First Aid provision 
in schools

On 1 October 2013, the Health and Safety (First Aid) Regulations 1981 (the Regulations) were amended. The amendment did not change a school’s headline responsibility to ensure adequate first aid provision. However it did remove the previously mandatory requirement for the HSE to approve the providers of first aid training and qualifications, which means that schools now have more flexibility in how they facilitate their provision of first aid.

First aid provision in schools
All schools have an overarching duty under the Health and Safety at Work etc Act 1974 (the Act) to ensure the health and safety of employees and of anyone else affected by the school’s operation. This obligation includes a duty to protect the health and safety of pupils, contractors and other visitors to the school’s site.
   
As part of this duty, the Regulations require all employers to provide adequate and appropriate first-aid equipment, facilities and people so that immediate help can be given if someone is injured or taken ill at work.
   
Schools must undertake an assessment of their first aid needs in order to establish what provision for first aid is required. Factors to consider include the location and size of the school, the number of sites, the number of employees and pupils, the age of pupils, their health needs and activities carried out. 
   
Site access and communication with the emergency services is vital in an emergency situation and should be included within the school’s arrangements for managing first aid.

Schools should consider all their operations when assessing need, and give particular importance to the provision of first aid in areas of specific need, such as in physical education, science departments, school trips and away sporting fixtures.
   
The obligations under the Regulations are limited to a school’s duties to employees. However, the HSE strongly recommends that schools include non-employees, such as pupils and visitors, in their assessment of first aid needs and make adequate provision for them.

The HSE has issued guidance on First Aid at Work (L74). The latest version can be found at www.hse.gov.uk.

Minimum requirements
In addition, the Education (Independent School Standards)(England) Regulations 2010 require schools to draw up and implement a written policy on first aid.
   
In summary, the minimum requirements for school first aid provision are a first aid needs assessment; a written policy on first aid; and an appointed person to take charge of first aid arrangements. A school needs  suitably stocked first aid boxes in appropriate locations such as labs and PE departments. There is no mandatory content but it is recommended that schools consider the content of BS 8599.
   
Schools also need an appropriate number of first aiders. Where there are fewer than 50 employees at least 1 first aider is needed; and where there are more than 50 employees at least one first aider is needed for every 100 employees.
   
Schools must also provide sufficient information to staff and pupils about the school’s first aid arrangements.

Beyond minimum requirements
In practice, first aid provision in schools is likely to exceed these minimum requirements.

Schools should ensure that first aiders have undertaken suitable training, have an appropriate first-aid qualification and remain competent to perform their role. Typically, first-aiders should hold a valid certificate of competence in either first aid at work or emergency first aid at work.
   
In EYFS settings first aiders should have a paediatric first aid qualification.
   
It is important to think about who is likely to need first aid within a school, including pupils, staff and visitors. Many grandparents make the school run for working parents. By looking at accident data it is easy to identify what the common injuries and ailments are so that adequate first aid provision can be made.
   
According to Allergy UK, 50 per cent of children and young people have one or more allergy. Each year the number of allergy sufferers increases by five per cent and half of those affected are children. The UK is one of the top three countries in the world with the highest incident of allergy.    
   
Every school is likely to have at least one pupil who is severely food allergic and many schools will have more. Peanut allergies are particularly common with one in 70 children nationwide thought to be affected
   
Asthma is also very common in schools and hospitalises someone every seven minutes and tragically 1,500 people die from asthma every year.  
   
It is therefore important that first aiders in schools are made aware of pupils who have allergies and how to treat them.
   
The British Heart Foundation has lots of resources for schools and co-ordinates the ‘Heartstart’ programme which teaches emergency life support skills for young people at no cost. More information can be found at www.bhf.org.uk.
   
Whilst there is no mandatory requirement in this country, many schools are purchasing Automatic External Defibrillators (AEDs). Survival rates after a cardiac arrest decrease approximately seven per cent to ten per cent with every minute that defibrillation is delayed. These life‑saving pieces of equipment are widely available at a competitive cost.

Key areas where first aiders may be required
Teachers, including those leading trips and PE staff, is an area where a first aider would be required. Cricket, football and rugby are usually the greatest causes of injury in most schools and sports injuries often result in fractures, dislocations, sprains and strains and rarely head and spinal injuries.
   
Early Years staff should also have a first aider. In the younger age ranges special awareness can often be slow to develop and as a result there are often lots of bumped heads during playtime. Paediatric first aid allows recognition of common childhood illness and speedy referral to a GP minimising the length of absence from school.
   
Support staff may also need a first aid trained person. Playground supervisors often have to deal with slips and trips which result in soft tissue injuries. Dining hall staff may have to deal with choking and anaphylaxis in a dining room.
   
Whilst it is not mandatory on the school curriculum, it is a good idea for pupils to be trained in first aid. First aid is an important life skill and putting an unconscious casualty in the recovery position and opening their airway whilst waiting for the emergency services can often make the difference between life and death.
   
First aid training is available from a wide range of providers. These include voluntary aid societies such as St John Ambulance and British Red Cross.
   
Training is also available from those who offer regulated qualifications, ie first aid qualifications which are regulated by qualification regulators (Ofqual, SQA and the Welsh Government). First aid is also provided from those who operate under voluntary approval schemes; for example, a trade or industry body with quality assurance schemes accredited by a third party. It’s also available from those who operate independently of any such scheme, for example, where a training provider chooses to demonstrate their competence by providing evidence that they meet the criteria set by the HSE.
   
The HSE does not advocate, support or promote any particular provider and schools are free to chose whichever provider best suits their requirements, based on their needs assessments and appropriate due diligence. The HSE’s guidance on Selecting a First-aid training provider (GEIS3) provides a useful checklist for evaluating the competence of potential first aid training providers.
   
In-house training can also be provided, but it must be fit for purpose and it is the school’s duty to ensure that the training and syllabus is fully compliant with the regulatory requirements. Regular (every 12 months) refresher training is important to ensure staff retain the confidence to treat casualties.

FURTHER INFORMATION
www.hse.gov.uk
www.iosh.co.uk