Introduction

1. This paper will be of particular interest to employer duty holders, first-aiders and first aid training providers.  It outlines the Health and Safety Executive's (HSE's) current position on introducing a new training regime for first-aiders in the workplace.  It provides an overview of the new first aid courses then focuses on approval and monitoring of training providers that wish to run these courses.  The latter includes a description of preliminary work HSE has undertaken with the Qualifications and Curriculum Authority and of early discussions with the Scottish Qualifications Authority aimed at developing proposals for approving relevant accredited first aid qualifications within the framework of the Health and Safety (First-Aid) Regulations 1981 (First Aid at Work Regulations) in Great Britain.

2. The 'What happens next?' section covers research, guidance and HSE's future links with stakeholders that have an interest in first aid at work (FAW). 

The structure and content of new courses for first-aiders in the workplace

3. HSE conducted a review of the FAW Regulations in 2003/04, aimed at evaluating whether they were still effective in meeting the needs of modern businesses.  To help inform the review, HSE commissioned research and consulted widely with stakeholders - employers, first-aiders and FAW training providers.  Relevant documents produced as part of this programme of work are available on HSE's website at: http://www.hse.gov.uk/firstaid/program.htm.  Following an analysis of the review's findings, the Health and Safety Commission agreed with the recommendation to change first aid training for workplace first-aiders. 

4. The main drivers for this change were to help employer duty holders access competent first aid, provide a more proportionate response to their first aid needs, and to minimise burdens on business.  HSE published a Position Statement in 2005 containing a detailed rationale to support the introduction of a new training regime and outlining the structure and content of new first aid courses (http://www.hse.gov.uk/firstaid/review/positionstatement.pdf).  This was subsequently updated in June 2006 (http://www.hse.gov.uk/firstaid/review/june06.htm).  For quick reference, the configuration of the new training courses is summarised in Appendix 1.  This has been through an extensive consultation process and there are no plans to make further changes to it.

5. In brief, when the new courses are introduced (possibly early 2009 but the exact timing will depend on the outcome of the work described in this paper), employers will be able to send prospective first-aiders on either:

• a full three day course in FAW; or
• a one day course in emergency first aid at work (EFAW).

6. Selecting the appropriate course will depend on the circumstances of the workplace and will be informed by the findings of the employer's first aid needs assessment.  HSE will issue revised guidance for employers to help them decide which course is suitable.  A three year certificate will be issued to those who successfully complete an FAW or EFAW course.  During any three year certification period, first-aiders should undertake annual refresher training to update their basic skills.  At the end of this period, it will be necessary to requalify.

[back to top]

Approval and monitoring of training providers

Current arrangements

7. HSE's First Aid Approval and Monitoring Section (FAAMS) administers a system by which training organisations can gain approval to run FAW courses by demonstrating they meet the standards described in relevant guidance (http://www.hse.gov.uk/firstaid/approval.pdf).  Once approved, training organisations are subject to ongoing monitoring to ensure the standards are maintained.  These arrangements ultimately aim to produce qualified first-aiders who are competent to administer first aid in the workplace.     

8. FAAMS will continue to approve training providers running FAW courses, for the foreseeable future. 

Proposed arrangements for delivering the new first aid courses

Rationale

9. HSE is committed to ensuring that providers running courses for first-aiders in the workplace use suitable training standards.  As noted in paragraph 8, HSE intends to retain its FAAMS function.  HSE will continue to work towards full cost recovery for its FAW approval and monitoring activities while at the same time looking for opportunities to streamline FAAMS' processes.

10. In implementing the new first aid courses, some first aid training organisations may wish to run EFAW courses only (and not full FAW courses).  HSE recognises that employers would require assurance that organisations offering this course are using suitable training standards.  HSE approved providers have suggested that such organisations should be required to gain 'approval'.  However, HSE does not wish to expand FAAMS and develop a separate procedure for this purpose.

11. Nevertheless, HSE accepts that training providers only wishing to run EFAW courses should be able to demonstrate they meet acceptable standards of training.  As a result, HSE has been in discussion with the Qualifications and Curriculum Authority (QCA - http://www.qca.org.uk/) to explore the possibility that these training providers could obtain 'approval' through QCA and its fellow qualification regulators for Wales and Northern Ireland.  This approach is consistent with central Government's promotion of joint working between public authorities, and both HSE and the QCA see a range of advantages from this approach for both employers and training providers (see paragraph 17).

Roles of HSE and the QCA  

12. HSE has enforcement responsibility in relation to employers' duties under the FAW Regulations.  The Regulations allow HSE to approve qualifications accredited by the qualification regulators but in doing so, it has to ensure the training is of a requisite standard to confer the qualification.  Therefore, HSE would need to work closely with the QCA to ensure appropriate standards are in place.

13. The QCA is a non-departmental public body sponsored by the Department for Children, Schools and Families and also works with the Department for Innovation, Universities and Skills.  Together with its fellow qualification regulators for Wales and Northern Ireland, the Department for Children, Education, Lifelong Learning and Skills (DCELLS) and the Council for the Curriculum, Examinations and Assessment (CCEA), it regulates Awarding Bodies, examinations, qualifications and national curriculum assessments to ensure qualifications are fair, standards are secure and public confidence is sustained.  As well as maintaining and developing the national curriculum, the qualification regulators accredit and monitor qualifications in colleges and at work.  A number of recognised Awarding Bodies already offer a variety of first aid qualifications including outdoor, sports, paediatric, emergency and basic first aid.

14. In the context of EFAW, the qualification regulators will continue to provide a robust system, ensuring that it meets HSE requirements when accrediting the qualification.  Awarding Bodies could then offer EFAW, ensuring that training standards meet specified requirements.  

