Safeguarding Training Levels: UK Healthcare Sector

A. Safeguarding Children and Young People

Level 1 – Basic Awareness
Who it’s for: All healthcare staff, including administrative, reception, support, and non-clinical staff.
Focus: Recognising possible signs of abuse or neglect, understanding professional responsibility, and knowing how to report concerns.
Typical settings: Hospitals, general practice, community health services, mental health services, hospices, pharmacies, dental practices, opticians, ambulance services, and specialist clinics.
This matches the children’s intercollegiate framework, which applies Level 1 broadly across healthcare staff.

Level 2 – Staff with Regular Contact with Children, Young People, Parents, or Carers
Who it’s for: Staff who regularly interact with children, young people, and/or their parents or carers in the course of their role, including clinical and relevant non-clinical staff.
Focus: Recognising a wider range of safeguarding concerns, responding appropriately, recording concerns clearly, and understanding internal and external referral routes.
Typical settings: Hospitals, general practice, community services, mental health, hospices, pharmacies, dental practices, opticians, ambulance services, and specialist clinics.
The children’s framework uses increasing competencies across Levels 1–5 rather than purely site-based distinctions, so role/contact is more important than setting.

Level 3 – Clinical Staff Working with Children and Young People
Who it’s for: Registered healthcare professionals and others who assess, treat, or care for children and young people and who may need to act on safeguarding concerns.
Focus: Identifying complex safeguarding concerns, contributing to assessment and referral, information sharing, documentation, interagency working, and applying safeguarding law and guidance in practice.
Typical settings: Hospitals, GP practices, community paediatrics, school-linked services, mental health services, sexual health, ambulance services, and other child-facing services.
In the children’s framework, Level 3 is a substantial practice level for clinicians, not only for people in formally designated safeguarding posts.

Level 4 – Senior / Named Professionals
Who it’s for: Professionals in named or senior safeguarding roles, such as Named Doctors, Named Nurses, Named Midwives, and equivalent senior leads in provider organisations.
Focus: Professional leadership, supervision, safeguarding advice, policy implementation, quality improvement, training support, and oversight of complex cases.
Typical settings: Provider organisations and services with identified internal safeguarding leadership responsibilities.
The current children’s framework explicitly uses Level 4 senior/named professional language.

Level 5 – Senior Strategic Lead / Designated Professionals
Who it’s for: Senior strategic safeguarding professionals, such as Designated Doctors and Designated Nurses for safeguarding children.
Focus: Strategic leadership across systems, expert advice, interagency coordination, escalation support, assurance, policy development, and system-level safeguarding oversight.
Typical settings: Integrated care and larger system-level arrangements, including organisations with cross-system safeguarding responsibilities.
The current children’s framework explicitly distinguishes Level 5 senior strategic lead/designated roles from Level 4 named roles.

Senior Managers and Executives
Who it’s for: Executive and non-executive directors and senior managers with organisational responsibility for safeguarding governance and assurance.
Focus: Accountability, governance, organisational culture, compliance, resourcing, and strategic oversight of safeguarding arrangements.
For children’s safeguarding, the current framework describes this as an additional category for senior managers and executives, rather than a standard “Level 6.”

B. Safeguarding Adults at Risk

Level 1 – Basic Awareness
Who it’s for: All staff working in health or social care settings, including non-clinical staff.
Focus: Recognising indicators of abuse, harm, or neglect; understanding basic safeguarding responsibilities; and knowing how to raise concerns.
Typical settings: Hospitals, GP practices, community services, mental health services, hospices, pharmacies, dental practices, opticians, ambulance services, and specialist clinics.
The adult framework states Level 1 applies to all staff and includes core awareness of adult safeguarding.

Level 2 – Staff with Regular Adult Contact
Who it’s for: Staff with regular contact with adults who may be at risk, including clinical and relevant non-clinical staff.
Focus: Acting on immediate safety concerns, recognising patterns of abuse or neglect, documentation, and using local safeguarding procedures and referral pathways.
Typical settings: Hospitals, general practice, community health, mental health, hospices, pharmacies, dental practices, opticians, ambulance services, and specialist clinics.
The adult framework builds Level 2 on Level 1 and expects a more active safeguarding response.

