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The Oliver McGowan Mandatory Training on Learning Disability and Autism is now a legal requirement for all staff working in Care Quality Commission (CQC) registered health and social care settings. It is the government’s preferred and recommended training package for meeting the standards set out in the Health and Care Act 2022.
As this requirement becomes more widely implemented, many organisations and candidates are asking the same questions:
- What is the difference between Tier 1 and Tier 2
- How do you know which one you need?
The guidance below provides a clear and practical overview, using information from official NHS resources, to help employers and staff understand the correct training pathway.
1. All staff begin with Tier 1 Part 1, which is a free e-learning course.
2. Once completed, staff move on to either Tier 1 Part 2 or Tier 2, depending on their role, responsibilities and whether they provide direct care.
Employers are responsible for confirming which tier applies to each member of staff.
Official NHS guidance can be found here:
Tier 1 is designed for staff who need general awareness rather than hands-on clinical or care responsibilities.
This introductory course is required for all staff. It covers the key principles of learning disability and autism, including communication, sensory needs, reasonable adjustments, health inequalities, Ask Listen Do, and the purpose of health passports. It lays the foundation for safe, respectful and legally compliant practice.
After completing the e-learning, non-patient-facing staff typically proceed to Tier 1 Part 2. This includes administrative teams, reception staff, HR, facilities and other roles where general awareness is required but direct care is not part of the job.
Tier 2 is for staff who provide direct care or support to autistic people or people with a learning disability. Tier 1 Part 1 must be completed before attending the Tier 2 classroom course.
Delivered by experienced trainers, including trainers with lived experience, this session covers the essential knowledge and practical skills needed for safe and inclusive care. Content includes diagnostic overshadowing, common comorbidities, key legislation, hospital passports, reasonable adjustments, communication, working with families, STOMP and STAMP, and learning from LeDeR reviews.
Typical roles requiring Tier 2 include nurses, healthcare assistants, support workers, allied health professionals and mental health staff.
A simple guide is:
The employer makes the final decision in line with national guidance and the Oliver McGowan Code of Practice.
HSG provides the full training pathway:
• Tier 1 Part 1 – free e-learning
The Healthcare Certificate Register is a FREE certificate validation service designed for INDEPENDENT delegates who have completed training with The Health and Safety Group.
Click here to Log-in
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