aid at Work (FAW).
While these qualifications are a good standard for workplaces, the DFE have added two additional courses for those who work with children and young people:
- Paediatric First Aid (PFA) – A two day course
- Emergency Paediatric First Aid (EPFA) – A one day course
The courses are quite similar to the EFAW/FAW courses, but the EPFA/PFA cover some illnesses more likely to be found in children.
Some procedures are also different for children. CPR has slight variations as does the procedure for dealing with choking (in babies), and the use of Automated External Defibrillators among other things. Though it’s worth pointing out that many EFAW/ FAW courses will cover these variations.
The PFA/ EPFA courses cover children up to the onset of puberty.
The DFE stipulates the content of the PFA/ EPFA courses, as the HSE does for the FAW/ EFAW courses. (See Annex A of the EYFS Framework document)
EYFS Regulations (for Children aged 0-5)
Where employers are concerned, the HSE are careful not to be too prescriptive about what qualifications people must have, but that’s not the case with those who care for children in the ‘Early Years Foundation State’. In other words, children up to five years old.
The DFE Framework document sets clear rules regarding First Aid provision for children in this age group, and these rules bind “all early years providers in England: maintained schools; non maintained schools; independent schools; all providers on the Early Years Register; and all providers registered with an early years childminder agency.”
The rules say that:
At least one person who has a current paediatric first aid (PFA) certificate must be on the premises and available at all times when children are present, and must accompany children on outings. […] Childminders, and any assistant who might be in sole charge of the children for any period of time, must hold a full current PFA certificate. […] Providers should take into account the number of children, staff and layout of premises to ensure that a paediatric first aider is able to respond to emergencies quickly. All newly qualified entrants to the early years workforce who have completed a level 2 and/or level 3 qualification on or after 30 June 2016, must also have either a full PFA or an emergency PFA certificate within three months of starting work in order to be included in the required staff:child ratios at level 2 or level 3 in an early years setting. Providers should display (or make available to parents) staff PFA certificates or a list of staff who have a current PFA certificate.Statutory framework for the early years foundation stage, para 3.25
In other words, basically, for just about any work with under fives…
- There must be at least one person with a full PFA certificate on the premises at all times.
- That person must be available to respond if needed. In other words, it’s no good having somebody at the other end of the school who can’t leave his/ her class.
- Depending on their qualifications and when they started working, it is likely that all other staff will be required to have at least an EPFA certificate.
First Aid Equipment
In addition to the requirements for employers, the DFE say that:
Providers must ensure there is a first aid box accessible at all times withStatutory framework for the early years foundation stage, para 3.50
appropriate content for use with children.
For those already operating under the regulations for employers, this may simply mean checking the First Aid kits already on site to ensure that they are suitable for use with children.
Recording and Reporting Regulations
The EYFS Framework document (which related to children five and under) says this about First Aid treatment:
Providers must keep a written record of accidents or injuries and first aid treatment. Providers must inform parents and/or carers of any accident or injury sustained by the child on the same day as, or as soon as reasonably practicable after, and of any first aid treatment given.Statutory framework for the early years foundation stage, para 3.50
In the case of more serious incidents, there is also a requirement (with force of law) to inform Ofsted:
Registered providers must notify Ofsted or the childminder agency with which they are registered of any serious accident, illness or injury to, or death of, any child while in their care, and of the action taken. Notification must be made as soon as is reasonably practicable, but in any event within 14 days of the incident occurring. A registered provider, who, without reasonable excuse, fails to comply with this requirement, commits an offence. Providers must notify local child protection agencies of any serious accident or injury to, or the death of, any child while in their care, and must act on any advice from those agencies.Statutory framework for the early years foundation stage, para 3.51
Don’t forget that the RIDDOR regulations may also apply. In the case of schools, the regulations are here.
More Guidance for Schools
The DFE First Aid in Schools document gives a fairly comprehensive guide to what schools need to do, though it doesn’t touch on the EYFS regulations (noted above) which schools have to comply with if they have nurseries and/ or reception/ Year 1 classes.
The document says a few things worth noting:
First Aiders are required to complete an HSE approved course (i.e. FAW/ EFAW) which is interesting since the HSE don’t actually mandate these courses for employers. This also means that a primary school will almost certainly have to have PFA, EPFA, and EFAW/FAW qualified staff on site.
In fact, the guidance notes (para. 52) state that standard First Aid courses do not cover resuscitation procedures for children. So, we can assume that PFA/ EPFA certificates are required throughout primary schools.
Given that PFA/ EPFA courses cover children up to the onset of puberty, secondary schools should also have sufficient PFA/ EPFA cover for their younger students.
The document also has some specific regulations for schools about reporting.
First Aid Rooms in Schools
The First Aid in Schools document points our that:
The Education (School Premises) Regulations 1996 require every school to have a suitable room that can be used for medical or dental treatment when required, and for the care of pupils during school hours. The area, which must contain a washbasin and be reasonably near to a WC, need not be used solely for medical purposes, but it should be appropriate for that purpose and readily available for use when needed.First Aid in Schools, para. 63