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Capabilities in Practice (CiPs)

Allergy (Allergy and Clinical Immunology) CESR Portfolio Guide

Complete guide to the Allergy (Allergy and Clinical Immunology) Portfolio Pathway: 12 Capabilities in Practice (CiPs), 2 evidence sections, and a 5-year currency window. Based on official GMC Specialty Specific Guidance, published by Joint Royal Colleges of Physicians Training Board (JRCPTB).

SSG Version: 31/01/2025

12
CiPs
2
Evidence Sections
5yr
Currency Window
~100 docs
Evidence Volume

Capabilities in Practice (CiPs)

The Allergy (Allergy and Clinical Immunology) SSG defines 12 Capabilities in Practice (CiPs) that Portfolio Pathway applicants must demonstrate competence in.

Generic CiP 1

Able to function successfully within NHS organisational and management systems

  • Aware of, and adheres to, the GMC professional requirements
  • Aware of public health issues including population health, social determinants of health and global health perspectives
  • Demonstrates effective clinical leadership
  • Demonstrates promotion of an open and transparent culture
  • Keeps up to date through learning and teaching
  • Demonstrates engagement in career planning
  • Demonstrates capabilities in dealing with complexity and uncertainty
  • Aware of the role and processes for commissioning
  • Aware of the need to use resources wisely
Generic CiP 2

Able to deal with ethical and legal issues related to clinical practice

  • Aware of national legislation and legal responsibilities, including safeguarding vulnerable groups
  • Behaves in accordance with ethical and legal requirements
  • Demonstrates ability to offer apology or explanation when appropriate
  • Demonstrate ability to lead the clinical team in ensuring that ethical and legal factors are considered openly and consistently
Generic CiP 3

Communicates effectively and is able to share decision making, while maintaining appropriate situational awareness, professional behaviour and professional judgement

  • Communicates clearly with patients and carers in a variety of settings
  • Communicates effectively with clinical and other professional colleagues
  • Identifies and manages barriers to communication (e.g. cognitive impairment, speech and hearing problems, capacity issues)
  • Demonstrates effective consultation skills including effective verbal and non-verbal interpersonal skills
  • Shares decision making by informing the patient, prioritising the patient’s goals and wishes, and respecting the patient’s beliefs, concerns and expectations
  • Shares decision making with children and young people
  • Applies management and team working skills appropriately, including influencing, negotiating, re-assessing priorities and effectively managing complex, dynamic situations
Generic CiP 4

Is focussed on patient safety and delivers effective quality improvement in patient care

  • Makes patient safety a priority in clinical practice
  • Raises and escalates concerns where there is an issue with patient safety or quality of care
  • Demonstrates commitment to learning from patient safety investigations and complaints
  • Shares good practice appropriately
  • Contributes to and delivers quality improvement
  • Understands basic Human Factors principles and practice at individual, team, organisational and system levels
  • Understands the importance of non-technical skills and crisis resource management
  • Recognises and works within limit of personal competence
  • Avoids organising unnecessary investigations or prescribing poorly evidenced treatments
Generic CiP 5

Carries out research and manages data appropriately

  • Manages clinical information / data appropriately
  • Understands principles of research and academic writing
  • Demonstrates ability to carry out critical appraisal of the literature
  • Understands the role of evidence in clinical practice and demonstrates shared decision making with patients
  • Understands public health epidemiology and global health patterns
  • Demonstrates appropriate knowledge of research methods, including qualitative and quantitative approaches in scientific enquiry
  • Demonstrates appropriate knowledge of research principles and concepts and the translation of research into practice
  • Follows guidelines on ethical conduct in research and consent for research
  • Recognises potential of applied informatics, genomics, stratified risk and personalised medicine and seeks advice for patient benefit when appropriate
Generic CiP 6

Acts as a clinical teacher and clinical supervisor

  • Delivers effective teaching and training to medical students, junior doctors and other healthcare professionals
  • Delivers effective feedback with action plan
  • Able to supervise less experienced trainees in their clinical assessment and management of patients
  • Able to supervise less experienced trainees in carrying out appropriate practical procedures
  • Able to act as a clinical supervisor to doctors in earlier stages of training
Specialty CiP 1

Managing, developing, and delivering allergy services in all appropriate service settings

  • Demonstrates effective clinical management of allergic diseases and other conditions that can present with features of allergic disease
  • Demonstrates professional behaviour with regard to patients, carers, colleagues and others
  • Delivers patient centred care including shared decision making
  • Demonstrates effective consultation skills
  • Formulates an appropriate diagnostic and management plan, taking into account patient preferences
  • Explains clinical reasoning behind diagnostic and clinical management decisions to patients/carers/guardians and their colleagues and clearly communicates risk/benefit analysis of proposed interventions.
  • Takes a relevant patient history including patient symptoms, concerns, priorities and preferences
  • Shows appropriate clinical reasoning by analysing physical and psychological findings
  • Formulates an appropriate differential diagnosis
  • Formulates an appropriate diagnostic and management plan, taking into account patient preferences, available resources, the urgency of intervention and the risk/benefit ratio of potential interventions
Specialty CiP 2

