Browse through these FAQs to find answers to commonly raised questions.

First Aid Training

3.25. 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. Childminders, and any assistant who might be in sole charge of the children for any period of time, must hold a full current PFA certificate. PFA training30 must be renewed every three years and be relevant for workers caring for young children and where relevant, babies. Providers should take into account the number of children, staff and layout of premises to ensure that a paediatric first aider is able to respond to emergencies quickly. All newly qualified31 entrants to the early years workforce who have completed a level 2 and/or level 3 qualification on or after 30 June 2016, must also have either a full PFA or an emergency PFA certificate 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 setting32. Providers should display (or make available to parents) staff PFA certificates or a list of staff who have a current PFA certificate. 
30. Providers are responsible for identifying and selecting a competent training provider to deliver their PFA training. Training is available from a wide range of providers including: those who offer regulated qualifications; or the Voluntary Aid Societies (St John Ambulance, the British Red Cross and St Andrew’s First Aid who together are acknowledged by the Health and Safety Executive (HSE) as one of the standard-setters for currently accepted first aid practice for first aid at work training courses); or those who operate under voluntary accreditation schemes; or one that is a member of a trade body with an approval and monitoring scheme; or those who operate independently of any such accreditation scheme. The Register of Regulated Qualifications may help providers identify PFA providers, which can be found at: http://register.ofqual.gov.uk/qualification . It may also be helpful to refer to HSE’s guidance about choosing a first aid training provider, which can be found at: www.hse.gov.uk/pubns/geis3.htm

31. In this context, “newly qualified entrants” includes staff who have been apprentices or long term students who have gained a level 2 or level 3 early years qualification.

32. Providers can make an exception to this requirement where a newly qualified entrant to the workforce is unable to gain a PFA certificate if a disability would prevent them from doing so. Such a newly qualified entrant can still be included in the staff:child ratios if otherwise competent to carry out their childcare duties. Where possible, such staff should attend a relevant PFA training course and obtain written evidence of attendance.

Paediatric First Aid Training Providers
No. Millie's Mark does not have preferred suppliers for Paediatric First Aid training. To be eligible you must have up-to-date first aid certificates with training by a registered provider. Nurseries can choose their own training provider. Preferably, it should be one with a nationally-approved and accredited first aid qualification or one that is a member of a trade body with an approval and monitoring scheme. The audit will ask about how a training provider was chosen and the quality checks carried out on staff competencies following the training.
Every three years.
A comprehensive check of the paediatric first aid training provider undertaken by the nursery provider to check its course content and evaluate its quality. A factsheet to support you in carrying out due-diligence will be available to download when you sign-up.
The criteria states that 100% of staff working directly with children are required to have paediatric first aid. Please be aware that this does not include:
  • First aid at work
  • Emergency first aid at work
  • Outdoors first aid
  • Forest School first aid
These courses are not accepted as part of the Millie's Mark criteria.
Millie’s Mark can only award settings when it has seen all staff members paediatric first aid certificates therefore we would recommend trying to request a duplicate certificate from the training provider. Where this is not possible the member of staff would need to attend another course and the certificate would need to be uploaded.
No, we will need to see a copy of the PFA certificate; additional copies can be requested from your trainer.
For best practice Millie's Mark recommends that all staff complete the full 12 hour paediatric first aid training course. We understand this is not always feasible and do allow for a mix of 6 and 12 hour certificates. To meet the criteria there would need to be a minimum of one member of staff with 12 hour PFA onsite at all times. We would always recommend that you exceed this and each setting should perform due diligence to look at the size of the setting and number of staff to decide which training should be completed. This should also be risk assessed to make sure the requirements are always met and there are procedures in place to cover any staff absences from the setting. This is a requirement for all nations regardless of whether or not they follow the EYFS.

