Paediatric first aid training is a mandatory requirement for many childcare professionals in England, and Ofsted's updated Early Years Foundation Stage (EYFS) framework has introduced clearer expectations about the ratio of trained staff and the acceptable currency of qualifications.

EYFS Paediatric First Aid Requirements

Under the Statutory Framework for the Early Years Foundation Stage (2024 revision), all newly qualified entrants to the early years workforce who have completed a level 2 or level 3 qualification on or after 30 June 2016 must also have either a full or emergency paediatric first aid certificate. The certificate must be renewed every 3 years.

Ratio Requirements

Ofsted expects that at least one person who has a current paediatric first aid (PFA) certificate is on the premises and available at all times when children are present. For settings with children under 2 years, this requirement is more stringent, with inspectors looking for evidence that PFA-trained staff are present throughout the day.

Every 3 Years Paediatric first aid certificates must be renewed to remain valid for Ofsted purposes

What Qualifications Are Accepted?

Ofsted accepts paediatric first aid qualifications from a range of awarding organisations, provided they meet the criteria set out in the EYFS framework. The two main types are:

  • Paediatric First Aid (PFA): A 2-day qualification covering a comprehensive range of paediatric emergencies including CPR, choking, anaphylaxis, and management of common childhood illnesses
  • Emergency Paediatric First Aid (EPFA): A 1-day qualification covering basic paediatric life support and management of the most common emergencies
"Inspectors will check that the required number of staff hold a current paediatric first aid certificate and that the certificate is from an approved provider." — Ofsted Early Years Inspection Handbook, 2026

Paediatric First Aid Trainer Course

Qualify to deliver accredited paediatric first aid training. Emergency Paediatric First Aid (1 day) and full Paediatric First Aid (2 day) trainer courses available.

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Common Inspection Findings

Ofsted inspectors frequently note issues with paediatric first aid provision during early years inspections. The most common problems identified include: certificates that have expired or are about to expire; insufficient numbers of trained staff to meet the ratio requirements; and staff who completed their training more than 3 years ago and have not renewed.

Settings that are found to have inadequate paediatric first aid provision during an inspection may receive a requirement to address this as a condition of their registration, and persistent non-compliance can lead to enforcement action.