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Infection Control Training: Who Needs It, Level 1 or Level 2, How Often, and What a Good Course Covers
Infection control training is one of the few pieces of workplace training that care providers in England are inspected on directly, and one of the easiest to get wrong by treating it as a yearly box-ticking video. The legal duty is to prevent and control the spread of infection; training is how an employer shows that staff know what to do. This page sets out the law, the two training levels used across health and care, how often each should be refreshed, what a course should cover, and how to make the training change behaviour rather than just produce certificates.
Who needs infection control training?
The clearest requirements are in health and social care, but infection prevention and control (IPC) is relevant to any business where staff touch people, body fluids or shared equipment.
- CQC-registered providers: hospitals, GP and dental practices, care homes, home care agencies and other regulated services.
- Non-clinical staff in those settings: cleaners, porters, catering and reception staff, contractors and volunteers.
- Personal services: tattooists, piercers, beauty and aesthetics businesses, where local authority licensing conditions usually set hygiene standards.
- Childcare and schools: nurseries and early years settings, where outbreaks of sickness and diarrhoea spread fast.
- Any employer with a biological hazard: labs, waste handling, sewage work and similar, under the general health and safety duties below.
Food businesses have their own hygiene training rules, covered in our page on food allergen training; the principles overlap, but the law is different.
What the law says
There is no single statute that says "every worker must complete an infection control course". The requirement comes from duties that cannot be met without training:
- Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 12. Safe care and treatment includes assessing the risk of, and preventing, detecting and controlling the spread of, infections, including those that are health care associated. Regulation 18 separately requires staff to have the training they need for their role. CQC inspects against both.
- The Code of Practice on the prevention and control of infections. Issued under the 2008 Act, it sets ten criteria that registered providers must have regard to. One requires systems to make sure all care workers, including contractors and volunteers, are aware of and discharge their responsibilities for preventing and controlling infection. CQC uses the Code when judging compliance.
- Health and Safety at Work etc Act 1974 and the Control of Substances Hazardous to Health Regulations 2002 (COSHH). Biological agents are hazardous substances under COSHH, so employers must assess the risk and give workers suitable information, instruction and training.
Level 1 and Level 2: the Core Skills Training Framework
Most NHS trusts and many care providers use the Core Skills Training Framework (CSTF), run by Skills for Health, to set the content and frequency of mandatory training. It splits infection prevention and control into two levels.
| Level 1 | Level 2 | |
|---|---|---|
| Who | All staff, including contractors, unpaid and voluntary staff | Healthcare staff providing direct patient care, and other staff based on role and local risk assessment |
| Refresher | Every 3 years | Every year |
| Core content | Standard precautions: hand hygiene, PPE, spillages, sharps and exposure, the environment, care equipment; when your own illness makes you a risk | Level 1 plus legislation, healthcare associated infections, the chain of infection, routes of transmission, decontamination, single-use items, risk assessment and alert organisms |
The CSTF also says extra refresher training is needed whenever national guidance or the organisation's own policy changes, and that staff who can show current competence through a robust assessment may not need to repeat the course. Check the current version of the subject guide, as Skills for Health reviews it periodically. Social care providers will also see infection prevention and control as one of the standards in the Care Certificate for new care workers.
What a good course covers
The chain of infection
Almost every IPC course is built on the chain of infection: an infectious agent, a reservoir where it lives, a way out (portal of exit), a mode of transmission, a way in (portal of entry), and a susceptible host. Every precaution breaks one link. Hand hygiene breaks transmission; vaccination protects the host; cleaning removes the reservoir. Staff who understand the chain make better judgements in situations the policy never anticipated.
Standard infection control precautions
In England, NHS settings follow the National Infection Prevention and Control Manual (NIPCM), published by NHS England, which sets out the standard precautions to use with every patient, every time:
- Patient placement and assessment for infection risk
- Hand hygiene, including the World Health Organization's "five moments" for hand hygiene
- Respiratory and cough hygiene
- Personal protective equipment: choosing, putting on and taking off in the right order
- Safe management of the care environment and of care equipment
- Safe management of linen, blood and body fluid spillages, and waste including sharps
- Occupational exposure management, such as needlestick injuries
Transmission-based precautions
For Level 2 staff: what changes when someone has, or may have, an infection spread by contact, droplets or the airborne route, such as norovirus, Clostridioides difficile, influenza, COVID-19 or tuberculosis. This includes isolation, cohorting and enhanced cleaning.
Fitness to work
A point often skipped: staff must know when their own illness makes them a risk. The usual rule for diarrhoea and vomiting is to stay away until 48 hours after symptoms stop. Training is wasted if your sickness policy or pay arrangements push people to come in anyway, which is why this is as much an ethics and management question as a training one.
How to run training that actually works
- Map roles to levels. List every role, including agency staff, contractors and volunteers, and decide Level 1 or Level 2 for each based on contact with patients or clients.
- Combine e-learning with practical assessment. E-learning covers knowledge well, but hand hygiene and PPE are physical skills. Observe staff doing them; a UV hand-hygiene box shows missed areas quickly.
- Use your own data. Audit results, outbreak reviews and near misses should shape the next round of training.
- Keep records an inspector can follow. Who was trained, at which level, when, how it was assessed and when it is due again.
- Name an IPC lead. Give one person clear responsibility for infection prevention and control, including keeping training on schedule; in a small service this is often the registered manager.
Infection control training sits alongside the rest of a compliance programme; our pages on how to build a compliance programme, what corporate compliance means and display screen equipment training cover the wider framework. More guides are on the e-Business Ethics homepage.
Sources: Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 12; DHSC, Code of practice on the prevention and control of infections; NHS England, National Infection Prevention and Control Manual; Skills for Health, Core Skills Training Framework England subject guide.
Frequently Asked Questions
Is infection control training a legal requirement?
For CQC-registered health and care providers, in effect yes: Regulation 12 requires them to prevent and control the spread of infection and Regulation 18 requires staff to be trained for their role. Other employers have duties under COSHH where staff are exposed to biological agents.
How often should infection control training be refreshed?
Under the Core Skills Training Framework, Level 1 is refreshed every 3 years and Level 2, for staff giving direct patient care, every year. Extra training is needed when national or local guidance changes.
What is the difference between IPC Level 1 and Level 2?
Level 1 covers standard precautions such as hand hygiene and PPE for all staff. Level 2 adds the chain of infection, transmission routes, decontamination, risk assessment and alert organisms for direct care staff.
Do contractors and volunteers need infection control training?
Yes. The Core Skills Training Framework puts contractors, unpaid and voluntary staff in Level 1, and the Code of Practice expects all care workers, including contractors and volunteers, to know their responsibilities.
Is online infection control training enough?
E-learning covers the knowledge, but hand hygiene and PPE are practical skills. Good providers add observed practice and audits so they can show staff actually follow the precautions.