NHS Greater Manchester Stockport Locality – General Practice Mandatory Training Guide
Training is required to enable the workforce to demonstrate the competence and expertise to undertake the care and treatment activities each individual is responsible for. This may be to comply with your GMS / PMS contract, LCS / DES requirements, or standards promoted by bodies such as the CQC. There is also the optional participation in the training requirements of guidance such as QOF.
The UK Core Skills Training Framework (CSTF)
The UK Core Skills Training Framework (CSTF) sets out 11 statutory and mandatory training topics for all staff working in health and social care settings. The CSTF includes nationally agreed learning outcomes and training delivery standards.
NHSE and E-learning for Healthcare (elfh) have worked with a range of subject matter experts to develop high quality, national elearning training sessions, which address all the knowledge outcomes at level 1 and at level 2, where appropriate for elearning. The sessions are freely available to all health and social care staff.
It is the responsibility of individual health and social care employer organisations to ensure that their workforce complete the appropriate training to comply with their statutory and mandatory requirements. It is also an employer’s responsibility to determine the best mode of delivering the training, whether that is face-to-face, elearning or a blended approach. The CSTF provides further guidance on this – https://www.skillsforhealth.org.uk/wp-content/uploads/2021/07/CSTF-Eng-Subject-Guide-v1.1.pdf and the relevant information from this is summarised below.
The eAssessments within the elfh sessions consist of 2, randomly selected, multiple choice questions per learning outcome. The eAssessments have an 80% pass rate and allow learners 3 attempts. If they fail, they are encouraged to review the knowledge chapters. As learners work through the eAssessments, they get feedback on both correct and incorrect answers.
For each session, it takes approximately 20 minutes to complete the knowledge chapters and approximately 10 minutes to complete the eAssessment.
All sessions can be accessed via mobiles and tablet devices.
The guidelines offered in the below table reflect the minimum standards expected and the ones relevant to general practices in Stockport are shown below. Many healthcare organisations will already meet and exceed these guidelines, and it is not the intention of this guidance to disturb this.
Please note the Safeguarding Adults and Children recommendations are based on the adult and children intercollegiate documents.
| Subject | Audience | Proposed Refresher Period | Comment |
| 1. Equality, Diversity and Human Rights | All staff, including unpaid and voluntary staff | 3 Years *.
More frequently if change of role to more HR or service delivery focus. |
This can be accessed via elfh – Equality, Diversity and Human Rights. The course name is ‘Equality and Diversity and Human Rights – Level 1’ |
| 2. Health, Safety and Welfare | All staff, including unpaid and voluntary staff | 3 Years* | This Health & Safety module can be accessed via elfh – Health Safety and Welfare. The course name is ‘Health Safety and Welfare – Level 1’
Further job specific training may be needed based upon local risk assessment. |
| 3. NHS Conflict Resolution (England) | All frontline NHS staff and professionals whose work brings them into direct contact with members of the public | 3 Years* | Part of this training can be accessed via elfh – Conflict Resolution . The course name is ‘Conflict Resolution – Level 1’
This elearning may be appropriate to support the delivery of knowledge aspects of CRT but should not be the sole means of training and is not a substitute for practical instruction. We are currently establishing if this can be provided on a face to face basis in Stockport |
| 4. Fire Safety | All staff, including unpaid and voluntary staff | Induction: Site specific training followed by regular updated fire safety training.
Staff who may need to help evacuate others, should receive training more frequently than those who may only be required to evacuate themselves. 2 years (organisations should risk assess to determine the appropriate frequency) |
E-learning cannot be used as the sole mode of training. Elearning can support delivery of knowledge aspects of learning outcomes. The elearning aspect can be accessed via elfh – Fire Safety. The course name is ‘Fire Safety – Level 1’
Practical instruction also required e.g. evacuation techniques and use of firefighting equipment. Supplemented by specific job/site training as necessary to ensure safe working practices. Training provider recommended (see Fire Safety page) but alternative providers are available. Practices required to fund this themselves. |
| 5. Infection Prevention and Control | Level 1: All staff including contractors, unpaid and voluntary staff
Level 2: All healthcare staff groups involved in direct patient care or services |
3 years*
1 year* |
This module can be accessed via elfh – Infection Prevention and Control Level 1. The course name is ‘Infection Prevention and Control – Level 1’.
This module can be accessed via elfh – Infection Prevention and Control Level 2 . The course name is ‘Infection Prevention and Control – Level 2’.