15. As explained above, QCA works with the Welsh Assembly Government's Department for Children, Education, Lifelong Learning and Skills and the Council for the Curriculum, Examinations and Assessment in Northern Ireland, to recognise Awarding Bodies and accredit qualifications in England, Wales and Northern Ireland.  Subsequent to accreditation, qualifications are approved by the relevant government departments for use in England, Wales and Northern Ireland as appropriate. 

16. The FAW Regulations extend to England, Wales and Scotland.  The relevant authority for accrediting qualifications in Scotland is the Scottish Qualifications Authority (SQA).  HSE has had preliminary discussions with SQA and is hopeful that the proposal for EFAW approval can be mirrored in Scotland.      

Benefits of accredited first aid qualifications for the workplace

17. HSE and the QCA recognise that accrediting first aid qualifications for the workplace has a number of potential advantages.  They include:

• linking first aid training for the workplace to other first aid and occupational health and safety qualifications delivered under national regulatory  frameworks – National Qualifications Framework (NQF) and emerging Qualifications and Credit Framework (QCF).  These frameworks set out 'levels' at which qualifications can be recognised.  It helps learners and employers make informed decisions about what qualifications they need in a wider occupational health and safety context;
• linking first aid training for the workplace to wider recognised health industry qualifications;
• introducing employees, who may have missed out on earlier vocational training, to the national framework through first aid training and encouraging wider training and education;
• influencing the standards and quality of general first aid training through new training providers requesting approval.  This may have a positive impact on standards in the wider first aid training community.

Proposals

18. The proposals for approving training organisations to run the new first aid courses are summarised in Appendix 2.  If a provider wants to run full FAW courses, they will need to be approved by HSE for this purpose.  To run EFAW courses, they will need to have HSE approval for FAW (this would confer automatic approval to run EFAW) or obtain approval from a recognised Awarding Body eligible to award an accredited qualification in EFAW. 

19. Having direct approval from HSE (for FAW) or a recognised Awarding Body (for EFAW) would entitle an organisation to run the annual refresher training (basic skills update).  The proposals also allow for an employer's in-house occupational health doctor/ nurse, where available, to run this course as a potentially cost effective option for larger organisations with many first-aiders.  HSE is supportive of this approach but will need to consider any necessary conditions to safeguard training standards.

Implications for first aid training providers

20. The impact of these proposals on existing HSE approved organisations should be minimal.  They will be given automatic approval to run EFAW courses and will be entitled to run annual refresher courses. 

21. New providers wishing to deliver the full FAW course will need to apply to HSE for approval.  If successful, they will then have automatic approval to run EFAW courses.  New providers that only want to run the EFAW course will need to apply for approval to a relevant recognised Awarding Body. 

The longer term

22. It remains HSE's longer term aspiration to move all first aid approval and monitoring to one or more external organisations.  The QCA have indicated that they would like HSE to consider the possibility of qualification regulators accrediting the full FAW qualification.  HSE will consider this option in the light of satisfactory progress with the proposed EFAW approval arrangements.

[back to top]

What happens next?

Research

23. In exploring the recognised Awarding Body route for delivering quality EFAW training, HSE recognises that a range of factors will influence providers' decisions, including cost.  However, external validation of provision is a key element in ensuring standards are maintained, promoting public confidence and ensuring the competency of first-aiders.  Therefore, training providers may reasonably expect to cover such costs that are required for this necessary function. 

24. HSE is beginning work to scope the number of training organisations that will have an interest in running the new first aid courses in the future and the likely volume of approval work that would result.  As part of this, staff at HSE's Health and Safety Laboratory will be contacting a number of first aid training organisations to help collect this information.  However, organisations can decline to take part in the research if they wish.  The project is scheduled for completion by the end of 2007.

Guidance

25. HSE will include the new approval arrangements in its revised guidance for employers and training providers.  In the case of the latter, it will indicate where providers should apply for approval to run the new first aid training courses.  It will also describe in detail, HSE's procedures for gaining and maintaining approval to offer full FAW training.  These standards are likely to form the basis for delivery of EFAW courses through recognised Awarding Bodies but more discussions are required between HSE and the QCA before considering the detail. 

26. HSE aims to issue its revised guidance for external consultation in autumn 2007.  However, the exact timing will depend on the outcome of discussions with both the QCA and SQA. 

Stakeholders

27. In issuing its draft guidance for consultation, HSE wants views on the proposals from a wide range of stakeholders, including employers, employees, first-aiders and first aid training providers.  As with previous consultation, HSE will aim to do this in as effective and an efficient way as possible.  For example, by engaging with relevant bodies that represent a large number of stakeholders and interests, and asking them to collate comments and provide HSE with a single, coordinated response.

Summary points

28. Under the proposals presented in this paper:

• for the foreseeable future, HSE will retain responsibility, through FAAMS, for the approval and monitoring of training providers running FAW courses;
  
• existing HSE approved training organisations will be given automatic approval to run EFAW courses;
  
• new providers wishing to run FAW courses will need to apply to HSE for approval;
  
• new providers wishing to run EFAW courses only will need to gain approval from a recognised Awarding Body;
  
• annual refresher courses can be run by providers approved by HSE (for FAW), recognised Awarding Bodies (for EFAW) or by in-house occupational health doctors/ nurses;
  
• HSE plans to consult on its draft guidance for employers and training providers and obtain views from all key stakeholder groups, where appropriate, in developing and implementing these new arrangements;
  
• In the longer term, the qualification regulators want to explore accrediting the FAW qualification subject to satisfactory progress with the EFAW arrangements.

[back to top]

Appendix 1: First aid courses to complete over an initial three year period and in subsequent years (dotted line).

 

Appendix 2: Proposed routes for approving training providers to run the new first aid training courses.

[back to top]