When you’re looking at pre-hospital care training in the UK, two qualifications you’ll come across are Immediate Response Emergency Care (IREC) and First Response Emergency Care (FREC). Both have played important roles in training responders beyond basic first aid, but the landscape has changed significantly over recent years.
You will see several Pre-Hospital Care Qualifications beyond first aid such as:
- Pearson's First Person on Scene (FPOS),
- QNUK's First Person on Scene International (often shortened to FPOSi hanging off the original copyrighted FPOS by Pearson)
- Qualsafe's First Response Emergency Care (FREC)
- FutureQuals First Responder on Scene (FROS)
- FutureQuals Immediate Responder Emergency Care (IREC)
- Skills for Justice First Person on Scene Support (FPOSS)
- Highfields First Aid Response
There are any amount of Pre-Hospital Care qualifications but you need to ask yourself, what do you want to do, where do you eventually want to go with them?
It is clear the two big players in Pre-Hospital care are Qualsafe Awards and FutureQuals
Who Are Qualsafe?
Qualsafe Awards has been a major part of the UK training landscape for over a decade and is now one of the largest awarding organisations for first aid and pre-hospital care qualifications; working mainly with the private sector including private training providers, private ambulance services, and starting to appear in some NHS Ambulance Service Organisations.
They were established with a clear aim: to raise standards in safety-critical training and give employers confidence that a certificate represents real competence, not just attendance.
Over the years, Qualsafe has become especially well known for its pre-hospital care suite, including the widely recognised FREC pathway. Their qualifications are developed and regularly reviewed with input from clinical subject-matter experts such as doctors, paramedics, nurses and emergency care specialists.
Qualsafe works closely with nationally recognised bodies and guidance, including:
Resuscitation Council (UK)
The Faculty of Pre-Hospital Care (Royal College of Surgeons of Edinburgh)
UK health, safety and regulatory frameworks
This means their qualifications are designed to reflect how emergency care is actually delivered in the real world, whether that’s in event medicine, ambulance support, security, or high-risk workplaces.
At its core, Qualsafe focuses on:
Strong clinical foundations
Clear progression routes (particularly through FREC 3 to FREC 4 and beyond)
Consistent assessment standards that employers understand and trust
Who Are FutureQuals?
FutureQuals is a more recent but fast-growing awarding organisation, known for being learner-centred, modern, and responsive to sector needs. This awarding organisation supply qualifications to basically every NHS ambulance service in the UK; so if you are looking at a career in the NHS ambulance Service, you should not discount their Pre-Hospital Care Qualifications.
FutureQuals was set up with a strong emphasis on listening to employers and industries and then designing qualifications that meet specific operational requirements, rather than taking a one-size-fits-all approach. You should be aware of their Qualifications used by Ambulance Services including the FutureQuals Certificate in Emergency Response Ambulance Driving (CERAD) and the FutureQuals Diploma for Associate Ambulance Practitioners (AAP)
In pre-hospital care, they are best known for developing the CERAD and AAP, as well as the IREC suite, which was created in response to lessons learned from major incidents and the evolving needs of event, crowd safety and security environments. Their qualifications are closely aligned with guidance such as the Purple Guide and focus heavily on immediate, life-preserving actions.
FutureQuals works with:
Employers and service providers in events and security
Sector experts involved in emergency response planning
UK regulators across England, Wales and Northern Ireland
Their style is often described as:
Practical and role-specific
Clear about scope of practice
Designed around defined job functions rather than broad clinical progression
In Simple Terms
Both Organisations offer the wide range of first aid (First aid at Work - FAW etc) and other qualifications we see available from nearly every Awarding Organisation
Qualsafe Awards tends to be associated more with private sector, with broader pre-hospital care pathways and longer-term progression in emergency care roles in this sector; if you have aspirations to remain in the private sector, you certainly can use their FREC pathway, FREC 3 > FREC4 > FREuC 5
FutureQuals focuses more on targeted response roles, and those qualifications used (amongst others) within NHS Ambulance Services and other agencies; and you would have an easier time using FutureQuals Qualifications to RPL into FutureQuals Qualifications like, IREC 3 into IREC 4 into AAP (the EMT Qualification)
Whilst they offer both regulated qualifications, plan your route - you will find it easier accepted to claim recognition of prior learning (RPL) for a Qualification from one organisation into the same organisation, as they know their own products inside out. It is historically difficult to get agreement on RPL from any organisation, therefore trying to get RPL from one organisation's qualification to another can be significantly more work - just a thought if you're ultimate goal is to work as an EMT on an NHS ambulance Service who deliver FutureQuals CERAD and FutureQuals AAP to their Emergency Medical Technicans (EMT's)
Both are regulated awarding organisations, both work with industry experts, and both play an important role in raising standards — they just do it in slightly different ways, for different audiences; however both cover broaly the same topics, and can be used for similar roles like Ambulance Care Assistant - although there are specific qualifications for that role for example; however many private ambulance services, and those working on NHS contracts look for a basic regulated pre-hospital care qualification - which includes both FREC 3 and IREC 3 (or higher)
At SCTNI, we work with both FutureQuals and Qualsafe Awards because different learners, employers and environments need different but equally robust solutions. Both awarding bodies are regulated, quality-assured and respected — but each brings a slightly different focus. By offering qualifications from both, we can match learners to the most appropriate pathway for their role, whether that’s broader pre-hospital care progression or a more focused immediate-response requirement. Our priority is always the same: the right qualification, delivered properly, for the right purpose