Paediatrics CESR Portfolio Guide

You will have developed your knowledge of the current legal framework related to babies, children, young people, families and carers to your clinical practice (e.g. adoption and safeguarding). You are expected to act as a role model by taking a self-regulatory approach in ensuring professional values and behaviours, demonstrating the qualities required by a paediatrician undertaking independent practice.

• Demonstrates leadership in the management of relationships where religious or cultural beliefs may cause conflict between children, young people and families and healthcare professionals
• Acts as a role model to colleagues by demonstrating a flexible, holistic, reflective, evidence-based approach to practice
• Practises independently in a safe manner
• Demonstrates self-awareness and insight, recognising their limits of capability and demonstrating commitment to continuing professional development (CPD)
• Considers the capacity of children and young people to make informed decisions about their medical care
• Demonstrates compassion, empathy and respect for children, young people and their families
• Follows the principles of the law with regard to consent, the right to refuse treatment, confidentiality and the death of a baby, child or young person

You will have worked increasingly in an unsupervised role within multi-disciplinary teams and can apply communication skills with children, young people and families/carers in a range of environments and challenging situations. You will have developed your communication skills across the entire range of paediatric healthcare settings and all levels of complexity. You are expected to apply communication skills in a range of contexts, for example, in multi-disciplinary teams (MDTs), with children, young people, families/carers, external agencies and other professionals, across a range of media, including legal and child protection reports. You will be able to effectively and sensitively support and communicate with families and lead the team in the actions needed when a baby, child or young person is dying or has died.

• Effectively communicates with the multi-disciplinary team (MDT), children, young people and their families, where there is a range of differential diagnoses and management is uncertain
• Models and teaches effective active listening skills in consultation with children and young people
• Demonstrates to others how to manage an effective consultation, including communicating a diagnosis and prognosis effectively to children, young people and their families
• Leads MDT in a range of situations with children, young people and their families, including challenging circumstances
• Demonstrates effective communication with external agencies, including authoring legal documents and child protection reports
• Demonstrates effective communication skills with children, young people, families and colleagues, both spoken and written (including electronic notes)
• Demonstrates courtesy and respect for different cultures and those with protected characteristics
• Responds appropriately and empathises with children, young people and their families in dealing with conflict and/or those who are experiencing difficulty, anxiety or distress

You can perform all clinical skills that are required in paediatrics with babies, children and young people and can confidently teach these to junior staff. You are expected to be capable in the full range of clinical skills relevant within paediatrics, including appropriately co-ordinating the skills of other health professionals, when required.

• Teaches, supervises and assesses junior staff undertaking clinical procedures
• Recognises the potential life-threatening events and manages and co-ordinates the response to an emergency situation
• Leads the resuscitation team during advanced life support
• Demonstrates capability in taking consent for genetic and genomic testing and discusses the results with children, young people and their families
• Performs advanced airway support, including airway opening manoeuvres and the use of airway adjuncts to the point of intubation
• Undertakes key procedures, including the following: Peripheral venous cannula, Neonatal umbilical venous catheterisation, Lumbar puncture, Intraosseous needle insertion for emergency venous access
• Performs appropriate clinical assessments of a baby, child and young person

You have become an expert at managing a wide range of paediatric conditions in a variety of settings and have moved towards independent practice and supervising junior staff. Your management of babies, children and young people is now fluid and highly proficient. You are expected to consider the full range of differential diagnosis, treatment and management options available, including new and innovative therapies, relevant within paediatrics, anticipating the need for transition from paediatric services and planning accordingly. You will be able to resuscitate, stabilise and treat extremely unwell babies, children and young people, liaising with specialist teams, as necessary. You will be able to recognise, investigate, initiate and continue the management of the full range of acute and chronic health problems presenting to paediatric outpatient clinics, drawing upon the expertise of other specialists as necessary.

• Assesses the evidence base for treatment and assessment strategies, their limitations and when to act outside them with appropriate advice
• Demonstrates leadership in encouraging children and young people to participate in their individual care, using external resources appropriately
• Supervises junior staff and supports colleagues in the assessment and management of cases which are complex or nuanced
• Anticipates the need for transition to another service, or works jointly alongside another service, to care for the baby, child or young person
• Engages in multi-professional management of a baby, child or young person’s physical, mental and developmental status, incorporating biological, physiological and social factors across multiple clinical contexts

You are able to consider the promotion of health from a leadership perspective, covering health promotion, prevention and public health, including global aspects. These concepts should be considered from the perspective of not only the individual baby, child, young person and family but also from a strategic service and population perspective. You are expected to work with the wider healthcare community, promoting wellbeing, physical and mental health to improve the health of babies, children and young people.

• Understands the impact of wider economic, cultural and social factors which impact on mental and physical health at a population level
• Applies knowledge of the factors which contribute to child health inequalities and the consequences of those inequalities in terms of disability, life expectancy and health economics
• Demonstrates leadership and understanding of the systems that enable clinicians to analyse data relating to the patients under their care
• Utilises local, national and international health information in order to advocate for systems and policies which promote health and reduce inequalities
• Understands contextual barriers to accessing healthcare, including socioeconomic, cultural, psychological, which constrain the ability to make “healthy choices” and adapts practice to reduce these.
• Demonstrates leadership in health promotion by undertaking educational and/or quality improvement activity in this area across professional groups
• Evaluates the way that patients and families use the health system and adapts their practice to encourage self-management and early engagement

You can lead a multi-disciplinary team, promoting an open culture of learning and accountability by challenging and influencing the behaviour of colleagues and supporting the development of their leadership qualities and critical decision-making skills. You are expected to lead in multi-disciplinary teams (MDTs) and quality improvement projects, inspiring colleagues and supporting their development. You will be able to assume the role of Acute Paediatric Team Leader, liaise with primary care and other hospital and community specialist teams to effectively manage and coordinate patient flow, staffing, safety and quality in the paediatric acute assessment and inpatient units. You will be able to co-ordinate and lead the inpatient care of babies, children and young people with a spectrum of common and complex conditions, liaising with primary care and other hospital and community specialist teams, as necessary.