Managing, developing, and delivering clinical immunology services in all appropriate service settings

  • Demonstrates effective clinical management of primarily immunological conditions and other conditions that can mimic immunological disease
  • Delivers patient centred care including shared decision making
  • Demonstrates effective consultation skills
  • Formulates an appropriate diagnostic and management plan, taking into account patient preferences
  • Takes a relevant patient history including patient symptoms, concerns, priorities and preferences
  • Shows appropriate clinical reasoning by analysing physical, immunological and psychological information
  • Formulates an appropriate differential diagnosis
  • Formulates an appropriate diagnostic and management plan, taking into account patient preferences, available resources, the urgency of intervention and the risk/benefit ratio of potential interventions
  • Explains clinical reasoning behind diagnostic and clinical management decisions to patients/carers/guardians and other colleagues and clearly communicates risk/benefit analysis of proposed interventions.
Specialty CiP 3

Providing advice to colleagues on selection, interpretation and limitations of laboratory and other investigations for common immunological and allergic conditions

  • Demonstrates understanding of the principles and utility of commonly used investigations for diagnosis and monitoring for immunological and allergic conditions and their limitations
  • Understands and can manage uncertainty in the interpretation of immunological tests and its effect on diagnostic utility
  • Demonstrates ability to select appropriate tests and to interpret test results appropriately in patients with suspected allergic and immunological conditions
  • Demonstrates ability to explain the clinical reasoning behind diagnostic decisions to patients/carers/guardians and other colleagues.
  • Demonstrates ability to advise patients, colleagues, and an MDT on interpretation of test results and choice of test
  • Demonstrates understanding of genomics and impact of investigations on the diagnosis and treatment of allergic and immunological
Specialty CiP 4

Supporting the management of patients with allergy, immunodeficiency, auto-immune disease, and auto-inflammatory disease, in liaison with other specialties including primary care

  • Demonstrates ability to develop effective management plans for patients with allergic and immunological conditions in a variety of care settings
  • Demonstrates effective liaison with other specialties including primary care in the management of patients with suspected allergic and immunological disease
  • Participates in the development of pathways and/or protocols for patients with allergic and immunological diseases
  • Participates actively in the multi-disciplinary team
  • Recognises the importance of prompt and accurate information sharing with primary care team
  • Accurate and appropriate confirmation or exclusion of allergic conditions
  • Supporting identification of allergic and non-allergic diseases
Specialty CiP 5

Delivering and supporting both immune-mediated and other therapeutic interventions in allergic and immunological conditions

  • Demonstrate ability to deliver effective: Therapeutic interventions for allergic and immunological conditions including: Immunoglobulin, C1 Inhibitor and other treatments for angioedema, Immunotherapy, Desensitisation therapies, Biologics, Rescue medications, Sequencing of therapies
  • Treatment and follow up of patients with anaphylaxis
  • Support for patients and their carers, on self-care and home therapies
Specialty CiP 6

Understanding the needs of adolescents and young adults with allergic and immunological diseases transitioning to adulthood

  • Demonstrate ability to deliver transition services in accordance with national guidelines by: Understanding behavioural and psychosocial issues in transition, Developing effective plans for transition between paediatric and adult services, Effective communication with the patients and when appropriate their carers

Evidence Requirements

The SSG specifies 2 evidence sections. Each section describes what evidence to provide and how to present it.

Evidence of training, qualifications, and employment

Evidence of your training as background evidence to allow evaluators to see your whole career pathway.

What to provide

  • Primary medical qualification (PMQ)
  • Specialist medical qualification(s) - MRCP(UK) or comparable, ACICE/FRCPath Part 1
  • Recent specialist training curriculum or syllabus
  • CV
  • Employment letters
  • Job descriptions
  • Rotas
  • Departmental/Unit annual caseload statistics
  • Appraisal

How to present

Submit electronically under the correct section of your online application. Group evidence together to keep the number of individual electronic uploads manageable.

Practical Procedures

Evidence for practical procedures and the level of competency expected.

What to provide

  • Logbooks
  • DOPS (Direct Observation of Procedural Skills)

How to present

Provide one summative DOPS for each procedure for which an applicant must be competent to perform unsupervised, or a structured report concentrating upon procedural skills.

Index Procedures

11 index procedures require procedural-based assessments (PBAs) with specified minimum assessors and competence levels.

