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HPAC Grades Framework

Statutory & Mandatory Training

Pre-hospital care personnel working for CQC-registered employers are required to complete staff induction training covering statutory and mandatory subjects, such as safeguarding, moving and handling, and health and safety in the workplace. This is a fundamental requirement for personnel in the pre-hospital sector and aligns with Health and Safety Executive (HSE) obligations. Clinicians who do not work for a CQC-registered employer are encouraged to complete these sections voluntarily.

Under Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, CQC-registered organisations must ensure that their staff are suitably qualified, competent, and experienced to meet all other regulatory requirements outlined in the Act. This includes ensuring staff are adequately trained in statutory and mandatory subjects to fulfil their roles safely and effectively.

We provide a Statutory and Mandatory evidence section, which will allow you to add these qualifications as you acquire and accumulate them. It will help registrants and employers monitor their compliance in this area. 

Helpful sites to visit are: elfh and Skills for Health


Certificate Validity

We accept only certificates fully accredited by the awarding body. These certificates must have no outstanding modules, preceptorship hours, or additional elements and must remain valid for at least six months from the date of submission. All required refresher courses must also be completed.

*While most awarding bodies recognise the integrity of their own qualifications without imposing additional charges, any fees some bodies may require to validate a certificate will be the applicant's responsibility. The applicant will be notified of any such fee and asked to authorise the charge against their registered payment method. HPAC will not add any extra fees to this process.


Continuous Professional Development and Key Skills Refreshers

We expect all registrants across every grade to actively engage in continuous professional development (CPD) and related key skills refreshers. This commitment helps ensure you possess the most current knowledge, understanding, and competencies needed to safely meet your registered grade's scope of practice. Engaging in these activities not only enhances your professional growth but also helps ensure the highest standards of care and service are met.


Scope of Practice

HPAC is a regulator, not an authoriser of practice. Actual scope of practice is the responsibility of the individual and/or their employer with reference to the relevant law/guidelines/training/competencies in accordance with practice jurisdiction.


FPHC PHEM Skills Framework

The Faculty of Pre-Hospital Care of the Royal College of Surgeons of Edinburgh created the *PHEM Skills Framework to encompass personnel of varying levels, ranging from First Aiders to Advanced Pre-Hospital Medical Practitioners, and to span multiple organisations within UK prehospital care. Find out more here

*Please note that HPAC does not base its registrant grading on the FPHC PHEM Skills Framework but references it as a general guide only. Some qualifications accepted for a particular grade may not align with the FPHC PHEM Skills Framework level indicated for that section (e.g., they may map to a higher level on the FPHC PHEM Skills Framework). However, qualifications referenced in each section have been carefully assessed by HPAC as appropriate for the corresponding grade on our register.


Blue light drivers: View requirements


Applicants who have been struck off, suspended, or placed under a restricted practice order by HCPC, NMC, or GMC are not be eligible to apply.


HPAC Regulated Grades


First Aider (FA)
Category A or B on the FPHC PHEM Skills Framework

First Aid certificates MUST be nationally recognised certificates part of the Regulated Qualifications Framework (RQF), regulated by a national qualification regulator (Ofqual, Scottish Qualifications Authority (SQA) or Qualification Wales) OR certificates must issued by a Voluntary Aid Society named on our First Aid requirements page. The minimum training time for an HPAC registered First Aider is a one-day course.

Find out more here


Ambulance Care Assistant (ACA)

Requires one of the following:

NHS Ambulance Trust Patient Transport Service (PTS) qualification
Qualsafe Level 3 certificate in Ambulance Patient Care: Non-Urgent Care Services (RQF) (more information)
Qualsafe Level 3 certificate in Ambulance Patient Care: Urgent Care Services (RQF) (more information)
Qualsafe Level 3 certificate in First Response Emergency Care (FREC 3) (more information)FutureQuals Level 3 certificate in Ambulance Patient Care (more information)
FutureQuals Level 3 certificate for Ambulance Service First Responders (more information)
First Person on Scene (intermediate/Enhanced) (FPOS-I/E) (RQF)
Pearson's Level 3/4 Certificate for First Person on Scene (RQF) (more information)
QNUK Level 3 Award for the First Person on Scene (International) (RQF) (more information)
QNUK Level 3 Award for First Responders (RQF) (more information)
QNUK Level 3 Award in Rescue Trauma and Casualty Care (RTACC) (RQF) (more information)
First Person on Scene (intermediate/Enhanced) (FPOS-I/E) (RQF)

In order to meet the ACA standard, registrants are required to have all the elements of Core Skills Training Framework (CSTF) NHS / Skills for Health. Read more here. If you are seeking recognition of prior learning, evidence will be mapped against current level 3 Ambulance Support Worker Non-urgent standards (enhanced evidence scrutiny fees may apply for the cross-mapping exercise).



