Psychiatry of learning disability CESR Portfolio Guide
Complete guide to the Psychiatry of learning disability Portfolio Pathway: 25 High Level Outcomes (HLOs), 11 evidence sections, and a 10-year currency window. Based on official GMC Specialty Specific Guidance, published by Royal College of Psychiatrists (RCPsych).
SSG Version: 10/02/2025
High Level Outcomes (HLOs)
The Psychiatry of learning disability SSG defines 25 High Level Outcomes (HLOs) that Portfolio Pathway applicants must demonstrate competence in.
Professional Values and Behaviours
Professional Values and Behaviours
Professional Relationships
Professional Relationships
Professional Standards
Professional Standards
Professional Skills
Professional Skills
Communication
Communication
Clinical skills
Clinical skills
Complexity and uncertainty
Complexity and uncertainty
Professional Knowledge
Professional Knowledge
Knowledge of legal and organisational frameworks in your UK jurisdiction
Knowledge of legal and organisational frameworks in your UK jurisdiction
Working within NHS organisational structures
Working within NHS organisational structures
Health Promotion and Illness Prevention
Health Promotion and Illness Prevention
Health promotion and illness prevention in community settings
Health promotion and illness prevention in community settings
Leadership and Teamworking
Leadership and Teamworking
Teamworking
Teamworking
Leadership
Leadership
Patient Safety and Quality Improvement
Patient Safety and Quality Improvement
Patient safety
Patient safety
Quality improvement
Quality improvement
Safeguarding Vulnerable Groups
Safeguarding Vulnerable Groups
Safeguarding
Safeguarding
Education and Training
Education and Training
Education & Training
Education & Training
Supervision
Supervision
Research and Scholarship
Research and Scholarship
Undertaking research and critical appraisal
Undertaking research and critical appraisal
Evidence Requirements
The SSG specifies 11 evidence sections. Each section describes what evidence to provide and how to present it.
Evidence of training and qualifications
Evidence to demonstrate how you meet your self-identified KSE cohort.
What to provide
- KSE cohort statement
- CV
- Primary medical qualification (PMQ)
- Specialist medical qualification(s)
- Specialist training curriculum/syllabus and ARCPs
How to present
Grouped by type of evidence
Evidence of employment in posts and duties
Evidence of employment history.
What to provide
- Employment letters
- Job descriptions
How to present
Grouped by type of evidence
HLO 1 Professional Values and Behaviours
Evidence of professional relationships and standards.
What to provide
- Feedback from colleagues and patients
- Correspondence demonstrating collaboration
- Reflective practice
- Structured reports
- Successful annual appraisal in the last five working years
How to present
Grouped by the type of evidence. E.g., all patient feedback grouped together. One PDF bundle by organisation.
HLO 2 Professional Skills
Evidence of clinical skills, communication, and managing complexity.
What to provide
- Case histories demonstrating advanced communication skills
- Full psychiatric history and Mental State Examination (MSE)
- Biopsychosocial formulation
- Treatment and management plans
- Evidence of continued work with a patient
- Physical examination and investigations
- Working across interfaces
- Application of psychological therapies
How to present
Organised by case and coordinated to tell the story of the patient. Organised by diagnosis within the organisation. One PDF bundle by organisation.
HLO 3 Professional Knowledge
Evidence of knowledge of legal and organisational frameworks.
What to provide
- Documentation of approval under the Mental Health Act
- Case reports (Tribunal report/Court report/MOJ report)
- Redacted legal forms (detention papers)
- Appraisal of completion of CPD in this area
How to present
No evidence is required to be uploaded into this section. All evidencing requirements for HLO3 will be submitted under other HLOs.
HLO 4 Health Promotion and Illness Prevention
Evidence of health promotion and illness prevention in community settings.
What to provide
- Case histories showing understanding of health inequalities and lifestyle interventions
- Psychoeducation about lifestyle
- Working with carers
- Engaging patients in self-care and self-management
- Advocacy role in developing health and social care
How to present
No evidence is required to be uploaded into this section. All evidencing requirements for HLO4 will be submitted under other HLOs.
HLO 5 Leadership and Teamworking
Evidence of teamworking and leadership.
