Full or Emergency Paediatric First Aid: Which One Do You Need?

The 6-hour course is half the time off the floor and costs less, so it is a fair question whether it will do. The answer turns on two sentences in the framework that say slightly different things, and most guidance on this topic does not put them next to each other. Here they are.

Last reviewed: 20 September 2026 against both EYFS statutory frameworks in force from 1 September 2026.

The short answer

Full PFA does everything emergency PFA does, and satisfies the requirement that emergency PFA cannot. So the decision is rarely “which one” for a setting as a whole — it is “who needs full, and who can hold emergency”. A nursery that trains everyone on the 6-hour course has spent real money and still has a compliance gap. A nursery that trains two people fully and the rest on the emergency course has good cover and no gap.

What each course covers

Annex A of the EYFS framework defines both. The full course is not a different subject — it is the emergency course plus a second layer.

Look at what is in the second column and ask which of those a nursery realistically meets. Anaphylaxis, asthma, febrile convulsions and burns are not exotic in early years settings — they are the ordinary week. That is the practical case for the full course, quite apart from the compliance one.

The two clauses that decide it

These sit in different parts of the framework and they are worded differently. The difference is the whole answer.

Clause 3.37 (and 3.42 for childminders): “At least one person who has a current paediatric first aid (PFA) certificate must be on the premises and available at all times when children are present and must accompany children on outings. The certificate must be for a full course consistent with the criteria set out in Annex A.“

Clause 3.39: “All staff who obtained a level 2 and/or level 3 qualification since 30 June 2016 must obtain a PFA qualification within three months of starting work in order to be included in the required staff:child ratios at level 2 or level 3 in an early years setting.”

One says “a full course”. The other says “a PFA qualification”. Annex A defines two PFA courses, the emergency one and the full one. So on a plain reading:

• the setting’s cover requirement can only be met by the full 12-hour course; and
• the three-month ratio requirement asks for “a PFA qualification”, which the emergency course is.

That reading is shared across the training industry and it is the sensible one. But it is worth being straight about something: the Department for Education does not say so in as many words. It does not state anywhere that an emergency certificate satisfies clause 3.39. If the difference matters to you — if a member of staff is load-bearing in your ratios and you would rather not have the conversation with an inspector at all — put them through the full course. It costs a day more and removes the question.

Who needs the full 12-hour course

• Whoever is providing your statutory cover, on every session, including early and late hours.
• Childminders, who must hold a PFA certificate to register and throughout registration, for a full course consistent with Annex A.
• Anyone who goes on outings as the qualified person — the requirement travels with the children.
• Room leads and deputies in practice, because they are the people left holding the setting when someone is off.
• Anyone whose place in the ratios you do not want to be arguable, per the point above.

The arithmetic most settings land on: enough full-PFA certificates that two qualified people are on site through the core day, and at least one through the early and late hours — because one person cannot cover a setting open 7.30am to 6pm once leave and sickness are counted. The reasoning is set out in our guide to paediatric first aid requirements.

When emergency PFA is the right call

It is not a lesser product, it is a narrower one, and there are good reasons to buy it:

• A new starter inside the three-month window. A level 2 or level 3 qualified member of staff who needs a PFA qualification quickly to be counted in the ratios, with the full course booked later.
• Widening cover across a team. If two people hold full PFA and six hold emergency, someone competent is always close to the incident. That is better provision than two full certificates and nothing else, even though only the two count for the statutory requirement.
• Staff who are rarely alone with children — kitchen, office or maintenance staff who would nonetheless be first on the scene in the corridor.
• Volunteers and students where a full course is disproportionate to the hours they do.
• Budget sequencing. Getting eight people to emergency level this term and upgrading the two key people next term beats training nobody while you save up.

Which course, by setting

Does either count towards staff:child ratios?

Full PFA certainly does. Emergency PFA does on the plain reading of clause 3.39, as set out above. Two further points that are easy to miss:

• Staff who completed the experience-based route must obtain a PFA qualification before being counted at level 3. There is no three-month grace period for them.
• To keep counting, “the certificate must be renewed every 3 years”. An expired certificate removes that person from your ratio calculation on the day it lapses — which is a staffing problem, not just a paperwork one.

There is also a disability exception: where a member of staff cannot gain a PFA certificate because of a disability, they can still be included in the ratios if otherwise competent to carry out their childcare duties, and where possible should attend a course and obtain written evidence of attendance.

Time, cost and getting people off the floor

The real cost of training early years staff is rarely the course fee — it is cover while they are away from the children. That is why the 6-hour course is tempting and why the honest advice is not simply “always buy the bigger one”.

Two days does not have to mean two consecutive days. A group course at your own setting, split across two weeks, keeps ratios intact and avoids travel time entirely. Current prices for both delivery routes are on the course pages below — we do not quote them here because they change.

Renewal

Both certificates run for three years, and this is where paediatric first aid differs from workplace first aid in a way that catches people out: there is no shorter requalification course. Workplace First Aid at Work has a two-day requalification route for existing certificate holders. The EYFS framework sets out no equivalent — renewal means the full course again, at whichever level the person needs.