Process and costs

While it's a fantastic achievement to already train 100% of staff in paediatric first aid, Millie's Mark is about much more than this. Millie's Mark requires that the first aid learning is kept alive and in the forefront of practitioners’ minds, so they are confident, ready and capable should an emergency occur. The comprehensive process helps you to identify staff strengths as well as fears and enables you to strategically deploy the most confident staff across the setting. Read more about the process.
Millie's Mark costs from £230 to £330 (+VAT) depending on the number of staff at a setting. The cost of Millie's Mark includes access to a mentor and their support throughout the process, from answering your questions to developing an action plan for areas for improvement. Costs also cover a full online assessment of documentation uploaded, spot check assessments (where applicable) and IT support. Settings that sign up also gain access to a number of different templates and resources including a due-diligence factsheet, staff confidence audit and staff training matrix.
Nurseries have a minimum of three months and maximum of six months to complete Millie's Mark. The three months minimum time is in place to allow time for settings to carry out a full audit with all staff and ensure all staff are confident and competent in applying paediatric first aid. It also allows any identified changes in practice to be made and embedded.
No. Settings have up to 6 months to submit for assessment and then additional time for the assessment process.
Each setting is assigned a mentor at the start of the process. They are then available via phone and email to provide any answers to queries around the documentation or to check through any completed forms. Common queries include questions about the audit and how to carry out due-diligence. The mentor is there for support and guidance and to give you confidence that everything is covered prior to submitting for assessment.
Yes, as per the Terms and Conditions of Millie’s Mark each nursery needs to register individually. This is because each setting is assessed on the staff's confidence and competencies which will differ across the settings. There is also a requirement to submit a floor plan so that decisions regarding calling on people in an emergency can be assessed.

Millie's Mark Criteria

The criteria says: 'The nursery provider will be responsible for determining which staff have direct care of children and the type of PFA certificate they should hold: for example, this might also include other staff that come into regular close contact with children at key times (in addition to early years staff), like lunchtime supervisors, drivers, and escorts at SEN settings, etc.'
Settings will be required to include this information on a risk assessment (template provided).
If you have identified in your assessment that the support staff e.g. cooks, cleaners and office staff require a paediatric first aid certificate then they should be included in the total number of staff when purchasing.
There is a three month grace period to allow for these instances.
Yes. The Millie's Mark criteria gives a 3 months grace period so new staff will need to be trained within 3 months.
Although there is a 3 month grace period, all staff are expected to be trained and have a certificate at the time that the award is made. There may be occasions where new staff may start after you sign up and are waiting for a course following the panel date. In these cases a conditional award may be offered and the official award including announcement on the website will be made after sight of the certificates.
Millie's Mark looks only at paediatric first aid certificates. For further information regarding first aid at work please see Health & Safety Executive guidance www.hse.gov.uk/firstaid/
Yes. It is the responsibility of the nursery provider to ensure that 100% of staff who work directly with children are trained in paediatric first aid. This therefore includes any bank/supply staff they may have. Nursery providers are subject to a spot check at any time and if there are any members of staff including bank/supply staff at the premises with direct care of children without a full and valid paediatric first aid certificate then they will not pass Millie's Mark.
NDNA define bank staff as regular cover staff that may or may not be on the nursery providers books. These need to be included on the staff training matrix completed at the start of the process.
NDNA define supply staff as those emergency staff that you may seek in emergencies from a supply agency. These are still required to have a paediatric first aid certificate on site with them. However you would not be expected to put these on your training matrix. If you are spot checked and there is a supply member of staff working directly with children and they do not have a paediatric first aid certificate you will not pass Millie's Mark or you may have the mark withdrawn.
Yes. Students on longer term placements that are included in ratios are expected to have paediatric first aid certificates. Shorter term student placements and work experienced students are not required to have a paediatric first aid certificate but should not be left unsupervised with children at any time.
Yes. Volunteers are required to have a paediatric first aid certificate.
If a member of staffs paediatric first aid certificate expires whilst they are on maternity leave, it is not expected that they renew their certificate whilst on maternity leave. However managers should work with the member of staff to arrange the training in line with when they return e.g. maybe through a keep in touch day and at least within the three month grace period as from when they return to work. This should be evidenced in the Millie’s Mark audit/risk assessment. The same would apply for staff on long term sick leave.
It is advised that you check the website of the training provider to see the content of the course and ensure it covers the full or emergency content. If you cannot verify this they may need to complete another course.
Yes it is advised that you do have a lone worker policy for the cleaner and also consider if there are any other times of the day that staff may work alone (even if they are not in the building alone) e.g. during nappy changing, toileting etc.
Consider if you have any times during the day when staff are on their own, even for a few minutes e.g. taking a child to the toilet, cooking alone in the kitchen. If so then yes you need a lone worker policy and risk assessment for these occurrences.
Near misses are defined as an event not causing harm, but has the potential to cause injury or ill health e.g. slight trip over something where children have stopped themselves falling.
This was taken from the HSE website. If something was not done about these hazards, this could result in an accident in the future.
Millie's Mark does not state when and how this should be done. It is recommended as good practice and the assessor would expect to see how the setting has reviewed these to further support health and safety in the setting.
Yes you do. We have a section on the portfolio that supports reporting of accidents please refer to this for the documentation you need to complete. Any accident or incident that requires a child to receive emergency treatment needs to be reported to Millie's Mark within 5 working days. This will require you to fill out the forms on the system and send to Millie's Mark with your original accident or incident form attached.
Considerations for this question should include where your first aid boxes are kept, where you keep emergency medication such as epi-pens or inhalers. If there was an accident consider how you would keep children away from the accident/area so they are safe.
In these cases it is important to explain that you are open plan and what this means e.g. set the scene for an assessor that cannot see your setting visually. Include how the open plan environment enables you to call on others for assistance and redirect other children away. If you have 6 hour trained staff as well as 12 hour trained staff, please explain how you decide where staff are deployed so you have a good mix of 6 and 12 hour trained staff within each room and that there is staff cover in all areas including toileting, nappy changes and outdoor play etc.
There are no specific expectations of how the staff confidence tool is used. However, this is good practice and you can also use them in staff supervisions or to plan to support your less confident staff – perhaps buddy them up with more confident staff members.
This has to be decided on a case by case basis. We would need to see the full course content e.g. exactly what the training covered and how many hours the training was. The course would also need to not only have followed the current EYFS stated topics, but followed European RESUS Guidelines as this ensures all major topics are taught the same way. Please note some countries teach American guidelines, which cover different ways of treatment which European guidelines don't recognise. Please contact info@milliesmark.com for further information.
You do not need a copy of the trainer's qualifications. Just use the due diligence list to make your checks.
The three month grace period is activated once you have achieved Millie's Mark and applies to those who are new to your setting. You have three months from the date of employment to train this person in PFA.
The three month grace period does not apply to existing staff whose certificates are due to expire.
The three month grace period does not apply when you are applying for assessment. 100% of staff need to be trained at the point of award, this includes any new staff regardless of when they have started.
As apprentices have to complete PFA either as part of their training or within 3 months following their course completion we do not require them to be PFA trained for Millie's Mark. However, you must ensure they are never left alone with children and risk assess this to put safeguards in place to prevent this happening.
You are required to keep your online portfolio up to date, as you could be spot checked at any time when you hold the Millie's Mark Award.


