FourteenFish blog

Every month we add new content to our Clinical Library to help GPs stay up to date with the most common clinical topics. With over 100 modules already available, we make it easy to achieve your CPD goals.

In four weeks' time I’ll be cycling from Lands End to John O’Groats!

After losing my best mate Tim Pike last year I've been thinking about what I can do to help raise awareness for CALM and their work against suicide.

In response to the Covid pandemic appraisals were initially suspended. Then appraisals were restarted and a new appraisal template was provided that was designed to reduce the administrative burden of appraisals for Doctors. There was more of a focus on quality and the appraisal discussion and questions on wellbeing.

We are pleased to announce a new partnership with Practice Index. Practice Index is one of the UK’s leading providers of compliance, training and management software for primary care. The Practice Index HUB is a central place for all of your learning and compliance requirements, including eLearning, policies, safety alerts and CQC evidence management. 

FourteenFish is now part of EMIS Group and we are really excited about this change. Over the last few years we have become known for an easy to use, modern, Appraisal Toolkit and Trainee Portfolio for GPs. We plan to build further on this by reaching more doctors and health professionals with our appraisal system and have our trainee portfolio used by other specialities and training schemes. We want to increase our education offering, expanding on the content we already have and further develop our remote consultation tool for educational purposes.

We are really excited to announce our partnership with Blue Stream Academy, with the accompanying integration to the FourteenFish Appraisal Toolkit and Trainee Portfolio.

With Blue Stream Academy's range of market-leading digital solutions and our comprehensive portfolio platform, the new partnership and system integration will simplify life for GPs and nurses throughout the UK.

We're nearly ready to release the new FourteenFish Portfolio mobile app.

Use the FourteenFish Portfolio app to work on your Appraisal or Trainee Portfolio any time, anywhere. This app replaces the old Learning Diary app, which will eventually be retired once the Portfolio app is fully released.

Yesterday we had the worse outage of the FourteenFish website for several years. In total there were 35 minutes where our website was inaccessible, usually for 30 seconds to 2 minutes at a time. This happened between 12:50pm and 9:10pm yesterday.

Dear Users,

At FourteenFish we pride ourselves on two things – our easy to use systems and our excellent support service.

We have always worked hard to make sure that we provide a quick and informed support service but we realise that over the last couple of months we have been struggling to maintain this due to our Support inbox being inundated with requests. 

We expect you've heard that medical appraisals are resuming from October. The good news is that the GMC, AoMRC and BMA have agreed a new "rebalanced" Medical Appraisal 2020 process, which should reduce the amount of time it takes you to prepare for your appraisal and make it more supportive for you.

Free video modules in the GP Library

Dr Mark Coombe has produced two new videos on Covid-19 including one on telephone triage.  Both modules are free resources in our GP Library.  Download our Library app to access these or log in to your FourteenFish account on this website and go to Education.

If you were due to have your appraisal before October 2020 and you're a doctor then this has now been cancelled.

If this is the case and you use FourteenFish for your appraisals then at any time you can visit your main appraisal page where there is a link to cancel your appraisal. When you do this our system will...

Wouldn't It Be Nice If There Was An Easy To Use Resource To Avoid Medication Monitoring Errors?

Medication reviews are often a bit of a breather during a session. A lot of the time it can be really straight forward, particularly if the patient is generally fit and is only on a single blood pressure tablet.

We are thrilled to have been selected as the new supplier for the Trainee Portfolio for the Royal College of GPs.

The new Trainee Portfolio will be powered by the same platform as the FourteenFish Appraisal system which is used by thousands of GPs across the UK.

There is now a much more convenient way to manage your learning entries in FourteenFish.

Learning entries are things like CPD, QIA, Significant Events, Feedback and so on. Basically anything in the Supporting Information area of your appraisal.

Over the past 6 months, we’ve been working on some big changes to FourteenFish.

We’ve collaborated with appraisees, appraisers and trainees to help us improve the usability of the system. And from today, we’re inviting all our users to try the beta version of the system by going to beta.fourteenfish.com.

Over 50 organisations use the FourteenFish platform to manage their membership databases, websites and events. This announcement only affects users who are part of these organisations – typically LMCs and other membership organisations.

The FourteenFish Library is a collection of over 50 CPD video modules created by FourteenFish covering common General Practice topics and over 900 knowledge test questions.

