How to upload recordings made outside of FourteenFish

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75 comments

  • Dr Thomas Kelly

    We would really appreciate an update regarding consent and uploading remote consultations. 

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  • Dr Simon Smith

    Phil - So you've now changed:

    "If the first option (verbal consent) is selected, then as long as this is clearly audible towards the start of the recording then that’s all that’s required."

    to 

    "If the first option (verbal consent) is selected, then as long as this is clearly in the recording then that's all that's required.

    Does that mean the same thing?

    Where is the option for electronically recorded consent that is clearly specified as an option in the RCGP documents below?

    1) MRCGP Examination Recorded Consultation Assessment Policy: Last revised 5 June 2020 (https://www.rcgp.org.uk/-/media/Files/GP-training-and-exams/CSA-page/CSA-RCA/MRCGP-examination-RCA-policy-june-2020.ashx?la=en)

    Sections 2.4 to 2.9 says verbal consent must be at the start and end of the recording. Also says that if consent is not evidenced on the recording written (paper or electronic) consent should be obtained and retained by the candidate.

    2) MRCGP Examination Recorded Consultation Assessment Candidate Handbook To be read in conjunction with the RCA Policy Document and FAQs Last revised 9 June 2020 ( https://www.rcgp.org.uk/-/media/Files/GP-training-and-exams/MRCGP/mrcgp-rca-candidate-handbook-090620.ashx?la=en)**

    Page 3: “It is the responsibility of the candidate to obtain consent from the patient under the usual guidance for training and GDPR. This may be on the FourteenFish RCA Platform directly where this is used to record the consultation, written (paper/electronic) or verbally (on camera, the timing of which will not be counted as part of the ten minutes to be assessed or off camera, but a record kept)

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  • Phil Wilks

    Hello everyone! Thank you so much for your patience and I'm very sorry it's taken a long time to get a straight answer to your questions.

    We have been working hard on the uploading process to make it as seamless as possible to allow you to upload a large variety of file formats (basically any video or audio format in existence), and also making sure we can cope will big files up to 1Gb.

    Late yesterday evening the system for uploading recordings was made available. This morning we also had some further clarification from the RCGP about exactly what is and is not acceptable as consent evidence.

    The help article on this page has been updated this morning, so you can see exactly what the process for uploading recordings is.

    I'll try and address some recurring questions here, and then separately reply to your more specific questions...

    Regarding patient consent, ultimately the RCGP make the decision about what is and isn't acceptable. At the time of writing this (about midday on 12th June) the RCGP are in the process of producing more guidance on exactly what is an isn't acceptable as evidence. Once this is available (Monday hopefully) then we will summarise the guidance here.

    For the time being, we have now had confirmation from the RCGP data protection officer that the following evidence will definitely be acceptable...

    • Verbal consent as part of the recording
    • Screenshots of a text message (SMS) conversation with the patient
    • A photo or scan of a signed consent form

    Our understanding is that notes made by practice staff in the patient's clinical notes will not be acceptable. Basically, you either need to have the patient verbally consenting in the recording, or you need a screenshot, scanned document or other image that shows the patient actively giving consent. Just to be clear, this doesn't apply to recordings made via the FourteenFish platform because we collect consent automatically. 

    When examiners are assessing your consultations for the RCA exam, they will take into account the time taken for getting consent and will not stop watching the consultation after 10 minutes. For example, if it takes 30 seconds to get consent from the patient then the assessor will be lenient and give you around 10m 30s to conduct the consultation. 

    Due to this, it makes most sense to identify the patient first as you normally would (e.g. DOB, first line of their address) and then ask for consent for recording.

    Please do feel to ask any other questions you have below.

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  • Phil Wilks

    Hi Simon – thank you for highlighting the change in wording. It does mean the same thing, I was just trying to ensure people didn't think they needed to get consent before identifying the patient. I've now updated the wording further to make this clear, and added in my comment about examiners taking the time taken to do this into account.