Level 3 – Staff Assessing, Planning, Delivering, or Evaluating Care Where There Are Safeguarding Concerns
Who it’s for: Clinical and other specified staff who work directly with adults at risk and may need to assess needs, manage safeguarding issues, and support others.
Focus: Applying safeguarding knowledge in practice, documenting and reporting concerns, working with the person’s wishes and views, professional judgement, and interagency working.
Typical settings: Hospitals, general practice, community services, mental health, specialist services, and ambulance services.
This is broader than only staff in formal safeguarding posts; the adult framework places Level 3 with specified staff groups involved in care and safeguarding activity.

Level 4 – Professional / Organisational Safeguarding Leads
Who it’s for: Professionals with leadership responsibility for safeguarding adults within an organisation.
Focus: Expert advice, supervision, leading training and policy implementation, audit, service improvement, and managing complex organisational safeguarding issues.
Typical settings: Provider organisations with internal safeguarding leadership roles.
The adult framework continues through Levels 4 and 5 for more specialist and leadership responsibilities.

Level 5 – Senior Strategic Safeguarding Professionals
Who it’s for: Senior safeguarding professionals with strategic responsibilities across organisations or systems.
Focus: Strategic leadership, assurance, influencing policy, cross-agency work, oversight of quality and compliance, and supporting the wider safeguarding system.
Typical settings: Large providers, trusts, commissioning or system-level roles, and organisations with wider strategic safeguarding duties.

Board Level
Who it’s for: Executive directors, non-executive directors, and commissioning leads with governance responsibility for adult safeguarding.
Focus: Statutory and governance responsibilities, accountability, performance oversight, training assurance, legal duties, and safeguarding culture.
For adults, the current framework uses Board level, not “Level 6.” It also says board members should have Level 1 core competencies plus board-specific knowledge.

Knowledge and competencies

A. Safeguarding Children and Young People

Level 1 – Basic Awareness

Topics:
Safeguarding fundamentals; what safeguarding means in healthcare; signs and indicators of abuse and neglect; physical abuse, emotional abuse, sexual abuse, neglect; professional curiosity; listening to children and taking concerns seriously; how to respond to a disclosure; immediate safety and escalation; who to report to and how; basic record-keeping and factual documentation; information sharing basics; confidentiality and when it can be overridden for safety; children who may be especially vulnerable, including disabled children, children in care, care leavers, fostered/adopted children, children in residential care, children in youth justice settings, and children seeking asylum or refuge; awareness of online harm and grooming; domestic abuse and the impact on children; basic awareness of extra-familial harm; safer organisational culture and speaking up. The 2025 children’s framework expects all level 1 staff to understand safeguarding, children in care/care leavers, and how to report concerns; Working Together 2026 emphasises early help, harm inside and outside the home including online, anti-discriminatory practice, and effective information sharing.

Level 2 – Staff with Regular Contact with Children, Young People, Parents, or Carers

Topics:
Everything in Level 1, plus: wider indicators of vulnerability and cumulative harm; adverse childhood experiences; neglect in more depth; disguised compliance; parental factors such as domestic abuse, mental ill-health, substance misuse, and learning disability; child development and how abuse may present differently by age; responding to disclosures in more depth; escalation pathways and referral thresholds; internal and external referral routes; high-quality chronology, documentation, and body-map principles where relevant; information sharing in practice; consent, confidentiality, and lawful sharing; early help; missing children; online harm, cyber-enabled grooming, sextortion, and self-generated sexual imagery awareness; child sexual exploitation; child criminal exploitation and county lines; modern slavery and trafficking; radicalisation/PREVENT awareness; female genital mutilation; forced marriage; honour-based abuse; fabricated or induced illness awareness; non-accidental injury red flags; children in care and care leavers; voice of the child; equality, culture, and anti-racist practice. This fits the level 2 expectation to respond to concerns, while Working Together 2026 highlights online harm, grooming, sexual and criminal exploitation, radicalisation, and stronger information-sharing practice.

Level 3 – Clinical Staff Working with Children and Young People

Topics:
Everything in Levels 1–2, plus: recognising complex safeguarding presentations; thresholds for child in need, child protection, and escalation; risk assessment and formulation; undertaking and recording safeguarding histories; examination and forensic awareness within role boundaries; multi-agency working and strategy discussions; case conferences, core groups, reports, and chronologies; documentation for legal and safeguarding processes; information sharing for protection; professional challenge and escalation where responses are insufficient; looked after children and care leavers; transitional safeguarding; extra-familial harm and contextual safeguarding; child sexual abuse, CSE, CCE, county lines, trafficking, exploitation linked to gangs or peer groups; PREVENT/radicalisation; FGM, forced marriage, honour-based abuse; domestic abuse and teenage relationship abuse; harmful sexual behaviour and child-on-child abuse; perinatal and pre-birth safeguarding; parental capacity and concealed pregnancy awareness; fabricated or induced illness; mental health, self-harm, suicide risk, eating disorders, and neurodivergence in safeguarding contexts; trauma-informed practice; children with SEND and communication needs; court/report-writing basics; learning from child safeguarding practice reviews; supervision and reflective practice. The 2025 framework makes level 3 the expected standard for staff delivering clinical services to under-18s, and Working Together 2026 explicitly highlights harm outside the home, online harm, exploitation, radicalisation, and information-sharing duties.

