GP trainees at risk of disadvantage due to ‘detrimental’ platform changes, BMA warns
The BMA has demanded answers following changes to a privately-owned assessment platform which they say have disrupted training for GP registrars.
The union’s GP registrars committee has written to the owners of FourteenFish, the supplier used by the RCGP for its trainee portfolio, criticising the ‘immediate and detrimental’ impact of recent updates to the platform.
GP registrar committee co-chairs Dr Oliver Salazar and Dr Aimen Maksoud said that the changes were introduced without prior notice, without ‘meaningful consultation’, and at a time of ‘peak pressure’ within training programmes.
FourteenFish was acquired by EMIS (now Optum) in 2022 and is used by around 13,000 GP trainees in the UK, according to its website.
The committee has raised concerns about changes to the platform which require assessors to create an account, which have created ‘additional administrative burden’ and ‘delayed or prevented’ completion of assessments essential for registrar progression.
GP registrars completing a workplace based assessment (WPBA) collect evidence for an educational supervisor’s report (ESR) every six months. At the end of training, an annual review of competency progression (ARCP) panel decides on a trainee’s competence for licensing based on the evidence in the ESR and trainee portfolio.
A registrar’s placement assessor is expected to submit evidence for the ESR to the FourteenFish platform.
However, updates to FourteenFish last month mean anyone completing a case must now register an account. The BMA has claimed this has meant submitting the evidence is now delayed or does not happen at all.
As well as this, the platform started unannounced system maintenance on 27 January.
The GP registrars committee said that January and February represent ‘a critical period within GP training’ as registrars are required to ensure their portfolios are up to date and are subject to scrutiny to confirm they remain on track to progress.
The introduction of new account requirements has created ‘substantial barriers’ to completion of workplace-based assessments and signoffs, and registrars continue to experience ongoing disruption, the letter added.
The co-chairs said that the changes have resulted in GP registrars ‘carrying the consequences’ of a commercial platform decision over which they have no control.
They said: ‘To be clear, the current situation is not acceptable and places GP registrars at severe risk of unfair progression outcomes.’
The letter demanded an ‘immediate reversal’ of the access changes, a ‘clear and detailed rationale’ of the unannounced system updates, and ‘explicit assurance’ GP registrars would not be disadvantaged at interim ESR or ARCP.
It said: ‘Changes to an integral part of the system used to assess GP registrars should not have been made without proper consultation and assessment of the potential impacts.
‘The impact has been immediate and detrimental. External assessors already operate under significant time pressure, and the additional administrative burden has delayed or prevented completion of assessments essential for registrar progression.
‘While security considerations are acknowledged, the lack of prior notice, absence of contingency planning, and failure to consider the practical realities of assessment completion have resulted in GP registrars carrying the consequences of a commercial platform decision over which they have no control.’
BMA GP registrar committee demands
- Immediate reversal of the recent changes while a full impact assessment is undertaken, with mitigations developed in collaboration with the BMA GP Registrars Committee (GPRC) and those responsible for training and progression;
- A detailed explanation, following internal review, outlining why these changes were implemented without communication or consultation with GPRC and other key stakeholders, and what actions will be taken to prevent recurrence;
- Clear evidence of mitigating actions already taken to ensure that no trainee has been disadvantaged by platform changes or system downtime to date;
- A clear and detailed rationale, beyond general references to “enhanced security”, explaining the urgency and unannounced nature of these changes, particularly when other portfolio platforms continue to enable access for unregistered assessors;
- Explicit assurance that GP registrars UK-wide will not be disadvantaged at interim ESR or ARCP as a result of assessments delayed or prevented by platform changes or system downtime.
Source: BMA
More broadly, the co-chairs warned the recent issues raised ‘questions regarding reliance on commercial digital platforms for critical training and progression processes’.
The letter drew comparison with other portfolio providers like Horus, used by foundation doctors, which does not mandate account creation for assessors.
A spokesperson for FourteenFish said: ‘We apologise for any inconvenience caused by recent unplanned maintenance and the changes which require non-users to register to submit cases. We will reach out to the BMA to speak with them directly about their concerns.’
It follows the removal of FourteenFish Consult, a free recording tool used by GP trainees to record consultations, last October.
The tool was developed to be used for the now-defunct Recorded Consultation Assessment (RCA), although the BMA argued it was still a useful, cost-effective and GDPR-compliant tool for trainees to record consultations.
Pulse has contacted the RCGP for comment.
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READERS' COMMENTS [3]
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RCGP should have been proactively monitoring and urgently responding to this at the time.
They should have shared their information more widely and promptly.
They should also have admitted and shared their information or any inout to the PA debacle.
Add this to the ongoing list of RCGP failures to act or to act at the early required early stage. The RCGP serves only its elite imo and the only successes I can see are the number of Dames, Sirs etc it has created . How is this completely out of touch imo group in a travesty in my view being allowed to negotiate the contract with the BMA on our behalf? Otherwise no real idea where my decades of continuing RCGP subscriptions have disappeared to but I can have a good guess?
We keep scoring so many own goals for Trainees in their pathway that just adds to the disillusionment with training pathways.
14F markets itself on convenience yet initiates this system