Advice on the requirements for first aid provision in schools

Health and safety regulations

The Health and Safety (First Aid) Regulations 1981 require employers to provide adequate numbers of first aiders, facilities and equipment to enable first aid to be given to employees who are injured or who fall ill at work. These regulations apply to schools in the same way as all other workplaces.

Their requirements deal only with employees and do not specifically cover non-employees such as, pupils and other visitors to the school premises.

Nevertheless, under the provisions of the Health and Safety at Work etc Act 1974, employers have a duty to ensure, so far as is reasonably practicable, the health and safety of non-employees.

Moreover, Health and Safety Executive (HSE) guidance strongly recommends that non-employees are included in an assessment of first aid needs and that provision is made for them.

Assessment of first aid needs

The 1981 regulations require employers, in order to decide how to meet their obligations, to make an assessment of the first aid needs appropriate to the circumstances of each workplace. This assessment will then help employers to determine how many first aiders are needed and what other first aid facilities and equipment should be provided. The HSE ACoP advises that, when making this assessment of need, employers should consider workplace hazards and risks, the size of the organisation and the nature and distribution of the workforce, the organisation's history of accidents, the needs of travelling, remote and lone workers and access to the site for emergency medical services.

Making first aid procedures known

It is vital that all school staff know who their first aiders are and how to contact them and that there are agreed procedures in place for dealing with all kinds of emergencies, including those in isolated areas such as playing fields.

To ensure this, first aid notices should be clearly displayed giving information on the names and location of first aiders and the location of first aid equipment.

First aiders in school

The regulations impose no absolute requirement upon employers to provide a first aider at the workplace. Decisions must be based on an assessment of first aid needs. The NEU recommends that as a minimum every school should have at least one qualified first aider and one designated ‘appointed person’ to take charge of first aid matters in their absence. The hazards present in schools mean that it would be inappropriate for any school to be without a qualified first aider. The NEU believes that it is particularly important for a first aider to accompany pupils on educational visits.

The HSE ACoP divides workplaces into lower, medium and higher risk categories. The minimum requirement, in smaller and ‘lower risk’ workplaces, is to provide an appointed person to take charge of first aid arrangements, including looking after equipment and facilities and calling the emergency services. Larger and higher risk workplaces are required to have at least one first aider.

First aiders for young children

Specific legal requirements do, however, apply to first aid provision for very young children. These are set out in the DfE document Statutory framework for the early years foundation stage (September 2014).

At least one person with a current paediatric first aid certificate must be on the premises at all times when children are present. There must also be at least one person on school trips who has a current paediatric first aid certificate.

The paediatric first aid training must be relevant for workers caring for young children, and babies, where relevant. Providers are able to choose which organisation provides this training; however, the DfE recommends that a provider is chosen that has a nationally approved and accredited first aid qualification, or one that is a member of a trade body with an approval and monitoring scheme. Whichever provider is chosen, the training must cover the content which is included in the St John Ambulance or Red Cross paediatric first aid training courses, and must be renewed every three years.

Mental health first aid

Provision of mental health first aid is not a legal requirement upon employers. Mental health first aid training courses teach people to spot the symptoms of mental health issues, offer initial help and guide a person towards the support they need. They don’t teach people to be therapists. The NEU does not train its members to become mental health first aiders for their school because that should be an employer responsibility, in the same way as first aid is an employer responsibility.

The NEU does not seek to dissuade members from volunteering to become a mental health first aider in their workplace. In such cases training should be provided by, and paid for by, the school.

Becoming a first aider for your school

Being a first aider is a voluntary matter unless it is in an employee’s contract of employment. Teachers’ contracts of employment do not include any requirement to give first aid, in the same way as they do not include any requirement to administer medicines to pupils routinely.

Any member of staff may volunteer for first aid duties. The NEU advises that teachers should consider carefully before agreeing to become a school’s only trained first aider since there can be practical difficulties, such as not being able to leave their class easily.

When selecting someone to take up the role of a first aider, HSE guidance states that a number of factors need to be taken into account, including an individual’s:

  • reliability, disposition and communication skills
  • aptitude and ability to absorb new knowledge and learn new skills
  • ability to cope with stressful and physically demanding emergency procedures
  • normal duties - these should be such that they may be left to go immediately and rapidly to an emergency.

The NEU believes that, where teachers do become first aiders, they will need to be released occasionally from teaching for a period of non-contact time adequate to fulfil their responsibilities for checking all aspects of first aid provision.

    Qualifications and training for first aiders

    Before taking up first aid duties, a first aider should have undertaken training and have a valid certificate of competence in either:

    • first aid at work (FAW), or
    • emergency first aid at work (EFAW).

