Learning Disabilities & Autism Opinion

Developing autism training for health and care staff

Jim Thomas, Programme Head – workforce innovation at Skills for Care; Marie Lovell, Project Manager at Skills for Care; and Colin Wright, Development Manager (Frameworks) at Skills for Health

Last year, after a concerted campaign from autistic people and people with a learning disability, the Government committed to rolling out mandatory training for all health and care staff. This means professionals need a clear sense of what they need to know, and health leaders need to know how to get their workforce ready to meet this challenge.

Workforce development is about working out what skills, knowledge, behaviours and values people need to do particular jobs and planning the learning programme and support they will need to do those jobs.

Care or support will be better when people are supported by knowledgeable and confident workers who can adapt and flex their knowledge and skills to the particular needs of an individual and their family.

In late 2019 Health Education England published the ‘Core Capabilities Framework for Supporting Autistic People’. The framework was developed in partnership with autistic people of all ages, families and a wide range of health, social care, independent sector and voluntary sector organisations.



The framework sets out 19 capabilities (skills, knowledge and behaviours) that people need to bring to their work. Values underpin every aspect of the framework. These capabilities are grouped together under five domains and three tiers.


A. Understanding autism (and that that every autistic person has a different combination of traits and sensitivities and is unique)

B. Personalised support

C. Physical and mental health

D. Risk, legislation and safeguarding

E. Leadership and management, education and research.


1) People who require a general understanding of autism and the support autistic people may need.

2) 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.

3) 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.

The domains, tiers and the capabilities are all interlinked. Under each domain, there are a number of capabilities, which then set out the sort of knowledge and skills that are needed for each tier.

The best way to explain this is to look at one of the domains. The first domain is about understanding autism and has two capabilities in it. They are:

(1) understanding autism

(2) identification and diagnosis of autism.

For both of these, it’s essential that workers understand that each autistic person is different.

Tier one applies to all workers not providing specialist care to autistic people, but there are still likely to be autistic people using their service every day as part of the general population. You might address the capabilities by arranging for an autistic adult to talk about autism in team meetings or in supervision.

At tier two, workers need to know everything in tier one. They will also need to be able to understand and have skills from other domains – such as how to address the health inequalities experienced by autistic people. People needing this level of capability are likely to meet and work in services more specifically for autistic people.

Tier three is about expert knowledge and skills, understanding the medical and social models and key policy and legislation. These workers are likely to be working with autistic people all the time and advising or making decisions which will affect other workers.

The most important thing to remember is that the framework is not about progression from one bit to the next. It’s about checking what people need to know, when, and also how to apply that knowledge in practice. Even more importantly, it’s about engaging autistic people and their families in developing workers’ confidence and competence and everyone respecting each other.

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Edel Harris





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