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A First Aid Needs Assessment will help employers decide what first aid arrangements are appropriate for their workplace.

The Health and Safety Executive (HSE) states that first aid provision must be ‘adequate and appropriate in the circumstances’. This means that you must provide sufficient first aid equipment (first aid kit), facilities and personnel at all times. More info:

Your arrangements will depend on the particular circumstances in your workplace. In order to decide what provision you need to make you should undertake a first-aid needs assessment*. This assessment should consider the circumstances of your workplace, workforce and the hazards and risks that may be present. The findings will help you decide what first-aid arrangements you need to put in place.

*‘The Health and Safety (First-Aid) Regulations 1981’ document provides a needs assessment under regulation 3 – First aid at work: The Health and Safety (First-Aid) Regulations 1981. Guidance on Regulations L74 (

Ofsted dictate that nurseries, nursery schools, pre-schools, childminders and schools require paediatric first aid training.

The Department for Education (DfE) Statutory Framework for the Early Years Foundation Stage (EYFS) 2021 states 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. The certificate must be for a full course consistent with the criteria set out in Annex A*. 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. PFA training must be renewed every three years and be relevant for workers caring for young children and where relevant, babies. 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.

  1. Training is designed for workers caring for young children in the absence of their parents and is appropriate to the age of the children being cared for.
  2. Following training an assessment of competence leads to the award of a certificate.
  3. The certificate must be renewed every three years.
  4. Adequate resuscitation and other equipment including baby and junior models must be provided, so that all trainees are able to practice and demonstrate techniques.
  5. The emergency PFA course should be undertaken face-to-face and last for a minimum of 6 hours (excluding breaks) and cover the following areas:
    • Be able to assess an emergency situation and prioritise what action to take
    • Help a baby or child who is unresponsive and breathing normally
    • Help a baby or child who is unresponsive and not breathing normally
    • Help a baby or child who is having a seizure
    • Help a baby or child who is choking
    • Help a baby or child who is bleeding
    • Help a baby or child who is suffering from shock caused by severe blood loss (hypovolemic shock)
  6. The full PFA course should last for a minimum of 12 hours (excluding breaks) and cover the elements listed below in addition to the areas set out in paragraph 5 (the emergency PFA training elements outlined in paragraph 5 should be delivered face to face).
    • Help a baby or child who is suffering from anaphylactic shock
    • Help a baby or child who has had an electric shock
    • Help a baby or child who has burns or scalds
    • Help a baby or child who has a suspected fracture
    • Help a baby or child with head, neck or back injuries
    • Help a baby or child who is suspected of being poisoned
    • Help a baby or child with a foreign body in eyes, ears or nose
    • Help a baby or child with an eye injury
    • Help a baby or child with a bite or sting
    • Help a baby or child who is suffering from the effects of extreme heat or cold
    • Help a baby or child having: a diabetic emergency; an asthma attack; an allergic reaction; meningitis; and/or febrile convulsions
    • Understand the role and responsibilities of the paediatric first aider (including appropriate contents of a first aid box and the need for recording accidents and incidents)
  7. Providers should consider whether paediatric first aiders need to undertake annual refresher training, during any three year certification period to help maintain basic skills and keep up to date with any changes to PFA procedures.

Millie’s Mark is awarded as a special endorsement to childcare providers that go above and beyond these minimum requirements by having 100% of staff trained in paediatric first aid. The Millie’s Mark accreditation provides reassurance to parents that all childcare practitioners know what to do in a paediatric first aid situation. It acknowledges that children’s safety is at the forefront of your mind when you care for children.

Millie’s Mark in an exceptional achievement for a childcare setting and we’d be thrilled to work with you to achieve this.


We are following the guidance from the Resuscitation Council UK and the Department of Health and Social Care (DHSC) and Public Health England (PHE) with regards to teaching and assessing first-aid techniques.

The main infection risk in a room full of learners is contact with other people and/or surfaces rather than the manikin itself. Therefore, we ask that learners observe a high standard of handwashing, with alcohol gel provided in addition to using handwashing facilities.  Learners are reminded to cough/sneeze into a tissue and dispose of this into a bin immediately, washing hands afterwards. Alternatively, coughing/sneezing into the bent elbow if no tissue is available. As per government guidance, face coverings are required to be worn throughout training sessions.

First Aid courses which require practical demonstration and assessment of rescue breaths:

  1. Manikin lungs and airways are replaced after each training session.
  2. The face of the manikin will be wiped with 70% alcohol wipes after each learner uses it and the surface must be allowed to dry naturally before the next learner takes their turn.
  3. Face shields will be provided to each learner at the start of each course whilst infection rates remain high. These should be disposed of safely at the end of the session. The manikin chest, forehead and face will still be wiped to reduce the likelihood of hand to hand contamination.
  4. For courses that run over a number of days, once a skill has been assessed as satisfactory, learners will not need to demonstrate this during the remainder of the course.
  5. Manikins are cleaned with a disinfectant solution after completion of each training session.
  6. If a learner is concerned about the removal of a face covering in order to demonstrate rescue breaths, the learner(s) may demonstrate chest compressions only for adult resuscitation. This will not affect the validity or duration of certification, however attendance on annual refresher training is strongly recommended.
  7. There is good evidence that rescue breaths form an essential part of Cardiopulmonary Resuscitation particularly in children, infants and those who have drowned. The benefits of teaching rescue breaths to those who have a duty to provide first aid to these groups far outweighs the extremely small theoretical risk of transmission in the classroom whilst practising this skill. For this reason, rescue breaths will continue to be taught on paediatric first aid courses and with groups such as emergency service workers.

Depending on the current situation, we may ask all learners to complete a lateral flow test prior to attending a course. Learners who have symptoms of cough, cold and/or temperature prior to the course, or have been in contact with a potentially infected person, should complete a lateral flow test before attending the course. If learners need to exclude themselves from the course, we will allow them to transfer their place to a later date. 

If a learner who has attended a course subsequently finds they have symptoms, they should let us know. We will then alert all other learners to the situation.

We hope that the above reassures you that we are doing everything we can to ensure our courses are as safe as possible. If you have any concerns or queries, please contact us.