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| 6. Moving and Handling | Level 1: All staff, including unpaid and voluntary staff
Level 2: All staff, including unpaid and voluntary staff , whose role involves patient handling activities |
Refresher not required (unless load handling then 3 yearly) following induction unless context specific learning outcomes required/change of legislation etc. there is no need to repeat.
2 yearly |
This module can be accessed via elfh – Moving and Handling Level 1. The course name is ‘Moving and Handling – Level 1’. E-learning can support delivery of knowledge aspects of learning outcomes.
Additional, practical instruction is also required for staff involved in load handling and patient handling activities Level 2 practical training ideally should be face to face where reasonably practicable in either a classroom or the workplace setting. |
| 7. Safeguarding Adults | Level 1: All staff working in healthcare settings (inc. GP Admin) | Induction followed by every 3 years
Refresher training at 2 hours minimum every three years. The e-learning programme can also be accessed as part of refresher training |
This module can be accessed via elfh – Safeguarding Adults Level 1. The course name is ‘Safeguarding Adults – Level 1’ |
| Level 2: All non-clinical and clinical staff who have any contact with patients, their families or carers, or the public. (GP Practice managers, Health Care Assistants, APs, Pharmacists) | Over a 3 year period staff should receive refresher training equivalent to a minimum of 3-4 hours. | This module can be accessed via elfh – Safeguarding Adults Level 2 The course name is ‘Safeguarding Adults – Level 2’
The refresher requirement for L1&2 can be completed by undertaking the e-learning as a refresher plus by receiving training from the GP Safeguarding Lead, reading and reflecting on newsletters etc. |
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| Level 3: Registered health care staff who engage in assessing, planning, intervening and evaluating the needs of adults where there are safeguarding concerns (as appropriate to role inc. GPs/NPs/PNs) | Training at level 3 will include the training required at level 1 and 2 and will negate the need to undertake refresher training at levels 1 and 2 in addition to level 3.
Over a three-year period, professionals at level 3 should receive refresher training equivalent to a minimum of eight hours Required within six months of appointment require to have completed equivalent to a minimum of eight hours of education and learning at L3 |
Those requiring Level 3 compliance must complete training at Level 1 and 2 prior to completing level 3 in first instance. See separate page in the Portfolio for Safeguarding Adults Level 3 training. One key module that is recommended as part of your Safeguarding Adults Level 3 Training requirements is the Future Learn modules on elfh – https://www.futurelearn.com/courses/level-3-safeguarding-adults
Each Masterclass (x 4 per year) for GPs and their practice staff will have a dedicated session for safeguarding children/adults training which is mapped at the level 3 competency. Links sent out by the Safeguarding Team, local and national safeguarding conferences, multi-agency updates, on local and national safeguarding reviews including 7 minute briefings and new NHS GM guidance and can be discussed and reflected on with practitioners and their safeguarding lead as part of their level 3 training and put into their training passport. Safeguarding Level 3 Training Passport – Safeguarding Adults and Children This document can be used to document your safeguarding education hours. Please note it is essential that you keep all evidence of completion as this self-assessment will not be enough to demonstrate compliance. |
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| 8. Preventing Radicalisation | Level 1: All staff working in the healthcare settings, including non-clinical managers and staff
Level 2: All non-clinical and clinical staff who have regular contact with patients, their families or carers, or the public. In a GP Practice this may include: GP Practice managers Clinical Reception Managers and Receptionists
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3 years
3 years
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Basic Prevent awareness training should be included in all staff induction training.
Competency at level 1 and level 2 can be acquired by completing targeted Prevent training, including:
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| Level 3: All clinical staff working with adults, children, young people and/or their parents or carers, who could potentially contribute to assessing, planning, intervening and/or evaluating the health needs of a service user. In a GP Practice this may include:
All GP’s Advanced Practitioners Practice Nurses Any Counsellors employed by practice Pharmacists Paramedics, Physiotherapists and other AHPs Level 4: Named Professionals Level 5: Designated Professionals |
All staff should receive annual updates and a 3-yearly refresher. This refresher can be in the form of training or a blended learning approach, to be determined at a local level by individual providers and organisations.
Organisations should ensure that staff are provided with appropriate updating and/or briefing on Prevent at least yearly
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Please note if Level 3 is required, individuals do not need to complete Level 1 and 2 first. Training at level 3 can be delivered through a combination of face-to-face and e-learning, including:
Examples of completing the annual update could be receiving cascaded updates from the GP Safeguarding Leads and reading/actioning information shared from the NHS GM Stockport Locality Team in the GP Bulletin. Please see the competency framework for more details if required – NHS Prevent training and competencies framework – GOV.UK (www.gov.uk)(www.gov.uk)
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| 9. Safeguarding Children | Level 1: All staff including non-clinical managers and staff working in health care settings (GP secretaries/ administrators).
