Child and adolescent psychiatry CESR Portfolio Guide
Complete guide to the Child and adolescent psychiatry Portfolio Pathway: 9 High Level Outcomes (HLOs), 10 evidence sections, and a 10-year currency window. Based on official GMC Specialty Specific Guidance, published by Royal College of Psychiatrists (RCPsych).
SSG Version: 07/02/2025
High Level Outcomes (HLOs)
The Child and adolescent psychiatry SSG defines 9 High Level Outcomes (HLOs) that Portfolio Pathway applicants must demonstrate competence in.
Professional Values and Behaviours
- 1.1 Professional Relationships
- 1.2 Professional Standards
Professional Skills
- 2.1 Communication
- 2.2 Clinical skills
- 2.3 Complexity and uncertainty
Professional Knowledge
- 3.1 Knowledge of legal and organisational frameworks in your UK jurisdiction
- 3.2 Working within NHS organisational structures
Health Promotion and Illness Prevention
- 4.1 Health promotion and illness prevention in community settings
Leadership and Teamworking
- 5.1 Teamworking
- 5.2 Leadership
Patient Safety and Quality Improvement
- 6.1 Patient safety
- 6.2 Quality improvement
Safeguarding Vulnerable Groups
- 7.1 Safeguarding
Education and Training
- 8.1 Education & Training
- 8.2 Supervision
Research and Scholarship
- 9.1 Undertaking research and critical appraisal
Evidence Requirements
The SSG specifies 10 evidence sections. Each section describes what evidence to provide and how to present it.
Evidence of training, qualifications, and employment
Evidence to demonstrate how you meet your self-identified KSE cohort, including core competencies and specialist training/experience.
What to provide
- KSE cohort statement
- CV
- Primary medical qualification (PMQ)
- Specialist medical qualification(s) including MRCPsych certificate if applicable
- Specialist training curriculum/syllabus and periodic assessments (e.g., ARCPs)
- Employment letters
- Job descriptions
How to present
Grouped by type of evidence.
HLO 1 Professional Values and Behaviours
Evidence of professional relationships and standards from the last five working years.
What to provide
- Feedback from colleagues and patients (e.g., 360 feedback)
- Correspondence demonstrating multidisciplinary collaboration
- Reflective practice
- Successful annual appraisals for each of the last three to five working years
How to present
Grouped by the type of evidence (e.g., all patient feedback together). Submitted in one PDF bundle by organisation. Named: HLO1.1/ [Organisation Name] / Patient feedback/Dates.
HLO 2 Professional Skills
Detailed case histories demonstrating advanced communication, clinical skills, and management of complexity and uncertainty.
What to provide
- 12, 17, or 25 detailed case histories (depending on KSE cohort) covering specific age ranges (0-5, 6-11, 12-17)
- Evidence of at least two different models of evidence-based psychotherapy
- WPBAs and reflections to triangulate evidence
- For Cohort 2: 6 additional case histories of adult (4) and elderly (2) people
How to present
Organised by case and coordinated to tell the story of the patient. Grouped by organisation, then by diagnosis. Named: HLO2/ [Organisation Name] /C.H 6 /Dates.
HLO 3 Professional Knowledge
Knowledge of legal and organisational frameworks, including the Mental Health Act and Children's legislation.
What to provide
- Evidence of Approved Clinician role (or equivalent)
- Case histories showing use of the Mental Health Act and involuntary treatment
- Substantial reports (e.g., Tribunal report, Family Court report, Child Protection report)
- Evidence of attendance at Tribunal/Court with supervisor's report or WpBA
How to present
No additional evidence is required to be uploaded into this section. All evidencing requirements for HLO3 will be submitted under other HLOs (e.g., within HLO 2 case histories).
HLO 4 Health Promotion and Illness Prevention
Understanding of health inequalities, social determinants of mental health, and lifestyle interventions.
What to provide
- Case histories and clinical letters including descriptions of psychoeducation
- Minutes of professional meetings demonstrating multidisciplinary working
How to present
No additional evidence is required to be uploaded into this section. All evidencing requirements for HLO4 will be submitted under other HLOs (e.g., HLO 2 and HLO 6).
HLO 5 Leadership and Teamworking
Evidence of leadership activities, management, and teamworking.
What to provide
- Attendance at management and leadership CPD events
- Assessment of chairing a clinical meeting (e.g., DONCS)
- Reflection on Change Management or Service Development
- Job description and reflection on a leadership role (if applicable)
How to present
Grouped by activity. Named: HLO5/[Organisation Name] /CPD/Dates.
