Last Updated: 22 October, 2014

IntroductionFirst Aid, Logo

Following a review of the Health and Safety (First Aid) Regulations 1981, the Health and Safety Executive (HSE) made a number of key changes that affected first aid training requirements within the workplace. These changes took effect on 01 October 2009 for the majority of the United Kingdom (UK), and 01 September 2011 for businesses in Northern Ireland.

The three main changes from October 2009 were:

  • The First Aid at Work (FAW) Course: The FAW course changed from being a four-day course to a three-day course. Modern teaching methods and revision of some first aid protocols meant that the training could be more streamlined, but it is still as comprehensive as before.
  • The Emergency First Aid at Work (EFAW) Course: The HSE introduced a new, one-day course. Suitable for SMEs (small and medium enterprises) and low-risk working environments, this course allows the individual to gain a basic HSE accreditation and certificate in first aid. Although it is not as comprehensive as the three-day FAW course, those trained will be recognised by the HSE as workplace first aiders.
  • Risk Assessment: As part of the changes HSE recommended that employers conduct a new risk assessment so that they could select the most appropriate course and number of first aiders for their business. HSE suggested this involved consideration of a number of factors including hazards and risks in the workplace, number of employees, accident history, lone workers and distribution of workforce.

Legislation and Responsibilities

The legislation pertaining to first aid is the Health and Safety (First-Aid) Regulations 1981 (as amended, from time-to-time).

The law states that employers (in this case outdoor fitness providers including fitness boot camps, military fitness, small group trainers & personal trainers) are required to provide suitable first aid equipment, facilities and personnel to enable immediate assistance to be given to employees or clients (i.e. members) if they are injured or become ill at work.

Employed Fitness Instructors and Personal Trainers

For employed fitness instructors and personal trainers it is usually the employer’s responsibility to ensure that employee holds the required, up-to-date first aid qualifications at the appropriate level.

Self-employed Fitness Instructors and Personal Trainers

For self-employed fitness instructors and personal trainers it is usually the responsibility of the individual to ensure that they have the required, up-to-date first aid qualification at the appropriate level.

One-to-one Training

It is acceptable for personal trainers working on a one-to-one basis with clients to have the EFAW course. However, the FAW is always the better qualification due to providing a comprehensive a set of skills. As such, personal trainers must have:

  • As a minimum, the EFAW course;
  • Ideally, the FAW course.

Group Exercise

For trainers working in situations where they are responsible for multiple clients, for example group fitness instructors or personal trainers using the small group training model, then the FAW course is required.

Further, where an employee of a fitness organisation is appointed as the main first aider within that organisation then the FAW course is required.

First Aid CertificationFirst Aid, Logo (1)

First aid certification is a key qualification required by all fitness professionals.  The purpose of certification is to provide fitness professionals with the knowledge and practical skills to be able to deal with a range of injuries and illnesses.  There are currently three recognised first aid courses available for fitness instructors and personal trainers:

Emergency First Aid at Work Course

The Emergency First Aid at Work (EFAW) course, also known as the Fitness First Aid Course, is a one day practical course that typically covers:

  • Understanding the role of the first aider including reference to the use of available equipment and the need for recording incidents and actions;
  • Understanding the importance of basic hygiene in first aid procedures;
  • Assessing the situation and circumstances in order to act safely, promptly and effectively in an emergency;
  • Administering first aid to a casualty who is unconscious and/or in seizure;
  • Administering cardiopulmonary resuscitation (CPR);
  • Administering first aid to a casualty who is wounded or bleeding and/or in shock;
  • Administering first aid to a casualty who is choking;
  • Providing appropriate first aid for minor injuries; and
  • Recognising the presence of major illness and apply general first aid principles in its management

First Aid at Work Course

The First Aid at Work (FAW) Course is a three day practical course (with assessments) that typically covers:

  • As for the Emergency First Aid at Work course;
  • In addition demonstrating the correct first aid management of:
    • Soft tissue, chest, burn and scald injuries;
    • Injuries to bones including suspected spinal injuries;
    • Eye injuries including how to irrigate an eye; and
    • Sudden poisoning and anaphylactic shock.