We are always looking for ways to help make life easier for medical professionals. That might look like a new tool to help make recording CPD even easier, or it might be a new partnership with a like minded organisation.

NHS England released new guidance last week. Here is what it said in a nutshell...

If you are a Doctor working less than 40 sessions per year you will now be required to fill in one SRT form as part of your appraisal. For more details on this change and a more in-depth look at where this guidance came from we recommend this great blog by Dr Mark Sanford-Wood from the BMA.

Training can be one of those tricky things to stay on top of individually and as a practice. More so these days with the ever increasing list of training requirements.

Some training is just a one-off; other training needs to be repeated yearly or every three years. On top of that keeping track of all the certificates to use as evidence can be a real pain. 

The 9th of April 2018 saw the release of the latest GMC Guidance on appraisal and revalidation.

Dr Susi Caesar (GP and Service Lead at Wessex Appraisal Service) has written a great summary for anyone wanting a refresher/update on the appraisal and revalidation guidance and a more in-depth look at any changes. Read the full article here.

Reviewing Revalidation

In January 2017 Sir Keith Pearson published his report assessing the first 5 years of Revalidation. For me there were two key messages that stood out. Firstly, to keep Appraisal and Revalidation requirements simple - it was felt that some organisations and Responsible Officers were placing additional requirements onto Revalidation adding to the perceived burden. Secondly, that doctors should seek patient feedback more frequently. It is this second point that I wish to concentrate on here.

As you may know we have a few online packages, two of which are the Passing the AKT Package and the CSA Package .

Here at FourteenFish we are all about making essential processes as easy as possible.

We have discussed at length how to make this better for everyone and we are now very pleased to announce we have put in place a brand new system to create, manage and purchase for your team.

You asked, we delivered.

Actually nobody asked, but we thought we'd kick off 2018 by launching a subtle visual refresh of our products.

Why the change?

Most of our icons were designed in 2013, and we've expanded our offering a lot since then with things like the Library and more recently our Compliance Passport. The old icons looked alright, but we felt we could do better.

After a fun and exciting 2017 we are prepped and ready for an epic 2018! Here is a quick rundown of our 2017…

New Faces 

Adam Batty our new Operations Manager started with us in July and has hit the ground running building a great rapport with LMC teams, Practice Managers, users and of course the team here at Fish HQ.     

Recently we reached over 20,000 users and we are now at nearly 23,000!

Although word of our Appraisal Toolkit seems to be spreading far and wide people have been asking for some information about our system and tools to share with colleagues and friends.

As a doctor moving to the UK from abroad you will face various challenges just one of these is the PLAB 1 Exam.

This exam is carried out 4 times a year in test sites in both the UK and abroad.   The PLAB 1 Exam is pitched at the same level as trainees in the 2nd year of the foundation programme, and tests your ability to apply knowledge to care for patients. All questions relate to best practice in the UK. Its is a 3 hours exam 200 single best answer test.

We have recently launched our Tasks module as part of the offering of the FourteenFish website. This is a feature we built sometime ago and used ourselves at FourteenFish. We were hesitant about putting this on the website as we are conscious of already offering numerous products but then we realised it could be useful for everyone and it just didn't seem right to not let everyone have access to it. 

Here at FourteenFish we are always looking for ways to help make appraisal easy for busy Doctors like you!

Some of you may be new to appraisal or maybe you have had a career break and want to jog your memory on a few appraisal requirements? 

We're always looking for ways to make our website easier to use. Today we've launched our new website design which uses a wider layout to make better use of the available space. We've also made over 100 smaller usability improvements.

Leadership in the NHS is often criticised for being top heavy, loosing relevance and importantly empowerment as it is filtered down to those working at the coal face. There is a tremendous wealth of experience and a bubbling pot of innovative ideas amongst the grassroots. They must be nurtured, supported through followership and scaled to achieve impact.  GP+ Networking and Fourteenfish have both been born from experience of the poor alternative. Duncan and I share a common background. Both GPs with multiple extended roles collected along the way. We have gone the step further beyond ‘wouldn’t it be great if…’. We have taken many difficult steps since starting that journey but plan to work synergistically to ensure digital innovation is used to bring the fulfilment back to professional development in general practice and for professional development not to add to burnout but be used to fight back against it. 

