Paediatric First Aid vs First Aid at Work: Which Qualification Do You Need?

The Core Difference in One Sentence

Paediatric First Aid (PFA) is specifically designed for emergencies involving infants and children, and is the qualification required by Ofsted and the Early Years Foundation Stage (EYFS) framework for childcare workers. First Aid at Work (FAW) is a broader adult-focused qualification required under HSE regulations for workplaces with higher-hazard activities.

Neither is a substitute for the other in its required context. A nursery manager who holds the full 3-day FAW but not PFA does not satisfy the Ofsted childcare requirement. A construction site manager who holds PFA but not FAW does not satisfy the HSE requirement for their workplace. The two qualifications serve different populations with different physiological needs and different legal frameworks.

What Each Course Covers

Who is Required to Hold Paediatric First Aid?

The Early Years Foundation Stage (EYFS) statutory framework sets out the following requirements for Paediatric First Aid in England:

• Nurseries and pre-schools: At least one PFA-qualified person must be on the premises at all times when children are present. PFA is also a requirement for all newly qualified Level 2 and Level 3 staff.
• Childminders: All childminders must hold a current PFA certificate as a condition of Ofsted registration. This has been mandatory since September 2016.
• Out-of-school clubs and holiday clubs: EYFS applies to any setting providing early years education to children aged 0–5. Settings for children aged 5 and over are not subject to the EYFS PFA requirement, though a general first aid provision is still required under HSE regulations.
• Off-site trips: At least one PFA-qualified member of staff must accompany any trip or outing involving children under 5.

The requirement is for a full Paediatric First Aid certificate — a 2-day classroom qualification. Online-only PFA certificates do not satisfy the Ofsted requirement. If you are unsure whether your current certificates are accepted, call us and we can advise on the qualification level required.

Who is Required to Hold First Aid at Work?

The First Aid at Work (FAW) 3-day qualification is required under the Health and Safety (First Aid) Regulations 1981 for workplaces where the HSE's first aid needs assessment identifies a higher-hazard environment. This typically includes:

• Construction sites and civil engineering projects
• Warehouses and distribution centres
• Manufacturing and production facilities
• Hospitality and catering operations with significant kitchen hazards
• Transport and logistics operations
• Any workplace where the nature of the work creates a risk of major injury

For lower-hazard workplaces — offices, retail, schools — the 1-day Emergency First Aid at Work (EFAW) is usually sufficient. Our guide on EFAW vs First Aid at Work explains how to decide between the two adult-focused qualifications. For our industry-specific guides, see first aid requirements for construction sites and first aid requirements for offices.

Can First Aid at Work Replace Paediatric First Aid?

No — and this is the most important point in this guide. The 3-day FAW qualification does not satisfy the EYFS Paediatric First Aid requirement, regardless of the training provider or the Ofqual level of the FAW certificate. Ofsted inspectors specifically check for a current PFA certificate, and an FAW certificate alone will not prevent an action being taken against your registration.

The reasons are practical as well as regulatory. Infant and child physiology differs from adult physiology in ways that are directly relevant to first aid response. The rate and depth of chest compressions for infant CPR, the technique for clearing an infant's airway, the paediatric AED pad placement and energy settings — all of these differ from adult protocols. A first aider trained only in adult FAW is not equipped to manage an infant cardiac arrest or paediatric airway emergency with the same competence as someone trained in PFA.

Equally, PFA does not replace FAW. A nursery with staff who hold only PFA certificates has no compliant first aid provision for adult workplace injuries under HSE regulations — unless a separate risk assessment demonstrates the workplace is low-hazard and EFAW (not PFA) satisfies it.

Which Course Does a Primary School Need?

Primary schools present a common point of confusion. The EYFS applies to children aged 0–5, so the PFA requirement applies directly to Reception and Nursery classes. For children aged 5 and over (Year 1 upwards), EYFS no longer applies — but first aid provision is still required under general HSE regulations for the workplace and under DfE guidance for schools.

In practice, most primary schools maintain at least one PFA-qualified staff member to cover Reception, and ensure EFAW or FAW cover for the broader school population. Many schools train multiple staff in PFA precisely because the Ofsted requirement for a PFA-qualified person to be on premises at all times is difficult to satisfy without redundancy. For a full breakdown of school-specific requirements, see our guide on first aid requirements for schools. We also cover paediatric first aid courses in Kent delivered at your school or nursery premises.