First-aid training changes: Aide-mémoire

On 1 October 2009, there were a series of changes made to the way first-aid cover should be provided for workplaces. The most obvious of these are the reduction of the initial First Aid at Work course from 24 hours (normally four days) to 18 hours (three days), and the introduction of the one-day (six hours) Emergency First Aid at Work course, and the three-hour (1/2 day) annual refresher course.

Changing course

When the Health and Safety (First Aid) Regulations 1981 were first introduced, First Aid was in the hands of the hobbyist and enthusiast. The expectation was that a training course delivered every three years would give the trainee the same level of competence as someone who practised every week as a hobby. Huge emphasis was put on skills such as tying for dressings and whether or not to use a reef knot or a granny knot, and many companies would run competitions for first-aiders where they were awarded for style, among other things.

The course content was also much greater than it is today, including subjects such as the Holger Neilson method of resuscitation, and the immobilisation of fractures, which necessitated the four-day time scale.

Over the past 20 years or so, the attitudes towards first aid at work have been changing. Nowadays, companies tend not to get involved in competitions, and the subject and complicated practices have been simplified. However, until October 2009, the same 24-hour time scale was still in place, resulting in a lengthy training course often padded out with non-essential information. The initial First Aid at Work course is now 18 hours long, which has resulted in a much more time efficient and focused training package. This should result in a course that is easier for candidates to absorb, hence boosting the confidence of first-aiders in the workplace, confidence being the biggest obstacle for first-aiders to overcome.

As in the past, first-aiders who have been trained on the new 18-hour First Aid at Work (FAW) course need to requalify every three years, but the Health and Safety Executive (HSE) will allow the extension of the certificate for 28 days beyond the expiry date. The course has not altered and is still 12 hours long. This re-qualification course, along with the 18-hour one, must be conducted and examined by an HSE-approved company.

The new six-hour (one day) Emergency First Aid at Work (EFAW) course covers the basics of first aid, including resuscitation, bleeding, choking and minor injuries. This course must be retaken every three years. Although there is no formal examination at the end, the course can only be delivered by organisations approved by the HSE or a recognised awarding body of the Qualifications and Curriculum Authority (QCA)/Scottish Qualifications Authority (SQA).


Research has shown that following training, the practical skills of first-aiders can deteriorate. Therefore, the HSE strongly recommends that it is good practice for first-aiders to complete annual refresher courses during any three-year FAW/EFAW certificate period. The course could be up to three hours long and the content will include, among other topics, resuscitation, bleeding, and unconsciousness.

It is important that employers ensure qualified first-aiders attend these courses to help maintain their basic skills and keep up to date with any changes to first-aid procedures. First-aiders who were trained prior to 1 October 2009 are able to attend the annual refresher course in the interim years between requalification courses.

Any organisation approved by the HSE or QCA/SQA can conduct these courses. Where available, in-house occupational health professionals can run the annual refresher course if they meet certain criteria. They should have a formal training or teaching qualification and a list of evidence to show they have provided FAW training during the previous three years, or evidence to show that they have conducted at least two practical and two theoretical first-aid training sessions under the supervision of a qualified assessor.

Where an employer’s assessment of first-aid needs identifies that a first-aider is not needed, the minimum requirement is that an employer appoints a person to take charge of first-aid arrangements, including calling for emergency services when required. First-aid training is not necessary to fulfil their role. However, if it is still possible for an accident or sudden illness to occur (and when is it not?) it is recommended that the employer considers having a qualified first-aider available.


Employers now have a variety of first-aid courses to choose from. The level of cover depends on the requirements of each workplace. Each employer must assess what equipment, facilities and personnel are required. There is no requirement for the assessment of first-aid needs to be formal or written down, although this may be useful if at some time the employer needs to justify their level of provision.

In assessing needs, employers should consider:

  • The nature of the work, hazards and risks
  • The size of the organisation
  • The nature of the workforce
  • The organisation’s history of accidents
  • The needs of travelling, remote and lone employees
  • Work patterns
  • The distribution of the workforce
  • The remoteness of the site from emergency medical services
  • Employees working on shared or multi-occupied sites
  • Annual leave and other absences of first-aiders and appointed persons
  • First-aid provision for non-employees (The regulations do not oblige employers to provide first aid for non-employees. However in certain businesses – for example, shops – it is strongly recommended that they are included in the assessment of needs).

More detailed information can be obtained from The Health and Safety (First-Aid) Regulations 1981 Approved Code of Practice, available online at, along with advice on the number of first-aiders relative to certain levels of risk within industry.

Alan Scott is training manager at Kays Medical and has been a first-aid trainer for more than 20 years.

Kays Medical has trained more than 250,000 first-aiders, many in specialist areas such as chemical decontamination and defibrillation. The company will also write bespoke courses tailored to an organisation’s needs. For more information, call 0151 482 2830

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