ProcedureCategoryMin PBAsMin AssessorsMin Level
Skin Prick TestingSpecialty Procedures4
Intradermal TestingSpecialty Procedures4
Drug Provocation TestSpecialty Procedures4
Food Provocation TestSpecialty Procedures4
Drug DesensitizationSpecialty Procedures4
Aeroallergen ImmunotherapySpecialty Procedures4
Venom ImmunotherapySpecialty Procedures4
Perioperative anaphylaxis assessmentSpecialty Procedures4
SpirometrySpecialty Procedures4
Fractional Exhaled nitric oxide (FeNO)Specialty Procedures4
Anterior RhinoscopySpecialty Procedures4

Knowledge Requirements

Primary Path

Evidence of completion of full MRCP(UK) or comparable qualification (MRCPCH is acceptable for applicants demonstrating alternative core capabilities in paediatrics) AND Evidence of completion of appropriate test of knowledge - Allergy and Clinical Immunology Certificate Examination (ACICE)/FRCPath Part 1 or a comparable qualification.

Alternative Path

A detailed, thorough and succinct cross-referencing mapping exercise, demonstrating how each and every competency in the qualification has been covered in your own qualifications.

To demonstrate core internal medical capabilities, applicants need to provide MRCP (UK) or a comparable assessment of applied knowledge showing the application of core skills including outpatient capability.

Referee Requirements

4

Referee Reports Required

  • Current Head of Department or other senior colleague with knowledge of the breadth of your clinical activity (ideally an Educational Supervisor with at least 5 years experience)
  • One report from a laboratory director or equivalent
  • At least one further report from colleagues working with you at consultant level in both Allergy and Immunology

Volume and Assessment Targets

The SSG specifies minimum volume and assessment targets for this specialty.

Outpatient Care Assessment Tool (OPCAT)

4 OPCATs (2 for immunology clinics and 2 for allergy clinics each to level 4 entrustment)

Min count: 4Min level: 4

Case-based discussion and/or mini-clinical evaluation exercise (mini-CEX)

12 comprised of a mix of CbDs and mini-CEX to level 4 entrustment

Min count: 12Min level: 4

Quality Improvement Project Assessment Tool (QIPAT)

1 completed in last 12 of most recent practise (WTE)

Min count: 1last 12 months

Patient Survey (PS)

1 completed in last 12 months of most recent practise (WTE) including approximately 15 patients

Min count: 1last 12 months

Teaching observation (TO)

1 completed in last 12 months clinical practise (WTE)

Min count: 1last 12 months

Multi Source Feedback (MSF)

1 completed in last 12 months clinical practise (WTE) including approximately 12 colleagues

Min count: 1Min assessors: 12last 12 months

Multiple Consultant Report (MCR)

4 MCRs completed in the last 12 months clinical practise (WTE)

Min count: 4last 12 months

Currency Window & Evidence Volume

Currency Window

5

Years

Evidence of your recent practice will be given more weight to reflect current capabilities and we suggest that approximately 50% of your evidence for a curriculum outcome is drawn from within the last five years of clinical practice (WTE).

Evidence Volume

around 100 electronically uploaded documents

Additional Notes

Triangulated evidence (evidence comprised of three different sources) will make a stronger application.

Do not duplicate evidence that is relevant to more than one CiP – you should include one copy and then list it under each relevant CiP (cross referencing).

Evidence should only be cross referenced where it adds significant support to a CiP.

Evidence should be provided from a variety of clinical settings.

If you have worked in posts approved for a specialist training programme for a relevant qualification outside the UK in the past five years, please provide an authenticated copy of the curriculum or syllabus.

Frequently Asked Questions

What is the Allergy (Allergy and Clinical Immunology) CESR portfolio?
The Allergy (Allergy and Clinical Immunology) CESR portfolio is a collection of evidence demonstrating equivalence to UK CCT standards, submitted via the GMC Portfolio Pathway. It is assessed against the Specialty Specific Guidance for Allergy (Allergy and Clinical Immunology).
How many framework units does Allergy (Allergy and Clinical Immunology) require?
The Allergy (Allergy and Clinical Immunology) SSG defines 12 Capabilities in Practice (CiPs) and 2 evidence sections.
What evidence is required for Allergy (Allergy and Clinical Immunology) specialist registration?
Evidence requirements are defined in 2 sections covering areas such as Evidence of training, qualifications, and employment, Practical Procedures.
How long is the currency window for Allergy (Allergy and Clinical Immunology)?
The currency window for Allergy (Allergy and Clinical Immunology) is 5 years. Evidence of your recent practice will be given more weight to reflect current capabilities and we suggest that approximately 50% of your evidence for a curriculum outcome is drawn from within the last five years of clinical practice (WTE).
What index procedures are required for Allergy (Allergy and Clinical Immunology)?
Allergy (Allergy and Clinical Immunology) requires procedural-based assessments for 11 index procedures across the specialty.

Start Your Allergy (Allergy and Clinical Immunology) Portfolio

Map your evidence to the Allergy (Allergy and Clinical Immunology) framework, track readiness, and export your GMC submission.