Letter: ‘GP registrars are carrying the consequences of a decision over which they have no control’

The BMA’s GP registrars committee has written to the owners of FourteenFish, a privately-owned assessment platform, demanding answers following changes to the platform they say disrupted training for GP registrars. Read their full letter below

Dear Cleveland Henry [interim COO at OptumUK],

We wish to express our serious concern regarding the recent unannounced and unilateral changes made to the FourteenFish platform, alongside the significant operational issues now being experienced by GP registrars and trainers. These changes were introduced without prior notice, without meaningful consultation, and at a time of peak pressure within training programmes. 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.

January and February represent a critical period within GP training. 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. We are also aware that unannounced maintenance on 27 January prevented ARCP panels from proceeding as scheduled. This has undoubtedly created additional pressure for registrars, trainers, and NHS staff involved in progression processes.

Following these changes, external assessors are now required to create and access a FourteenFish account in order to complete assessments, with the previous email-link option removed. This approach is inconsistent with other portfolio providers; for example, Horus, used by Foundation Doctors, which does not mandate account creation for assessors. 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.

As a trade union, we are clear about what is now required:

1. 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.
2. 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.
3. Clear evidence of mitigating actions already taken to ensure that no trainee has been disadvantaged by platform changes or system downtime to date.
4. 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.
5. 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.

More broadly, these issues raise questions regarding reliance on commercial digital platforms for critical training and progression processes, particularly where changes are implemented unilaterally, without sufficient notice, and without safeguards for GP registrars. This is a matter we will continue to uphold on behalf of our members. Going forward, we would welcome a commitment to open and regular dialogue with GPRC as a keystone stakeholder and the recognised voice of GP registrars nationwide.

To be clear, the current situation is not acceptable and places GP registrars at severe risk of unfair progression outcomes. We therefore expect an urgent response to our points as above within the next

We remain available to meet and work constructively to resolve these concerns on behalf of GP registrars across the UK.

Yours sincerely,

Dr Oliver Salazar, BMA GP registrar committee chair

Dr Aimen Maksoud, BMA GP registrar committee deputy chair

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.’ Read the full story here