Paediatric First Aid: The 12-Hour Rule, the Face-to-Face Requirement, and Why HSE Has No Role

Paediatric first aid is one of the few genuinely hard numerical requirements in English early years regulation, and it is also one of the most misunderstood. A first aid at work certificate does not satisfy it. A fully online course cannot satisfy it. And the Health and Safety Executive, which most employers assume governs first aid, has no role in it at all.

Where the requirement comes from

The governing document is Annex A of the EYFS statutory framework, headed "Criteria for effective Paediatric First Aid (PFA) training". Annex A appears in both the group and school-based framework and the childminder framework in substantively the same terms, in the versions in force from 1 September 2026.

The HSE’s regime is separate and does not reach it. The Health and Safety (First-Aid) Regulations 1981 apply to all workplaces, including those with fewer than five employees and the self-employed, but the HSE states that the Regulations do not place a legal duty on employers to make first-aid provision for non-employees such as the public or children in schools. The HSE strongly recommends including non-employees in a first-aid needs assessment, but that is a recommendation.

The HSE also no longer approves first aid training or qualifications — a 2013 amendment removed that function. So paediatric first aid in England is set by the Department for Education through Annex A and policed by Ofsted or a childminder agency. A first aid at work certificate, covered in our workplace first aid training guide, is a different qualification for a different purpose.

The hours and the validity period

Annex A sets two course lengths and one renewal period:

• Emergency paediatric first aid — a minimum of 6 hours, excluding breaks.
• Full paediatric first aid — a minimum of 12 hours, excluding breaks.
• Certificate validity and renewal — every 3 years.

Providers should consider annual refresher training during those three years, and following training an assessment of competence leads to the award of a certificate. Annex A does not specify a number of days, so a 12-hour course may be delivered over two days or spread differently.

The face-to-face rule

This is the provision that disqualifies most convenient options, and it is worth quoting precisely. Annex A states that the emergency paediatric first aid course should be undertaken face-to-face. For the full 12-hour course, it states that the emergency paediatric first aid elements should be delivered face-to-face.

A footnote defines the term: face-to-face means trainers are physically present with their trainees, and this excludes the use of online platforms.

Annex A makes no express mention of blended learning, e-learning or self-study. The practical position is therefore that the emergency elements must be delivered with a trainer physically present, while the framework does not state that the remaining non-emergency content of the full course must be. What is clear is that a fully online paediatric first aid course cannot satisfy Annex A.

Who must hold it, and by when

In group and school-based settings, paragraph 3.37 requires at least one person with a current certificate on the premises, and that person must also accompany children on outings. The certificate must be for a full course consistent with Annex A.

Paragraph 3.39 sets a deadline for newer staff: all staff who obtained a Level 2 or Level 3 qualification since 30 June 2016 must obtain a paediatric first aid qualification within three months of starting work. Staff counted at Level 3 through the experience-based route must obtain it before they count in ratios.

Paragraph 3.57 makes it a condition of counting students and volunteers in ratios: a student or long-term volunteer aged 17 or over, or an apprentice aged 16 or over, may only be counted if they hold a valid paediatric first aid qualification.

At mealtimes, the framework requires a member of staff with a valid certificate to be in the room while children are eating.

For childminders the position is stricter. Paragraph 3.42 of the childminder framework requires a childminder to hold a paediatric first aid certificate to register, and to continue to hold it at all times while registered. A certificate holder must be on the premises whenever children are present and must accompany children on outings, with renewal every three years. The wider registration picture is in our guide to childminder registration in England.

What the course must cover

Annex A specifies content. The emergency 6-hour course must cover assessing an emergency situation and prioritising action, and helping a baby or child who is unresponsive and breathing normally, unresponsive and not breathing normally, having a seizure, choking, bleeding, or suffering hypovolemic shock caused by severe blood loss.

The full 12-hour course adds anaphylactic shock, electric shock, burns or scalds, suspected fracture, head, neck or back injuries, suspected poisoning, foreign bodies in eyes, ears or nose, eye injury, bites or stings, the effects of extreme heat or cold, diabetic emergency, asthma attack, allergic reaction, meningitis and febrile convulsions, and the role and responsibilities of the paediatric first aider including first aid box contents and recording accidents and incidents.

When commissioning a course, that list is the specification to check against — not the provider’s marketing summary.

Wales, Northern Ireland and Scotland

The requirement is not uniform across the UK.

In Wales, the National Minimum Standards for Regulated Childcare for children up to the age of 12 include guidance on paediatric first aid training. Child minders, and any assistant who might be in sole charge, must hold a current full paediatric first aid certificate before commencing child minding. Assistants not left in sole charge should have an emergency paediatric first aid certificate within three months of starting their role. Certificates are renewed every three years.

Welsh ratios also differ materially from England’s: a maximum of 10 children up to 12 years, of whom no more than six may be under eight, no more than four under five, no more than three under two, and normally no more than two under 18 months, with an exception possible for multiple-birth siblings.

In Northern Ireland, the Minimum Standards for childminding and day care for children under age 12, published in July 2012 and amended in October 2018, require under Standard 3 that there is at least one member of staff with up to date paediatric first aid training present at all times in full day care and sessional care, and that a childminder has up to date paediatric first aid training. No course type, hour count or renewal period is specified — only that it is up to date. The document also states there is no legal requirement for ratios of first aiders to children.

For Scotland we could not locate a primary source setting a prescriptive paediatric first aid rule equivalent to Annex A. The regime appears to sit under the Health and Social Care Standards, Care Inspectorate expectations and SSSC registration rather than a specified hour count and validity period. Rather than publish a figure we cannot source, our advice for Scottish settings is to take the requirement from the Care Inspectorate directly.

Frequently asked questions

How long is a paediatric first aid certificate valid?

Three years, under Annex A of the EYFS framework, with annual refresher training something providers should consider in between.

How many hours is the course?

A minimum of 12 hours excluding breaks for the full course, or a minimum of 6 hours for emergency paediatric first aid.

Can it be done online?

Not entirely. The emergency elements must be delivered face-to-face, which Annex A defines as trainers physically present with trainees, expressly excluding online platforms.

Does a first aid at work certificate count?

No. First aid at work sits under the Health and Safety (First-Aid) Regulations 1981 and is a separate qualification; the HSE does not approve first aid training and its regulations do not cover children as non-employees.

Do childminders need it before registering?

Yes. The childminder framework requires the certificate to register and to be held at all times while registered.

How soon must a new Level 3 member of staff obtain it?

Within three months of starting work, where the Level 2 or Level 3 qualification was obtained since 30 June 2016.

Fitting it into the wider training plan

Paediatric first aid is a specialist, in-person qualification that has to be bought from a qualified first aid training provider — it is not something a general compliance catalogue can deliver. What sits around it is: safeguarding training renewed every two years for all practitioners, a designated lead on a course meeting Annex C, and the qualification conditions attached to each ratio. Those are set out in our guide to the EYFS statutory framework from September 2026, with the content covered in our guides to safeguarding children and designated safeguarding lead training.

To see what Learnsignal provides for the rest of a setting’s compliance training, explore our CPD courses or see pricing for teams.