HLO 6 Patient Safety and Quality Improvement
Participation in clinical governance, patient safety, and quality improvement.
What to provide
- Appraisal evidence demonstrating learning from serious incidents/complaints
- Shadowing a Serious Incident review or PSIRF Investigation
- Meeting minutes demonstrating active participation in clinical governance
- Minimum of one Quality Improvement project/audit with a final report and re-audit
How to present
Grouped by activity/event. Quality improvement projects bundled together. Named: HLO6/ [Organisation Name] /Serious Incident review/Dates.
HLO 7 Safeguarding Vulnerable Groups
Knowledge and experience in safeguarding children and adults.
What to provide
- Child and Adult Safeguarding mandatory training certificates
- Case histories demonstrating recognising/reporting safeguarding concerns
- Minutes of safeguarding/child protection meetings
- UK Prevent training certificate and reflection
How to present
Grouped by activity. Safeguarding meetings submitted together. Named: HLO7/ [Organisation Name] /UK prevent training/Dates.
HLO 8 Education and Training
Evidence of teaching commitment, educational activities, and supervision of junior colleagues.
What to provide
- Job description of teaching/supervisory role
- Teaching materials (slides) with feedback and reflection
- Evidence of undertaking assessment and supervision of junior colleagues/trainees supported by WPBAs
How to present
Grouped by activity. Teaching evidence collated by session, assessment, and supervision. Named: HLO8/[Organisation Name]/Teaching role/Dates.
HLO 9 Research and Scholarship
Undertaking research, critical appraisal, and maintaining good clinical practice in research.
What to provide
- Attendance at CPD events for Research and Critical Appraisal
- Critical Appraisals presented at Journal Club or peer review
- Literature Review
- Relevant Research Qualification (e.g., MSc, MPhil, PhD, MD) if applicable
How to present
Grouped by activity. Each critical appraisal with corresponding triangulated evidence submitted separately. Named: HLO9/ [Organisation Name] /Critical Appraisal/Dates.
Knowledge Requirements
Primary Path
Completed Core Psychiatry Training (or equivalent) AND MRCPsych (or equivalent) passed.
Alternative Path
Completed Core Psychiatry Training without MRCPsych, OR cannot demonstrate completion of core psychiatry training. These place the applicant in KSE Cohort 1B or Cohort 2, requiring significantly more specialist experience and case histories.
Applicants must self-identify their KSE cohort (1A, 1B, or 2) using the matrix provided in the guidance, which dictates the volume of evidence (e.g., 12, 17, or 25 case histories) required.
Volume and Assessment Targets
The SSG specifies minimum volume and assessment targets for this specialty.
Case histories for KSE Cohort 1A
12 case histories (2 ages 0-5, 5 ages 6-11, 5 ages 12-17)
Case histories for KSE Cohort 1B
17 case histories (3 ages 0-5, 7 ages 6-11, 7 ages 12-17)
Case histories for KSE Cohort 2
25 case histories (5 ages 0-5, 10 ages 6-11, 10 ages 12-17)
Adult and elderly case histories (Cohort 2 only)
6 case histories of adult (4) and elderly (2) people
Evidence-based psychotherapy models
At least two different models of evidence-based psychotherapy
Quality Improvement Project
Minimum of one quality improvement project (audit and re-audit)
Currency Window & Evidence Volume
Currency Window
Years
Evidence is expected to be submitted from the timeframe as described within each HLO (WTE, doesn't need to be consecutive) although overall it must be within the last ten years. If you have worked less than full time (LTFT), or have had a break in practice in the last five years, evidence can be provided from additional years or whole-time equivalence (WTE).
Evidence Volume
No more than 1500 pages of evidence, and ideally no more than 1,200 pages.
Additional Notes
It is your responsibility to ensure you choose the correct KSE cohort based on your knowledge, skills and experience. Do not apply under a cohort that you do not meet the criteria for.
We recommend that you do not submit more than one PDF document for each organisation per HLO.
Case histories must be from real-world settings rather than a review written retrospectively, and must include detailed mental state examinations and biopsychosocial psychiatric formulations.
If claiming exemption from psychotherapy requirements via a recognised course certificate, at least 1 case history must still demonstrate application of contemporary knowledge and principles of psychological therapies.
Frequently Asked Questions
What is the Child and adolescent psychiatry CESR portfolio?
How many framework units does Child and adolescent psychiatry require?
What evidence is required for Child and adolescent psychiatry specialist registration?
How long is the currency window for Child and adolescent psychiatry?
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