• Takes an active role in promoting the optimum use of healthcare resources
• Works closely with all professional groups involved in creating a comprehensive care pathway
• Addresses challenging behaviour within the team and retains leadership qualities in situations of stress and conflict
• Engages effectively with stakeholders such as children, young people, families, charities and other healthcare organisations to create and/or sustain a family centred service
• Works with non-clinical and managerial colleagues to promote an effective paediatric service which meets the needs of children, young people and their families
• Participates effectively and constructively in the multi-disciplinary (MDT) and inter-professional teams, engaging with children, young people and families, facilitating shared decision making
• Supports appropriate decisions made within a team and communicates these effectively

You will consider all aspects of patient safety and prescribing practice. This will occur unsupervised and you will be role modelling to junior staff. You are expected to take responsibility for investigating, reporting, resolving and evaluating risk/hazard incidents, within different paediatric healthcare settings, including communication with affected children or young people and their families/carers.

• Advises children, young people and their families about the importance of concordance and about the actions of medications, including their side effects
• Takes account of risks to themselves and others within the clinical environment, including those related to personal interactions and biohazards
• Participates in investigating, reporting and resolving serious incidents, including through communication with children, young people and their families
• Understands the relationship between hazards, risks of exposure and likelihood of harm and recognises when a baby, child or young person has been exposed to a risk/hazard and escalates in accordance with local and national procedures
• Applies safety procedures to prescribing practice, following local and national processes in instances of patient harm or medication error
• Applies safety procedures when prescribing blood products, with adherence to local and national policies
• Applies the Duty of Candour principles to practice

You will demonstrate skill in optimising opportunities for improvement. This includes improvement across a range of areas, such as patient care, service delivery and management. You are an automatous reflective practitioner. You are expected to independently apply knowledge of quality improvement processes by initiating, planning and undertaking projects and audits to improve clinical effectiveness, patient safety and patient experience.

• Responds appropriately to health service targets and participates in the development of clinical services
• Employs the principle of evaluation, audit, research and development to improve healthcare, including children and young people’s experiences
• Applies understanding of national and local regulatory bodies, particularly those involved in standards of professional behaviour, clinical practice and education, training and assessment
• Proactively identifies opportunities for quality improvement

Safeguarding of babies, children and young people is central to all aspects of paediatrics. You work proficiently in and advise others about this area of practice. You are expected to independently lead the process of safeguarding for babies, children and young people, including assessment, investigations and reporting. You will be able to recognise, investigate and manage safeguarding issues, including providing advice to general practitioners, other healthcare professionals and social care providers.

• Applies knowledge of the impact of adverse childhood experiences in working with vulnerable babies, children and young people, including those with complex needs, across a variety of clinical settings
• Applies knowledge of the role of the paediatrician as it relates to those of other agencies in the management of babies, children and young people in need of protection
• Following sudden unexpected death in babies and children (SUDIC), applies local procedures, including involvement of a rapid response team when appropriate and recognises the urgency when abuse is suspected
• Instigates appropriate medical investigations, initiating and contributing to multi-agency involvement in all forms of suspected abuse
• Compiles and writes a range of reports which are clear and accurate as required for safeguarding work, including police statements, medical reports for social services and court reports
• Recognises and acts upon safeguarding concerns, taking into account risk factors
• Conducts an assessment for possible maltreatment which incorporates attention to the broader family function and the baby’s, child’s or young person’s developmental, physical and mental health status
• Follows local and national policies for possible sexual abuse
• Applies an understanding of consent and parental responsibility in relation to safeguarding procedures of “looked after” children

You will have highly effective teaching skills. You will also evaluate the impact of teaching and make adjustments accordingly. You are expected to demonstrate the required knowledge, skills and attitudes to provide appropriate teaching, learning opportunities, supervision, assessment and mentorship in the paediatric healthcare setting.

• Evaluates teaching practice in a range of contexts using a variety of methods and adapts their teaching to suit different learning needs
• Effectively uses supervised learning events (SLEs) on colleagues to develop and facilitate their learning
• Facilitates children, young people and their families’ understanding of their condition(s)
• Demonstrates the ability to plan and deliver teaching in a range of clinical and non-clinical contexts
• Provides appropriate feedback and assessment of others

You are capable of finding and using evidence-based practice to support patient care. You also use skills to support the development of guidelines, protocols and procedures. You are expected to demonstrate the independent development and revision of guidelines and policies, ensuring these are centred on current clinical research and evidence-based healthcare, to improve babies, children and young people’s health and paediatrics service delivery.

• Undertakes research and/or practises evidence-based medicine with an evaluation of the strengths and limitations to inform decision making and enhance patient care and patient outcomes
• Leads the development and revision of guidelines and procedures to improve service delivery
• Explains the purpose of research trials to children, young people and their families and identifies potentially eligible patients
• Evaluates and presents their own or other’s research findings to clinical or wider audiences

Currency Window

Evidence from the last five years of your clinical practise (WTE, does not need to be consecutive) is considered an indicator of your current level of knowledge, skills and experience.

Evidence Volume

Most applications contain no more than 150 uploaded documents.