    Both these qualifications permit an employee to be designated as a first aider.  An ‘appointed person’, however, is not the same as a first aider. An appointed person takes charge of first aid arrangements, looks after first aid equipment and calls the emergency services when required. Appointed persons do not have to undergo first aid training, though they may do so and if they complete either a FAW or EFAW course, they become a first aider for the purpose of the regulations.

    FAW and EFAW certificates are valid for three years. The contents of a FAW course and an EFAW course differ, but as the FAW course is more thorough, the NEU strongly recommends that schools use this course. But schools will need to make their own decisions based on:

    • the degree of hazard associates with their activities
    • number of employees, students and members of the public on site
    • previous record of injuries and illness
    • lone working
    • number of employees/students with disabilities.

    First aid facilities in schools

    The HSE ACoP advises that employers should provide a suitable first aid room or rooms where the assessment identifies that this is necessary. In schools, the 2012 Education (School Premises) Regulations require a medical room for pupils to be provided and this can, where necessary, be used for giving first aid to staff, pupils or visitors.

    The HSE ACoP contains advice on first aid rooms. They should contain essential first aid facilities and equipment, be easily accessible to stretchers and be clearly signposted and identified. They should have washable surfaces and adequate heating, ventilation and lighting, and should display a notice on the door advising of the names, locations and, if appropriate, telephone extensions of first aiders and how to contact them. Hot and cold running water, soap, paper towels and drinking water should also be provided.

    First aid kits

    Employers must provide at least one fully stocked first aid container for every work site and first aid procedures should make sure that someone is responsible for examining the contents of the containers and keeping them stocked. The NEU recommends that, in schools, additional first aid containers will be needed where there are split sites or split levels, for distant sports fields and playgrounds, for any other high risk areas (such as labs, gyms, workshops etc) and for off-site activities. The containers should be clearly marked with a white cross on a green background.

    There is no mandatory list of items to include in a first aid box. It depends on what the employer considers necessary in the light of risk assessment. The HSE ACoP provides a list of minimum recommended contents for a first aid container in a low hazard workplace:

    • a leaflet giving general advice on first aid [1]
    • 20 individually wrapped sterile adhesive dressings (hypoallergenic plasters can be provided if necessary)
    • 2 sterile eye pads
    • 4 individually wrapped triangular bandages (preferably sterile)
    • 6 safety pins
    • 6 medium-sized individually wrapped sterile unmedicated wound dressings
    • 2 large sterile individually wrapped unmedicated wound dressings
    • 1 pair of disposable gloves.

    Remember that this is a suggested list of contents only. Equivalent or additional items are acceptable. The HSE recommends that tablets and medication are not kept in first aid boxes. In addition, the contents of first aid containers should be examined frequently and restocked after use. Care should be taken to dispose of items safely once they reach their expiry date.

    Defibrillators in schools

    In recent years, there has been a growth in the number of automated external defibrillators (AEDs) sited in public areas. An AED is a machine used to give an electric shock, when a person is in cardiac arrest, ie when their heart stops beating normally. Cardiac arrest can affect people of any age and without warning; if that happens, swift action in form of prompt defibrillation can help save a person’s life. The NEU supports the calls for all schools to be fitted with a defibrillator, as they can save the lives of both pupils and staff. As with other first aid training, teachers cannot be compelled to be trained to use AEDS; this must be on a voluntary basis and training funded by the employer/school.

    Off-site visits

    Before undertaking any off-site activities, the head teacher should assess what level of first aid provision is needed. The HSE recommends that, where there is no special risk identified, a minimum stock of first aid items for travelling first aid containers is:

    • a leaflet giving general advice on first aid
    • individually wrapped sterile plasters (assorted sizes), appropriate to the type of work (hypoallergenic plasters can be provided if necessary)
    • sterile eye pads
    • individually wrapped triangular bandages, preferably sterile
    • safety pins
    • large sterile individually wrapped unmedicated wound dressings
    • medium-sized sterile individually wrapped unmedicated wound dressings
    • disposable gloves.

    Again, equivalent or additional items are acceptable. Additional items may be necessary for specialised activities.

    Public service vehicles

    Transport regulations require that all minibuses and public service vehicles used either as an express carriage or contract carriage have on board a first aid container with the following items:

    • 10 antiseptic wipes, foil packaged
    • 1 conforming disposable bandage (not less than 7.5cm wide)
    • 2 triangular bandages
    • 1 packet of 24 assorted adhesive dressings
    • 3 large sterile unmedicated ambulance dressings (not less than 15cm x 20cm)
    • 2 sterile eye pads, with attachments
    • 12 assorted safety pins
    • 1 pair of rustless blunt-ended scissors.

    For further guidance, download the full 'First aid in schools' advice. 

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