Emergency First Responder (EFR)

Category C or D on the FPHC PHEM Skills Framework

Requires one of the following:

NHS Ambulance Trust Community First Responder Certificate or proof of appointment to this role by an NHS Ambulance Trust
FutureQuals Level 3 certificate for Ambulance Service First Responders (more information)
Qualsafe Level 3 certificate in First Response Emergency Care (FREC 3) (more information)
First Person on Scene (intermediate/Enhanced) (FPOS-I/E) (RQF)
Pearson's Level 3/4 Certificate for First Person on Scene (RQF) (more information)
QNUK Level 3 Award for the First Person on Scene (International) (RQF) (more information)
QNUK Level 3 Award for First Responders (RQF) (more information)
QNUK Level 3 Award in Rescue Trauma and Casualty Care (RTACC) (RQF) (more information)
PHECC Emergency First Response Certificate (more information)

If you are seeking recognition of prior learning using a certificate not listed above, enhanced evidence scrutiny fees may apply for the cross-mapping exercise.



Emergency Care Assistant (ECA)

Category E on the FPHC PHEM Skills Framework

Requires one of the following:

Accredited NHS Ambulance Trust Emergency Care Assistant / Emergency Care Support Worker certificate (mapped against current level 3 Ambulance Support Worker Emergency, Urgent and Non-urgent standards)
Accredited St John Emergency Ambulance Crew qualification
FutureQuals Level 3 Diploma in Ambulance Emergency and Urgent Care Support (FAQ Level 3) certificate (more information)
Qualsafe Level 4 Certificate in First Response Emergency Care (FREC 4) certificate (more information)
PHECC Emergency Medical Technician certificate (Active on PHECC Register) (more information)

If you are seeking recognition of prior learning, evidence will be mapped against current level 3 Ambulance Support Worker Emergency, Urgent and Non-urgent standards (enhanced evidence scrutiny fees may apply for the cross-mapping exercise).



Ambulance Technician (EMT)

Category F on the FPHC PHEM Skills Framework

Requires one of the following:

BTEC Level 3 in Ambulance Aid / IHCD Ambulance Technician certificate (view training & common core syllabus)
NHS Ambulance Trust EMT certificate (mapped against current Level 4 Associate Ambulance Practitioner standards - more information)
Qualsafe Level 5 Diploma in First Response Emergency and Urgent Care (RQF) (FREUC) certificate (more information)
Diploma for Ambulance Technicians (SCQF) Level 7 (more information)
PHECC Paramedic certificate (Active on PHECC Register) (more information)

If you are seeking recognition of prior learning, evidence will be mapped against current Level 4 Associate Ambulance Practitioner standards (enhanced evidence scrutiny fees may apply for the cross-mapping exercise).



Associate Ambulance Practitioner (AAP)

Category F on the FPHC PHEM Skills Framework

Requires one of the following:

FutureQuals Level 4 Diploma for Associate Ambulance Practitioners certificate (more information)
Qualsafe Level 4 Diploma for Associate Ambulance Practitioners certificate (more information)
NHS Ambulance Service Accredited / Recognised Level 4 Associate Ambulance Practitioner


Updated 16.01.2025

Offshore Medic: Following feedback, it is with regret that we have withdrawn the Offshore Medic pilot. We will revisit this position in the future should circumstances change.

We thank everyone who participated in the pilot and provided invaluable input regarding this vital role. As HPAC is a non-profit voluntary register, we believe it is important to listen to feedback and direct our resources where they will be most beneficial to the public, registrants, and employers. If you applied to register as an Offshore Medic, a full refund will be processed to your account. 


HCPC Registered Paramedic (PA)

Paramedics must be registered with the HCPC in order to apply to the HPAC (more information).

Paramedics who register with the HPAC do so on a voluntary basis as an additional registration, provided that their HCPC registration has no current practice restrictions. Registering with the HPAC does not replace the requirement to maintain active HCPC registration, and a valid HCPC PA number is required in order to be registered with the HPAC. Paramedics must ensure that their HCPC registration remains active at all times in order to remain on the HPAC register. If a Paramedic's HCPC registration is revoked, suspended, or subject to a restricted practice order, they will be immediately removed from the HPAC register as the HCPC holds primary jurisdiction in these matters.

Awarding bodies who wish to have their qualification/s included on this page, provided the award is registered on the regulations Qualifications Framework, may email [email protected]. Please indicate which HPAC grade/s your qualification/s map to and include a specification document for assessment by our qualification compliance team.