HPAC Grades Framework

An overview of regulated grades, qualification standards, professional development expectations, scope of practice and eligibility for registration with HPAC.

Statutory and Mandatory Training

Pre-hospital care personnel working for CQC-registered employers are required to complete induction training that covers safeguarding, moving and handling, and health and safety in the workplace. Clinicians who do not work for a CQC-registered employer are encouraged to complete these sections voluntarily.

HPAC provides a Statutory and Mandatory evidence section for registrants to record qualifications and support compliance monitoring.

Helpful sites: e-LfH and Skills for Health

Continuous Professional Development

All registrants are expected to engage in CPD and key skills refreshers to maintain current knowledge and competence within their registered grade. This supports safe practice and high standards of care.

Certificate Validity

HPAC accepts only certificates that are fully accredited by the awarding body. Certificates must have no outstanding modules or preceptorship requirements and must remain valid for at least six months from the date of submission. All required refresher courses must be completed.

*Where an awarding body charges a fee to validate a certificate, the applicant is responsible for that fee. HPAC will not add any extra charge.

Scope of Practice

HPAC is a regulator, not an authoriser of practice. Actual scope of practice is the responsibility of the individual and their employer with reference to applicable law, guidelines, training and competencies.

FPHC PHEM Skills Framework

The Faculty of Pre-Hospital Care of the Royal College of Surgeons of Edinburgh created the PHEM Skills Framework to describe competencies across levels of pre-hospital care. View the framework.

*HPAC does not base its grades on the PHEM Skills Framework. It is shown as a general reference only. HPAC assesses each qualification independently for suitability within our grading structure.

Blue light drivers: View requirements

First Aider (FA)

Category A or B on the FPHC PHEM Skills Framework

First Aid certificates MUST be nationally recognised within the RQF and regulated by Ofqual, SQA or Qualification Wales, or issued by a recognised Voluntary Aid Society.

The minimum course length for application to register as First Aider is one day (8 hours).

Find out more

Ambulance Care Assistant (ACA)

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) (RQF) (more information)

FutureQuals Level 3 Certificate in Ambulance Patient Care: Urgent Care Services (more information)

FutureQuals Level 3 Certificate for Ambulance Service First Responders (RQF) (more information)

Pearson 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)

For CQC registered employers, completion of Core Skills Training Framework (CSTF) modules is required. Recognition of prior learning will be mapped against current Level 3 Ambulance Support Worker non-urgent standards. Enhanced evidence scrutiny fees may apply for cross-mapping.

Emergency First Responder (EFR)

Category C or D on the FPHC PHEM Skills Framework

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 (RQF) (more information)

Qualsafe Level 3 Award in First Response Emergency Care (FREC 3) (RQF) (more information)

First Person on Scene (Intermediate or Enhanced) (FPOS-I/E) (RQF)

Pearson 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)

Highfield Level 3 Award in Emergency Care for First Responders (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

Accredited NHS Ambulance Trust ECA or Emergency Care Support Worker certificate (mapped against current Level 3 Ambulance Support Worker Emergency, Urgent and Non-urgent standards)

FutureQuals Level 3 Diploma in Ambulance Emergency and Urgent Care Support (FAQ Level 3) (RQF) (more information)

Qualsafe Level 4 Certificate in First Response Emergency Care (FREC 4) (RQF) (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.

Emergency Medical Technician (EMT)

Category F on the FPHC PHEM Skills Framework

BTEC Level 3 in Ambulance Aid / IHCD Ambulance Technician certificate Download

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 (FREUC 5) (RQF) (more information)

Diploma for Ambulance Technicians (SCQF) Level 7 (more information)

PHECC Paramedic certificate (Active on PHECC Register) (more information)

Recognition of prior learning is mapped against Level 4 Associate Ambulance Practitioner standards. Enhanced scrutiny fees may apply.

Associate Ambulance Practitioner (AAP)

Category F on the FPHC PHEM Skills Framework

FutureQuals Level 4 Diploma for Associate Ambulance Practitioners (RQF) (more information)

Qualsafe Level 4 Diploma for Associate Ambulance Practitioners (RQF) (more information)

NHS Ambulance Service Accredited or Recognised Level 4 AAP

HCPC Registered Paramedic (PA)

An accredited certificate in Paramedic Science, issued by a recognised awarding organisation or university at the time of completion, must be provided.

Paramedics register with HPAC on a voluntary basis as an additional registration and must maintain active HCPC registration without restrictions. If HCPC registration is revoked, suspended, or restricted, HPAC registration will be removed.

Recognition of Student Paramedic Training

HPAC is not able to accept student paramedic training or partial completion of a paramedic degree as evidence of an accredited qualification for registration. Transcripts, module sign-offs, or placement records alone are not sufficient.

To register at a specific grade other than First Aider based on paramedic training, provide either:

A university step-off award that corresponds to a nationally recognised and regulated RQF qualification as referenced in the HPAC Grades Framework
An accredited Ofqual-regulated award confirming recognition of prior learning and competence at the required level (e.g. FutureQuals, Qualsafe Awards). The certificate itself must be Ofqual-regulated.
Evidence that an NHS Ambulance Trust has formally assessed and recognised you at a specific clinical grade (e.g. ECA, AAP)

Where year one of a paramedic degree has been completed, HPAC may recognise the registrant as a First Aider. First aid certification must be renewed at least every three years.

Recognition of Nursing Qualifications

HPAC cannot accept a nursing degree, diploma, or NMC registration alone as evidence of an accredited qualification for EFR, ECA, or any grade above First Aider. Nursing education does not include all competencies required for HPAC emergency care grades.

To register at a grade other than First Aider based on nursing qualifications, provide either:

A university-issued qualification that corresponds to a nationally recognised and regulated award listed on the RQF
An accredited Ofqual-regulated award confirming recognition of prior learning and competence at the required level. The certificate itself must be Ofqual-regulated.
Evidence that an NHS Ambulance Trust has formally assessed your competence and recognised you at a specific clinical grade

This aligns registration with national qualifications frameworks and protects the public and the registrant by ensuring scope of practice is supported by a formally recognised qualification.

HPAC may recognise the nurse as a First Aider. First aid certification must be renewed at least every three years to remain valid for registration

Eligibility and Restrictions

Not eligible: individuals who have been struck off, suspended, or placed under a restricted practice order by the HCPC, NMC, GMC, or other statutory regulator, or who appear on barred or sex offenders registers. Removal from non-statutory registers or barred lists may also be grounds for ineligibility. See terms and conditions clause 2.2.

Awarding Bodies

Awarding bodies that wish to have qualifications assessed for inclusion should email [email protected]. Please indicate which HPAC grade your qualification maps to and include a specification document for assessment.

Ready to Register?

Start your HPAC registration with confidence. All documents are handled securely and in compliance with GDPR.

Begin Application

Regulating pre-hospital urgent and emergency clinical responders in non-statutory roles

Check the Register