Managing your locum finances needn’t be as overwhelming as one often expects. The biggest difference when starting locum work is that instead of deductions being automatically taken from your monthly salary, you must manage your invoices, tax and pension contributions yourself. Here are key questions many new locum GPs have about their finances.

So you've heard about our awesome web clipper for the Learning Diary but you use Microsoft Edge instead of Internet Explorer? Have no fear! You can still use the web clipper, although it does require a bit of extra work...

Morning Rituals

I am in training... again. In a few weeks I am going to attempt to run 147 miles along the Viking Way path in Lincolnshire (http://www.vikingwayultra.com/). Should be fun? I prefer to get my running done first thing and have the rest of the day to spare. It feels like it impacts less on work and family life that way. In the winter it is not easy. It is dark and cold both on leaving and returning and I try various tricks to get myself out of bed each morning. I am finding it increasingly hard.

We get asked the same questions quite often regarding our Appraisal Toolkit, especially from new users. Here are the answers!

1) Am I able to use FourteenFish for my appraisal?

Short answer: Yes

Getting started on your Appraisal with FourteenFish

We are here to light the way through the dark and sometimes overwhelming world of the appraisals. Follow me for an action packed few minutes of toolkit literature, like a well laid out Ikea instruction pamphlet. 

We get contacted quite often by people who are new to using our Appraisal Toolkit and are confused by the PDP section. We've never been completely happy with it and in September we decided to go back to the drawing board. Today we've launched a completely revised way of managing your PDP which will make preparing for your appraisal even easier.

Picture this, you are at work and you get, a very rare, 5  minutes before your next patient walks through your door. You panic a little. ‘5 minutes!!! Quick! Think! What shall I do?’  Eureka!….emails!’ 

Some of you may already be familiar with the Learning Diary but it is our fear not all of you are. It really does help take the stress out of appraisal preparation and it’s free! 

How it works

Say hello to our new appraisal toolkit layout!

The appraisal overview screen (pictured below) is now...

• easier to use
• more logically organised
• simpler for first-time users

The functions that you are likely to use less often are now in a section at the bottom, and we've made a big effort to reduce the amount of text on the page. As always, we're trying to make your life easier and save you time.

You asked, we listened. To make our clinical update videos more accessible, we've moved to monthly pricing. This means you can now get an unlimited pass to all 20 modules, with more being added every 2-3 weeks.

I hate saying this but social media does not come naturally to me. I hate saying it because I have always been an early adopter, into technology and admitting it doesn't come easy is admitting that I recognise that I am now behind the curve. Over the last 6 months I have made a conscious effort to post more and have learnt from younger colleagues to whom it appears second nature. I reckon I am now starting to get it.

In light of recent court cases where reflection has been using as evidence should we continue to direction of reflection on our practice? Yes, but with caution.

This is a result of a recent question that came into Fish TV episode 5. If you haven't seen any Fish TV yet stop reading this and watch the video below!

We've just launched version 1.4 of our awesome Learning Diary app for iPhone and iPad! Here's what's new...

Automatic saving

No need to save your work manually any more. Instead, any changes are made as you go along. You can even close down the app in the middle of typing something and pick up where you left off another time.

We have a file size limit for appraisals - why is this and should we be scanning in files for supporting information anyway?

After consultation with NHS England we recently introduced a file size limit for our appraisal summaries of 9 MB. This was not to try and save on server space but rather to try and prevent large appraisal summaries that were causing difficulties in uploading to a national appraisal management system.

At FourteenFish we are often asked if we have any tips for Locums undergoing Revalidation. Whilst the following is aimed at GP Locums I hope the following should still be useful for hospital doctors, nurses and others.

Being a Deputy Practice Manager in a busy 13,500 patient practice, I know all too well the daily stresses of keeping on top of the workload in general practice.

There seems to be a growing focus on patient involvement. With contractual requirements including Friends and Family Test and Patient Participation Groups, and CQC requirements to show you are responsive to your patients needs (for those who haven’t had their visit yet, they also ask to see the findings and action plans from patient surveys).

4 years ago I left my career as a Family Doctor to start FourteenFish. Despite being very happy working as a GP it was an easy decision as I knew if I didn't give this opportunity a try I would always think what if.

We've been busy working on some exciting improvements to Communities this week.