What to provide
- Job description and reflection on leadership/management role
- Log activity of role
- Appraisal of role
- Attendance at management and leadership CPD events
- Assessment of chairing a clinical meeting (DONCS)
- Reflection on change management
- Reflection on service development activity
How to present
Grouped by activity.
HLO 6 Patient Safety and Quality Improvement
Evidence of patient safety and quality improvement.
What to provide
- Appraisal evidence demonstrating learning from incidents/complaints
- Shadowing a Serious Incident review or PSIRF Investigation
- Involvement in resolution of complaint
- Meeting minutes demonstrating participation in clinical governance
- Written report or presenting evidence at Coroner's Inquest
- Development of service guidelines
- Audit or service evaluation projects
- Quality improvement project
How to present
Grouped by activity/event. Quality improvement projects bundled together. Meeting minutes grouped by type.
HLO 7 Safeguarding Vulnerable Groups
Evidence of safeguarding.
What to provide
- Completion of child and/or Adult safeguarding training
- Summary of patient case involving safeguarding concern
- Relevant medico legal reports
- Meeting minutes evidencing attendance at safeguarding meetings
- Case demonstrating impact of victimisation/exploitation and trauma
How to present
Grouped by activity. Prevent training submitted together. Safeguarding meetings submitted together.
HLO 8 Education and Training
Evidence of education, training, and supervision.
What to provide
- Job description and reflection on teaching/supervisory role
- Log activity of role
- Appraisal of role
- Teaching activities with actual material and feedback
- Evidence of undertaking assessment and supervision of junior colleagues (WBPA)
How to present
Grouped by activity. Teaching evidence collated by session, assessment and supervision.
HLO 9 Research and Scholarship
Evidence of undertaking research and critical appraisal.
What to provide
- Job description and reflection on research role
- Critical appraisal reflecting on research methodologies
- Relevant research qualification certificate and dissertation
- Attendance at CPD events for research
- Publications and posters
How to present
Grouped by activity. Each critical appraisal with corresponding triangulated evidence submitted separately.
Knowledge Requirements
Primary Path
Completed Core Psychiatry Training (or equivalent) AND MRCPsych (or equivalent) passed.
Alternative Path
Consultant/Specialist experience in application specialty of a minimum of five years + Approved Clinician (Under the Mental Health Act England, Or equivalent).
Applicants must self-identify their KSE cohort (1A, 1B, or 2) based on their core competencies, specialist training, and experience. This determines the volume and type of evidence required.
Volume and Assessment Targets
The SSG specifies minimum volume and assessment targets for this specialty.
Total cases for HLO 2 (Cohort 1A)
Cases
Total cases for HLO 2 (Cohort 1B)
Cases
Total cases for HLO 2 (Cohort 2)
Cases
Case reports for HLO 3 Option 2 (Cohort 1A)
Case reports
Case reports for HLO 3 Option 2 (Cohort 1B and 2)
Case reports
Quality improvement project (HLO 6)
Projects
Teaching activities if no roles held (HLO 8 Option 2 - Cohort 1A/1B)
Activities
Teaching activities if no roles held (HLO 8 Option 2 - Cohort 2)
Activities
Critical appraisals (HLO 9 Option 3 - Cohort 1A)
Appraisals
Critical appraisals (HLO 9 Option 3 - Cohort 1B)
Appraisals
Critical appraisals (HLO 9 Option 3 - Cohort 2)
Appraisals
Currency Window & Evidence Volume
Currency Window
Years
Your evidence is expected to be submitted from the timeframe as described within each HLO (the time frame is all in WTE and doesn’t need to be consecutive) and overall 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
Additional Notes
You must self-identify your KSE cohort (1A, 1B, or 2) to inform your evidence submission.
We recommend that you do not submit more than one PDF document for each organisation per HLO.
If you have a piece of evidence that is relevant to more than one area, do not include multiple copies in your evidence. Instead, include one copy and cross-reference it.
All case history evidence should be organised by case and coordinated to tell the story of the patient and the work of the applicant.
Frequently Asked Questions
What is the Psychiatry of learning disability CESR portfolio?
How many framework units does Psychiatry of learning disability require?
What evidence is required for Psychiatry of learning disability specialist registration?
How long is the currency window for Psychiatry of learning disability?
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