Letter to Wes Streeting MP: RCGP and costs to trainees

See previous post about the RCGP and FourteenFish for context.

Today I’ve sent a letter to Rt Hon Wes Streeting MP, the Health Secretary, about what I see as an unnecessary and unfair cost being forced on every GP trainee in the UK. The Royal College of General Practitioners (RCGP) requires all trainees to pay at least £963 for access to its exclusive training portfolio platform, FourteenFish – with no alternative allowed.

It’s a compulsory fee for an electronic logbook, something that could just as easily be done on paper or via other digital platforms. At a time when the government’s 10-year workforce plan talks about removing barriers and recruiting thousands more GPs,¹ this arrangement is completely at odds with those aims.

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Dear Mr Streeting,

GP Trainee Costs and Barriers to Workforce Growth

Your Fit for the Future: 10 Year Health Plan for England¹ commits to “remove barriers to training and retention” as part of expanding GP training places and securing the future NHS workforce. Yet every GP trainee in the UK faces a significant and unnecessary barrier: the Royal College of General Practitioners (RCGP) requires all trainees to use a single commercial platform, FourteenFish, to record training and workplace assessments, at a personal cost of at least £963 over a three-year programme.

There is no alternative. Trainees cannot use any equivalent system, regardless of functionality, because the RCGP has granted FourteenFish exclusive control of the training portfolio. FourteenFish is owned by UnitedHealth, a private US-based healthcare provider. With over 3,500 GP trainees annually, this monopoly generates over £3 million each year, with no evidence of competitive procurement or public funding to offset costs.

This is, in essence, a mandatory fee for an electronic logbook – something that could be done on paper. It is a poor use of doctors’ personal funds, and it runs counter to the workforce expansion principles set out in your plan.

I urge the Department of Health and Social Care to:

1. Require the RCGP to review its exclusive arrangement with FourteenFish and allow equivalent alternatives.
2. Consider centrally funding or commissioning the portfolio so trainees are not personally charged for a mandatory requirement.
3. Ensure future portfolio systems follow open standards, enabling competition and fair pricing.

I am providing a copy of my correspondence with the RCGP for your review.² The RCGP’s own annual report³ repeatedly calls for increased GP recruitment, yet this costly, mandatory system undermines that aim. If the government is serious about removing barriers, this issue needs direct intervention.

Yours sincerely &c