Annual refresher training is not required. Annex A says providers “should consider whether paediatric first aiders need to undertake annual refresher training” during the three-year period. Worth considering, since practical skills decay, but its absence is not a compliance failure. The general principles on certificate expiry are in how long does a first aid certificate last.

Online and blended

This applies to both courses and it is not negotiable. Annex A requires the emergency elements to be delivered face-to-face, and the framework defines face-to-face as trainers being “physically present with their trainees”, explicitly excluding online platforms. Annex A also requires baby and junior manikins so that every learner can practise and demonstrate technique.

So an entirely online certificate at either level does not meet the criteria. Blended delivery can cover the additional content of the full course, but the emergency core has to happen in a room. If you are comparing a cheap online option against a classroom one, you are not comparing like with like.

Common mistakes

What this guide does not cover

It covers England; the other UK nations have their own early years frameworks. It is not first aid training and does not teach technique — the Annex A lists are a syllabus. For what EYFS requires overall, including outings, records and Ofsted notification, see the paediatric first aid requirements guide; for first aid law in workplaces generally, see workplace first aid requirements.

Our paediatric first aid course

We run the full 12-hour Paediatric First Aid course — the level the EYFS framework requires for your statutory cover — face-to-face, with baby and junior manikins so every learner practises and is assessed on infant and child technique. It runs as open course places for individuals and childminders, and as a group course at your setting for up to 12 people, which is usually the cheaper route from three or four learners and can be split across two weeks to protect your ratios.

If what you actually need is the 6-hour emergency course for part of your team, tell us — we would rather point you to the right thing than sell you two days you did not need.

Deals

First Aid at Work Courses

Frequently asked questions

Is emergency paediatric first aid enough for a nursery?

Not on its own. The EYFS framework requires the person providing the setting’s cover to hold a certificate “for a full course consistent with the criteria set out in Annex A” — the 12-hour course. Emergency PFA is a genuine qualification and widens cover across a team, but it does not discharge the “at all times” duty.

What is the difference between the 12-hour and 6-hour paediatric first aid courses?

The 6-hour emergency course covers assessing an emergency, an unresponsive baby or child whether or not breathing normally, seizures, choking, bleeding and shock from severe blood loss. The 12-hour full course covers all of that plus anaphylaxis, electric shock, burns and scalds, fractures, head, neck and back injuries, poisoning, foreign bodies, eye injuries, bites and stings, extreme heat and cold, diabetic emergencies, asthma, allergic reactions, meningitis and febrile convulsions, and the role of the paediatric first aider.

Does emergency paediatric first aid count towards staff:child ratios?

Clause 3.39 requires staff who gained a level 2 or 3 qualification since 30 June 2016 to obtain “a PFA qualification” within three months of starting work to be counted in the ratios. Annex A defines the emergency course as a PFA course, so on a plain reading it qualifies — and that is how the industry reads it. The Department for Education does not state it explicitly, so where a member of staff is critical to your ratios, the full course removes any doubt.

Do childminders need the full 12-hour course?

Yes. Childminders must hold a PFA certificate to register and throughout registration, and the certificate must be for a full course consistent with Annex A.

How long do paediatric first aid certificates last?

Three years, for both the emergency and the full course. Annex A states the certificate must be renewed every three years.

Is there a shorter requalification course for paediatric first aid?

No. Unlike workplace First Aid at Work, which has a two-day requalification route, the EYFS framework sets out no shorter renewal for paediatric first aid. Renewal means taking the full course again at the level required.

Can we do paediatric first aid online?

Not entirely. Annex A requires the emergency elements to be delivered face-to-face, which the framework defines as the trainer being physically present, explicitly excluding online platforms. It also requires baby and junior manikins for practice and assessment. Blended delivery can cover the additional content of the full course only.

How many staff should hold the full certificate?

The framework sets no number — it requires at least one on the premises at all times children are present, and says providers should take account of the number of children, staff and layout so a first aider can respond quickly. In practice most settings need enough certificates for two qualified people through the core day and one at each end, allowing for leave and sickness.

A new member of staff starts next week — which course should they do?

If they hold a level 2 or 3 qualification obtained since 30 June 2016, they need a PFA qualification within three months to be counted in your ratios, so book whichever course you can get a place on inside that window. If they came through the experience-based route they must hold it before being counted at level 3, so there is no window at all.

Is annual refresher training required for paediatric first aid?

No. Annex A says providers “should consider” whether paediatric first aiders need annual refresher training during the three-year certification period. It is worth considering because practical skills fade, but it is not a requirement.

Sources

• Department for Education, EYFS statutory framework for group and school-based providers, in force 1 September 2026 — clauses 3.37, 3.39 and Annex A
• Department for Education, EYFS statutory framework for childminders, in force 1 September 2026 — clause 3.42 and Annex A

Not sure which your setting needs? Call 0845 838 4643 or use the enquiry form on this page and we will work it through with you.