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Induction followed by every 3 years. Over a three-year period staff who require level 1 training should undertake refresher training equivalent to a minimum of 2 hours
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Available via elfh – Safeguarding Children Level 1
The refresher requirement can be completed by undertaking the e-learning as a refresher plus by receiving training from the GP Safeguarding Lead, reading and reflecting on newsletters etc.
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| Level 2: Non-clinical and clinical staff who have some degree of contact with children and young people and/or parents/carers. (This includes Practice Managers/Reception Managers/Safeguarding Administrators/HCAs/APs/ /Pharmacists (see L3 for pharmacists in General Practice). PNs and NPs should as a minimum attain level 2 and work towards level 3 safeguarding children) |
3 years. Over a 3 year period staff should receive refresher training equivalent to a minimum of 3-4 hours. Training should be undertaken within 6 months of coming into post.
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Available via elfh – Safeguarding Children Level 2 the course name is ‘Safeguarding Children – Level 2’.
See above for information about how to attain the minimum level of refresher training hours.
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| Level 3: Clinical staff working with children, young people and/or their parents/carers and who could potentially contribute to assessing, planning, intervening and evaluating the needs of a child or young person and parenting capacity where there are safeguarding/child protection concerns. (This includes GPs, Pharmacists working in general practice and some NPs. PNs and all NPs should work towards this)
GP’s, NPs and PNs should undertake a minimum of 12-16 hours level 3 training over 3 years. (Most staff will be required to complete 12 hours but there is a requirement for a Safeguarding Lead in each practice which would require 16 hours). Pharmacists working in General Practice should undertake a minimum of 8 hours level 3 training over 3 years. Min of 50% of this should be face to face training. |
3 years
Training should be undertaken within 6 months of coming into post |
There is no specific course to become level 3 competent. Practitioners should complete level 1 and 2 once then access training/development opportunities to gain the additional level 3 competencies and then refresh at Level 3 only.
There are a range of level 3 modules available on e-lfh. These modules can be accessed via e-learning for Healthcare: https://www.e-lfh.org.uk/programmes/safeguarding-children/ See the Safeguarding Level 3 page for more information regarding how to access Level 3 training. Safeguarding Level 3 Training Passport – Safeguarding Adults and Children This document can be used to document your safeguarding education hours. Please note it is essential that you keep all evidence of completion as this self-assessment will not be enough to demonstrate compliance. Each Masterclass (x 4 per year) for GPs and their practice staff will have a dedicated session for safeguarding children/adults training which is mapped at the level 3 competency. Links sent out by the Safeguarding Team about local and national safeguarding conferences, multi-agency updates on local and national safeguarding reviews including 7 minute briefings and new NHS GM guidance can be discussed and reflected on with practitioners and their safeguarding lead as part of their level 3 training and put into their training passport. |
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| 10. Resuscitation (including recognition and treatment of anaphylaxis) | Level 1: Non-clinical staff, dependent upon local risk assessment or work context
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1 year | The Resuscitation Council UK recommends – Non-clinical staff generally should have annual updates also. However, a local risk assessment may be undertaken to assess the likelihood of them encountering a patient requiring resuscitation (for example a driver for an out-of-hours doctor’s car may be required to assist at a cardiorespiratory arrest more frequently than a secretary in some daytime General Practices). NHS GM Stockport Locality recommends face to face training should be undertaken initially and then every 3 years. In between e-learning can be completed via elfh – Resuscitation – Level 1. The course name is ‘Resuscitation – Level 1.’ |
| Level 2: Staff with direct clinical care responsibilities including all qualified healthcare professionals
Level 3: Registered healthcare professionals with a responsibility to participate as part of the resuscitation team |
1 year
1 year
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General Practices in Stockport can access Basic Life Support – Adult & Paediatric training (details in the GP L&D Portfolio). This course meets the requirements specified for Level 2 training on the Core Skills Framework and is suitable for staff with direct clinical care responsibilities, including all qualified healthcare professionals. The course is 2 hours, those requiring L1 only can attend for the first hour only.
Anaphylaxis – Recognise and apply emergency treatment of anaphylactic reactions is included in the BLS training.