Paediatric First Aid Course

The Paediatric First Aid (PFA) course teaches CPR and First Aid Skills for the care of infants and children. The training has an emphasis on prevention strategies and is suitable for anyone working with children and young people.

It is recommended that individuals/organisations that provide group fitness/small group fitness sessions to children should have PFA certification. The PFA course is typically a two day course and covers the following:

  • Initial Assessment;
  • CPR (Infant, Child, Adult);
  • Rescue Breathing (Infant, Child, Adult);
  • Control of bleeding;
  • Choking Management;
  • Continuing Circle of Care;
  • Shock;
  • Respiratory Problems;
  • Meningitis;
  • And much more.

FAW versus EFAW

The FAW course is a more comprehensive three-day course that covers everything an individual needs to know to be an official first aider in their organisation. It is especially useful for organisations that are in high risk sectors or have more than 50 employees.

In contrast, the EFAW course is a basic one-day course that is better suited to low risk environments and organisations with few staff. It does allow the individual to act as a first aider in the workplace but it does not provide as comprehensive a set of skills as the three-day FAW course.

Updating and Refresher Training

Annual Updates

The HSE strongly recommends that anyone who completes either the FAW or EFAW course attend an annual first aid annual update (FAU) course to refresh their skills. Annual updates are typically delivered over a half-day and are not, currently, mandatory.

The HSE suggests the course content for annual refresher training should cover:

  • Assessing the situation and circumstances in order to act safely, promptly and effectively in an emergency;
  • Administering first aid to a casualty who is unconscious (including seizure);
  • Administering cardiopulmonary resuscitation;
  • Administering first aid to a casualty who is wounded and bleeding; and
  • Administering first aid to a casualty who is suffering from shock.

Refresher Training

Since October 2009 refresher training has been known as the first aid requalification (FAR) course. To maintain FAW accreditation individuals need to requalify by completing a two day requalification course before the expiry date shown on their certificate. The FAR course is valid for three years.

To maintain EFAW accreditation individuals need to attend the one day course for EFAW before the expiry date shown on their certificate. There is no formal requalification course for the EFAW certificate.

Update versus Refresher

An annual update is a half day course for first aiders who still have a valid certificate. This annual update is to maintain their confidence and skills in first aid and is recommended by the HSE. The requalification is a two-day course for first aiders who have already completed the FAW course and whose certificate is about to expire.

Changes to HSE First Aid at Work Regulations

Since 01 October 2013 the HSE is no longer required to formally approve first aid training and individuals/organisations should have more choices of training provider. This means there is also an increased responsibility on individuals/organisations to ensure the standards of the training and quality of training provider they choose. Guidance on completing a needs assessment has also been updated with new recommendations to help individuals/organisations decide how many first aiders they need and what training they should have.

Basis for the Changes

The Government commissioned an independent report on health and safety laws, which led to the Lofstedt report in June 2012. One of the recommendations from this report was that employers should be free to choose a first aid training provider, rather than having to use a training provider approved by the HSE.

Needs Assessments

All employers should make an assessment of their first aid needs based on the hazards and risks involved in their work. First aid can, and does, save lives and the level of provision should be “adequate and appropriate” to the organisation’s circumstances. Factors to consider when deciding what is adequate and appropriate for the organisation include[1]:

  • The nature of the work and how hazardous it is;
  • The nature of the workforce and if there are staff with pre-known medical conditions;
  • The size of the organisation; and
  • The needs of travelling, lone or remote workers.

Additional Training Needs

The HSE suggests there are number of circumstances where additional training may be required after a needs assessment. An example of this additional training, which is relevant to outdoor fitness, is the management of a casualty suffering from hypothermia or hyperthermia.

Training Standards

Individuals/organisations must ensure that where their needs assessment indicates that they need first aiders, they receive training that will teach them the necessary first aid skills and leave them feeling confident that they could respond to an emergency. To guarantee this, the individual/organisation should choose a training provider they can trust. When choosing a training provider, there are a number of factors to consider:

  • The qualifications expected of trainers and assessors
  • Monitoring and quality assurance systems
  • Teaching and standards of first aid practice; and
  • Syllabus content and certification.


[1] Not an exhaustive list.

Further Reading

Useful Links