Level 4 – Senior / Named Professionals

Topics:
Everything below, plus: named professional functions and accountability; supervision models and reflective practice leadership; giving specialist advice on complex cases; quality assurance; safeguarding audit; policy development and implementation; training needs analysis; curriculum design and quality control; escalation and dispute resolution; serious incident review processes and Child Safeguarding Practice Reviews; action planning from reviews; interagency leadership; assurance to provider boards; managing allegations against staff and position of trust processes; safer recruitment and organisational culture; legal updates; expert practice in information sharing and confidentiality; complex exploitation, organised abuse, online harm, FII, sudden unexpected child death processes, and contentious threshold decisions; equality, anti-racist and anti-discriminatory safeguarding leadership; data, themes, and assurance reporting. The children’s framework identifies level 4 as senior/named professional leadership, while NHS England requires providers to have named professionals, executive leads, policies, and effective training aligned to the intercollegiate competencies.

Level 5 – Senior Strategic Lead / Designated Professionals

Topics:
Everything below, plus: system leadership across the health economy; strategic advice to ICBs/health boards and commissioners; safeguarding partnership arrangements; system assurance and governance; commissioning levers and standards; strategic workforce planning; multi-agency training strategy; section 11 assurance; independent scrutiny and performance metrics; policy influence; expert legal interpretation; complex escalation across agencies; designated advice on serious reviews and thematic learning; professional leadership for level 4 staff; resolving system barriers to information sharing; service planning for children in care and care leavers; safeguarding data, inequality, and population risk; strategic response to exploitation, county lines, online harms, radicalisation, FGM, forced marriage, and domestic abuse; media/public interface and reputational management where relevant. The 2025 children’s framework distinguishes level 5 as a separate strategic designated function, and NHS England places executive accountability and strategic workforce planning with system leaders and boards.

Senior Managers and Executives

Topics:
Board/executive accountability; statutory duties; executive lead responsibilities; safeguarding governance structures; assurance frameworks; risk appetite and escalation; quality indicators and dashboards; safer culture and whistleblowing; safer recruitment; adequacy of named/designated provision; training compliance and impact; supervision assurance; policy approval and review; partnership obligations; review learning and organisational response; scrutiny of domestic abuse, exploitation, PREVENT, online harms, allegations against staff, and children in care as board-level risks; equality and health inequalities in safeguarding; commissioning and contracting assurance. NHS England says executive accountability for safeguarding cannot be delegated and providers must demonstrate effective safeguarding leadership and governance at every level.

B. Safeguarding Adults at Risk

Level 1 – Basic Awareness

Topics:
Adult safeguarding fundamentals; what an adult at risk is; main categories of abuse, harm, and neglect; physical, sexual, emotional/psychological, financial/material, discriminatory, organisational abuse, neglect and acts of omission, domestic abuse, modern slavery, self-neglect, and PREVENT awareness; signs and indicators; immediate safety; how to respond to a disclosure; how to report concerns; documenting facts clearly; basic information sharing; confidentiality and escalation; adults’ rights and wellbeing; awareness of Mental Capacity Act principles and deprivation of liberty basics; barriers to disclosure; the importance of listening to the person and carers. The 2024 adult framework applies level 1 to all staff and expects awareness of different forms of abuse, local reporting routes, information sharing, mental capacity, barriers to raising concerns, and the lifelong impact of abuse.

Level 2 – Staff with Regular Adult Contact

Topics:
Everything in Level 1, plus: acting on immediate safety concerns and protection planning; recognising patterns of abuse over time; Making Safeguarding Personal; wishes, views, and desired outcomes; documentation and defensible record-keeping; lawful information sharing; referral pathways and local procedures; domestic abuse in adults; coercive control; stalking and harassment awareness; modern slavery and trafficking; PREVENT; self-neglect and hoarding; carer stress versus abuse; organisational abuse; sexual safety; mental capacity, best interests, deprivation of liberty, and when to seek advice; cumulative risk; professional challenge; transitions and young adults at risk. The adult framework says level 2 adds active response, immediate safety, documentation, information sharing, and local priorities such as financial abuse, Prevent, and modern slavery; it also builds on mental-capacity knowledge.