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| 11. Information Governance and Data Securtity | All staff | 1 year* | Available via elfh – Data Security Awareness – Level 1 the course name is ‘Data Security Awareness – Level 1’. |
*Users can choose to view the knowledge chapters and then will need to complete and pass the eAssessment to demonstrate the required knowledge and understanding and to complete the course. A user’s training record will be updated with their eAssessment score. If users feel that they have the necessary knowledge, they can skip straight to the eAssessment without completing the knowledge chapters first.
Additional Core/Mandatory Training
Dependent on role the following training/updates may also be required, please note this list is not exhaustive. Individuals should only undertake tasks that they suitably trained and are competent to undertake.
| Subject | Proposed Refresher Period | Comment |
| ANTT | 3 yearly | The initial individual trained in ANTT MUST be re-assessed by the Health Protection Nurse and a competency certificate re issued on a three yearly basis to ensure standards of competence are maintained. All individuals assessed in house must be assessed following the initial individuals re assessment on a three yearly basis. New certificates of competency to be re-issued. See the full details in the GP L&D Portfolio. |
| Learning Disability and Autism Training
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At tier 1, it is recommended that training for understanding autism is refreshed at least every 3 years. At tiers 2 and 3, each employer organisation will need to determine the required refresher education and training as part of the continuing professional development for staff groups providing care and support for autistic people. Local Authority, NHS bodies and NHS Foundation Trusts should ensure that both general awareness and specialist autism training is provided on an ongoing basis and that new staff or staff whose roles change are given the opportunity to update their autism training and knowledge. | From 1 July 2022, all health and social care providers registered with CQC must ensure that their staff receive training on learning disabilities and autism appropriate to their role. This can be completed by completing the Oliver McGowan LD & Autism Training:
Tier 1 – (GP Receptionists and Administrators etc). This is for people who require a general understanding of autism, and the support autistic people may need. This is relevant to those in working in any sector who may occasionally interact with autistic people, but who do not have responsibility for providing direct care or making decisions about autism-specific care or support. For example, this may include those working in public services, commercial or charitable organisations providing health, social care, education, policing, custodial care, housing, transport, careers, employment or benefit services. It would include front-of-house and reception staff. Complete the e-learning package, available now and link below AND a 1 hour online interactive session (the interactive session should be available from 2023). Tier 2 – (Clinical roles) For people with responsibility for providing care and support for an autistic person or people, but who could seek support from others for complex management or complex decision-making for example, Tier 2 will be relevant to health and social care workers, including frontline care staff who are not autism specialists and those in other roles such as education and housing services that are providing care and support for autistic people. Complete the e-learning package, available now and link below AND attend a 1-day face to face training session (the face to face session should be available from 2023). For those needing to do Tier 2 they do not need to first complete Tier 1. The e-learning is now live. The online interactive sessions and face to face training are planned to commence in 2023. Updates can be found on the HEE webpage – https://www.hee.nhs.uk/our-work/learning-disability/current-projects/oliver-mcgowan-mandatory-training-learning-disability-autism . Tier 3 – For Health, social care and other professionals with a high degree of autonomy, able to provide care and support in complex situations and/or may also lead services for autistic people. This is relevant to staff working intensively with autistic people, including those who take a lead in decision making, practice management, commissioning and developing or disseminating good practice. Some indicative roles may include specialist healthcare professionals such as psychologists, psychiatrists, GPs with special interest, learning disability nurses, counsellors, psychotherapists, allied health professionals, social workers, educators etc. This will include LD Care Co-ordinators and all clinicians who undertake the annual health check for people with learning disabilities. Tier 3 training is yet to be made available |
| Cervical Cytology | Minimum 3 yearly update and additional updates as required in the event of major programme changes. For all sample takers. | Information in the GP L&D Portfolio re face to face and e-learning sessions https://www.gov.uk/government/publications/cervical-screening-good-practice-in-cervical-sample-taking
Please ensure your updates are recorded on the CTSD – http://cstd.cmft.nhs.uk/ |
| Chaperoning | Once | A formal chaperone implies a clinical health professional, such as a nurse. In a GP practice it can also mean a specifically trained non-clinical staff member, such as a receptionist. |
| Health Checks for those with Learning Disabilities | Once | As outlined in the DES – for the lead GP, lead PN and either the PM or the Senior Receptionist.
Tutor Led Training available in Stockport – see details in this Portfolio. |
| Immunisation and Vaccination -Childhood/Adult/Flu
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Annual | Information in the GP L&D Portfolio re face to face and e-learning sessions. Those who are new to immunising MUST complete a 2 or 3|z day face to face fundamentals of immunisation course, as is set out in the ‘National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners’.
