Level 4 Certificate in First Response Emergency Care –




What is FREC Level 4?


It is going to add more practical skills and underpinning knowledge to your level 3 and will be neccessary if you want to work within the NHS as a frontline ambulance Emergency Care Assistant (ECA). It is ideal where security personnel and others with a medical interest or specific responsibility can better prepare themselves for more high risk/remote environments.

 The course is made up of:

  • Pre-course reading (10 hours)
  • 5-day (43 hour) course 
  • Completion of 3 assessed workbooks (done after successfully finishing the course at our centre)


Pre-course reading should be from the recommended texts, with focus on the following areas:


  • Patient assessment strategy
  • ‘Normal’ physiological parameters for children and adults
  • Patient assessment strategy
  • Oxygen/entonox administration guidelines
  • Anatomy physiology (respiratory, cardiovascular, nervous and digestive systems)
  • Spotting the sick child
  • Sepsis

For the mandatory pre-course reading (found at the bottom of our FREC courses page), there is a choice between two textbooks Generic Core Material and Ambulance Care Essentials, both available from our awarding body Qualsafe. (or from Amazon etc). There are e-book versions available too!


Course prerequisites: Most candidates will have to successfully complete FREC Level 3 before being allowed onto the FREC Level 4 course. However if you have NHS training at ECA level or above, you can go straight onto FREC 4. We sometimes offer a shortened (3-day) FREC 3 conversion from FPOS-I or other APL on selected dates. For those with no previous medical experience, you will have to do the full 5-day Level 3 before attempting FREC 4. If you are unsure, please contact us before booking to confirm that your prior qualifications are sufficient. Learners must be at least 18 years old on the first day of the course.


Learners have a maximum of 12 months to complete the qualification, including any referrals.

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