This is laid out in the Terms and Conditions of Millie's Mark but generally it can be within a two month window to allow for assessment, verification, spot checks and final panel decisions to be carried out and completed.
A percentage of nurseries will receive an onsite visit. This could be after your application or any time in the next three years.
All online portfolios will be subject to an online assessment.
Due to the nature of Millie's Mark the spot check will still go ahead - an accident could happen when a manager is not there.
Yes, you are expected to maintain 100% of staff trained in paediatric first aid over the lifetime of the award. You are also required to submit annual declarations and inform NDNA of any changes, serious accidents, injuries or death within the nursery. This is in addition to your EYFS requirement to notify Ofsted (See EYFS 3.51, page 28).


The renewal cost will be the same as the initial accreditation fee (unless you now fall into a different bracket for staff numbers), as the same process is followed by NDNA and Millie's Trust. The process for renewals is identical to first accreditation meaning your portfolio will need to be reviewed by NDNA, go through the panel process and be subject to a potential spot check visit. You will once again have access to speak to a Mentor should you have any questions.
You are able to submit anywhere up to six month's after completing the renewal option. Your portfolio should already be up to date but you may want to have refresher sessions with staff or check through all your documentation before re-submission as a lot can change in three years. If your portfolio is not submitted and taken to panel before your current award expires there will be a gap in your award period.
Once awarded, we ask that you continue to maintain your portfolio and keep the matrix and certificates up to date. Six months before your current award expires you will be contacted to purchase the Millie's Mark renewal. You must complete the whole process again to show how you have continued to review practice and resubmit for assessment. You should submit your portfolio to attend a panel before your current award expires so there is no gap in your award period.