Level 3 – Staff Assessing, Planning, Delivering, or Evaluating Care Where There Are Safeguarding Concerns

Topics:
Everything in Levels 1–2, plus: risk and harm assessment; safeguarding history-taking and examination within role; communication with adults who have cognitive impairment, learning disability, autism, mental ill-health, substance misuse, or communication needs; inter-agency assessments and section 42 enquiry participation; safeguarding reports and legal-quality documentation; information sharing and confidentiality in complex cases; protection planning, resolution, and recovery; trauma-informed practice; transitional safeguarding; criminal and sexual exploitation of older adolescents and young adults; domestic homicide review awareness; learning from Safeguarding Adults Reviews; supervision and peer review; duty of candour; death of an adult in a safeguarding context; forensic awareness where role-relevant; challenging inadequate inter-agency response; support for families and carers. The 2024 adult framework explicitly includes trauma, information sharing, section 42-style safeguarding participation, multidisciplinary work, reviews, and transitional safeguarding risks such as exploitation, drug trafficking, and community violence.

Level 4 – Professional / Organisational Safeguarding Leads

Topics:
Everything below, plus: expert advice on complex adult safeguarding cases; supervision frameworks; complex MCA/DoLS interface; organisational abuse and whole-service risk; allegations against staff; policy development; audit and quality improvement; safeguarding training design and evaluation; legal and forensic issues; managing case reviews and chronologies; leading internal management reviews; working with boards and senior managers; media/public communications on safeguarding incidents; learning from SARs, DHRs, complaints, coroner findings, and audits; assurance reporting; multi-agency leadership; specialist topics such as domestic abuse, sexual safety, self-neglect, modern slavery, exploitation, and trauma-informed systems. The adult framework places level 4 at organisational leadership level and expects audit, training design, case reviews, specialist advice, supervision, risk assessment of organisational ability to safeguard, and service reviews.

Level 5 – Senior Strategic Safeguarding Professionals

Topics:
Everything below, plus: strategic leadership across organisations/systems; advice to commissioners and service planners; assurance of commissioned-provider compliance; strategic quality improvement; workforce and training strategy; multi-agency governance; board/executive advisory function; system learning from SARs and other reviews; cross-system policy and pathway design; performance and outcomes frameworks; influencing regulators and inspections; commissioning standards for MCA, domestic abuse, sexual safety, self-neglect, exploitation, modern slavery, PREVENT, trauma-informed care, and personalised safeguarding; escalation of system risks; population-level inequalities and access barriers. The adult framework describes level 5 as taking the strategic and professional lead across the health community, overseeing quality improvement, leading training analysis and commissioning, and advising boards, executives, service planners, and commissioners.

Board Level

Topics:
Level 1 core content plus board-specific governance: statutory and regulatory duties; roles of boards, commissioners, SABs, and partner agencies; accountability lines; safeguarding risk and assurance; performance indicators and dashboards; financial and health impact of safeguarding failures; gross negligence and organisational failure; safe staffing, training assurance, supervision assurance, and safer recruitment; whistleblowing; information-sharing arrangements; inspection and regulatory expectations; personalised safeguarding; sexual safety; domestic abuse as a workforce and patient-safety issue; assurance around MCA and deprivation of liberty; commissioning oversight and quality governance. The 2024 adult framework says board members should have level 1 core competencies including mental capacity/deprivation of liberty, plus board-specific knowledge on statutory role, partnership arrangements, policies, risks, performance indicators, and regulatory expectations.

Cross-cutting specialist topic bank for your course suites

These are the topics most worth turning into reusable short modules that can be plugged into multiple levels: information sharing; documentation and defensible records; voice of the child / wishes and views of the adult; trauma-informed practice; domestic abuse and coercive control; sexual safety; PREVENT/radicalisation; child sexual exploitation; child criminal exploitation and county lines; modern slavery and trafficking; online harm and grooming; FGM; forced marriage; honour-based abuse; self-neglect and hoarding; mental capacity and deprivation of liberty; professional curiosity; contextual safeguarding / extra-familial harm; transitional safeguarding; learning from reviews; supervision and reflective practice; equality, culture, anti-racist and anti-discriminatory practice; children in care and care leavers. These themes are repeatedly reinforced across the current frameworks and statutory guidance.