We wanted an easy way to react to a post rather than type out a comment. The "like" concept is pretty widespread now, so instead of reinventing the wheel we decided this was a good option. We also added a few other reactions, so if you just want to show you found something funny or shocking you can say that too. Facebook added a similar feature a few months ago, although we prefer our icons ??

This is a guest blog post from Dr Rachel Boyce, a GP and trainer in the Thames Valley.

@BucksGPST

Last week I attended an extremely positive event in Winchester, Hampshire. This was a "how was it for you" review of a pilot where practice nurses had undergone Appraisals using an adapted version of the doctors medical appraisal model. The appraisers had training and they then appraised other nurses, often external to their practice. 

Last week we launched the FourteenFish Library.

One of the reasons we are excited about Library is that we think it completes our circle of learning suite offerings. When we talk about this circle we mean taking a knowledge test or watching a module then capturing that learning into the Learning Diary.

Today we rolled out a new feature on the FourteenFish website – notifications!

The main purpose of this is so that you can get notified about stuff happening in your Communities.

For the last 6 months we have been working with Dr Mark Coombe on the FourteenFish Library and we launched this to our users last week.

We feel Library completes the circle in our learning suite line up. Our vision is that you can:

Our first user review was March 2013 and since then we have a steady flow of reviews from GP's, Locums, Hospital Doctors, Practice Managers and Appraisers.

Since the release of our Nurse and Midwife Revalidation Toolkit in April 2016, we are now receiving positive reviews from Nurses and Midwives using our system.

Benefits for doctors

As an appraiser I'm often asked ‘Should I use a toolkit or should i use the MAG MAF?’. So what are their advantages? Well the MAG MAF is good and has served us well and will continue to do so but it does have some limitations. It is a PDF and so is only available where the PDF is stored.

What is reflection?

A question I often get asked is: ‘What actually is reflection?’ and ‘What makes good reflection?’ Well reflection is a set of processes to identify what you need to change in order to be a better doctor. It is not a case of recording how you feel or listing the content of a meeting but more about what you would’ve done differently.

I certainly don't remember a time when General Practice was more under strain. The increasing work demands, along with decreasing funding, means that practices are looking for smarter and more efficient ways of working.

Today we start a series of regular blogs to help doctors, nurses and appraisers to gain the most possible benefit from the appraisal and revalidation process.

Over the next few weeks I will cover some of the issues that I often get asked about in my role as one of the Appraisal Leads for NHSE Yorkshire and Humber, in particular questions about “What is good enough supporting information?”

One of the questions we get asked a lot is "what counts as CPD"? Does it have to be a course attended or an online learning module and who judges this. The answer is any of these can be counted as CPD but it is the learning and the reflection that is the key.

Up until now we’ve been offering various services (surveys, appraisals, event bookings and so on) under the name of Revalidation Toolkit. Although we started out as a revalidation tool, we realised the word “revalidation” was restricting what we were doing and confusing people. Although medical revalidation remains one of our key areas we now offer a lot of other services. Some people also know us as myLMC which is even more confusing.

We have today launched a major update to both our Appraisal toolkit and Learning Diary.

The system remains familiar and easy to use but there are some big new features that we are very excited about.

Today we have changed the pricing for our appraisal toolkit and surveys. We've tried to make it simpler to understand our prices, which were quite complex before.

What are the new prices?

I'm delighted to announce that I'm joining FourteenFish Ltd (the company behind Revalidation Toolkit).

I've worked as a GP Partner in West Yorkshire for 31 years, and I've been involved in medical education, appraisal and IT development throughout my career.

Our app has been available to download for a couple of months now, but we've held off publicising it heavily as we wanted to make sure it worked well and get feedback from a small group of users before encouraging everyone to use it.

Appraisals are a part of life, in almost every industry and every business.

Some people grow to love them whilst others hate them. It is vital that appraisals are conducted in a proper manner for any benefits to be gained or skills to be developed for future progression. That’s why it’s important for tools that help conduct an appraisal should be relaxing and straightforward to use, so the process can be as painless as possible. 

Continuing professional development (CPD) is a feature that exists in many industries around the UK. It was introduced to the health sector with the purpose of improving safety and quality of care provided for patients. Recording CPD has been left with individual doctors to identify their own CPD needs, how to address them and undertake the CPD that will support their professional development and practice.