As a minimum, yearly updates should be attended by all immunisers who have completed a basic immunisation course It is recommended that travel health training is also refreshed as required if part of the HCPs role. |
| Mental Capacity Act and Deprivation of Liberty Standards | 3 yearly | All clinical staff including GPs, Nurses, Pharmacists, Pharmacy Technicians, Assistant Practitioners and HCAs.
Required as part of the Stockport Locality Safeguarding Assurance Toolkit. MCA training is available via e-lfh. There are 11 e-learning modules that can be accessed via the e-LfH Hub – https://portal.e-lfh.org.uk/ , selecting My Account > Enrolment and selecting the programme (search for MCA). You can then access the programme immediately in the My e-Learning section. Completion of these modules can contribute to your level 3 Safeguarding Children and Adults intercollegiate training requirements. |
| National Early
Warning Score (NEWS) 2 Standardising the assessment of acute-illness severity in the NHS |
Once | The Royal College of Physicians Report highlights that the NEWS provides the basis for standardising the training and credentialling of all staff engaged in the care of patients in hospitals and the prehospital assessment of patients. They recommend that this should
be extended to undergraduate education for all medical, nursing and allied healthcare professionals. The NEWS is supported by an online training module and certification of completion of training – https://news.ocbmedia.com/ . We also recommend that the NEWS becomes part of mandatory training for NHS clinical staff. |
| Spirometry | 3 yearly re-certification required | Relevant ARTP Certificate required (dependant on role) |
| The Care Certificate | Once | All Health Care Assistants/APs new to Health and employed after 1st April 2015 must complete The Care Certificate. It is recommended that all Support Workers undertake this. Please see further information under ‘Care Certificate’. |
| Venepuncture | 3 yearly | The National Patient Safety Agency advises that the update training should be undertaken a s a minimum 3 yearly. |
Recommended Training
This list outlines training that is not mandatory but is highly recommended.
| Subject | Audience | Proposed Refresher Period | Comment |
| Asthma for Children & Young People | All staff working with children and young people with asthma | 2 yearly | NHS England and partners have developed a competency framework for anybody working with children and young people with asthma. The framework divides different roles into 5 ‘tiers’. A tier describes the level of care a person may be expected to deliver to a child or young person with asthma. The more involved the care, the higher the level of tier. It is assumed that for healthcare professionals undertaking the training they will already have appropriate training and skills relevant in the care of children and young people. These courses are to provide additional training specifically relating to asthma and should sit alongside appropriate frameworks of training, supervision and mentoring as required. The tiers are not profession specific, but rather describe the minimum required knowledge and skills any individual must possess to safely carry out their role in caring for a child or young person with asthma. Individuals should look at their own role and choose the tier most appropriate to the care they deliver. Full details can be found in the National Capabilities framework and training to meet the first few tiers can be found here at e-lfh – Asthma (Children and young people) – elearning for healthcare (e-lfh.org.uk) |
| Reducing Antimicrobial Resistance | Whole general practice workforce | No recommendation – as required | This e-learning session provides key facts about antimicrobial resistance and describes the important role everyone working in a health and care environment, including non-clinical staff and the general public has in tackling it. As part of our NHS GM Stockport Locality commitment to increasing awareness of overuse of antibiotics we would like all staff to increase their knowledge on how we can all reduce the risk of antimicrobial resistance developing and spreading by completing this 30 minute on line course which can be accessed here: introductory e-learning session on antimicrobial resistance . You will need to use your E-Learning for Healthcare (e-lfh) login if you have previously undertaken any e-lfh training or alternatively you will need to register via the same link |
| Special Educational Needs and Disability (SEND)/ The Children and Families Act 2014 | All staff. Clinical staff have additional modules | TBC | All members of the General Practice Workforce should have an awareness of Special Educational Needs and Disability (SEND) and the Children and Families Act 2014 and how this impacts on their work role. There are 2 options for training available:
See the portfolio SEND pages for more information. |
| Sepsis | All staff. Clinical staff require more in-depth training | No recommendation – as required. | Recommended by the CQC in recent inspections as good practice for all staff.
For Clinical Staff – Modules are available for clinicians via e-lfh – In order to access any e-LfH programme, you will need an e-LfH account. To register use this link – Register > . If you already have an account with e-LfH, then you can enrol on to the Sepsis programme by logging in to the e-LfH Hub – https://portal.e-lfh.org.uk/ , selecting My Account > Enrolment and selecting the programme. You can then access the programme immediately in the My e-Learning section. For non clinical staff, CQC have advised that GP practices should take measures to help manage the risks associated with sepsis. Examples of good practice include:
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