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  • Phil Wilks

    Hi Simon – I'm really sorry but I'm afraid I can't give any more details on the official RCGP policy on any other form of electronically recorded consent that doesn't fit criteria above. I honestly don't know the answer, but hopefully we will soon and then I will update this page. In the mean time I would advise you to contact the college about this on exams@rcgp.org.uk or 020 3188 7660.

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  • Dr Ali Bakir

    Thank you Phil that's very helpful.

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  • Phil Wilks

    Hi Debjoy – Yes, a print out of an Accu RX conversation is fine. I'm guessing you can get a PDF of this? If not then just take a screenshot.

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  • Phil Wilks

    Hi Heidi – The RCGP have an standard consent form that you can use 

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  • Phil Wilks

    Thomas Kelly – We were aware that this was causing trainees stress and I'm very sorry that it's taken a while to get answers to what are fairly straightforward questions. Hopefully the comments on this page and the new help article above will address everything but please let us know if not.

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  • Phil Wilks

    Mohammad Hussain – Phoning the patient and putting them on speaker is fine as long the assessor can hear and understand them on the recording. You might want to try a phone call using the built in phone call system on FourteenFish though as this would probably give you better quality. You can do this without a mobile phone signal as you can just use a landline.

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  • Dr heidi carroll

    Thanks Phil, very much appreciate your responses and help as we try to get to grips with this. I note the RCGP form you suggest states 1y before recordings deleted- can I just check this as thought with data protection we had changed this to three months? thanks for clarifying

    Heidi

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  • Dr Leeanne Minto

    Please could you confirm whether or not consent at the beginning of the consultation is sufficient. And if not will it be okay for me to the submit paper consent to confirm the patient is still happy to use the recording?

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  • Dr Suleman Sami

    Hi Phil,

     

    Once again thanks for your responses. really helpful

     

    I just find it Slightly odd that for video consultation (on RCA 14fish platform) a consent is needed before and after consultation but for a telephone call a consent at the end of call is not sought through this platform.

    why is that?

    The guidance from RCGP; if i am correct was consent before and after all consultations whether it is video, face to face or telephone?

    thank you

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  • Dr John Vernon

    Hi. 

    A time saving question. If there is attached to my file a written consent form, and I don't need to therefore verbally consent the patient when uploading video consultations made outside of the FourteenFish platform, can I cut out the start of the video where I confirm identity/dob, and just start with 'how can I help?'. And, if not and I should keep it in, will this be considered as part of my 10 minute consultation, or discarded as would be the case if I were verbally consenting and doing ID checks prior to this... I know I'm talking about 10seconds here, but that final gem might come in at 10 mins 9 seconds... 

    Thanks. 

    John

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  • Dr Sonakshi Khorana

    Hi,

    Just wanted to check does checking identity, DOB and confirming consent count in the total 10 mins? Checking identity and consent is taking up valuable 30 seconds. Thanks

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  • Dr Simon Smith

    Hi Phil - Thanks for the update and appreciate your help. Could you possible enable us to mark the uploaded recordings as being verbally consented plus being able to upload evidence of consent? I have a few that I have consented verbally at the start and then confirmed via text messaging after the event. Thanks

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  • Dr Raghad Orton

    Hi, I want to check about uploading accurx messages used to consent patients as they include the patient's name, NHS number and DOB. Is it acceptable to upload a screen shot of this or would it breach confidentiality?

    Thanks

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  • Phil Wilks

    Hi Raghad – Consent evidence that is uploaded to our system has the same level of security as the consultation recording itself, so this would be covered by our data protection documentation at https://www.fourteenfish.com/datasecurityforpractices in the section "How will the recordings be stored?". We will update this documentation soon to make it clear that this also covers any attachments.

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  • Phil Wilks

    John Vernon – You should keep the identity check in the consultation. The examiner will take into account the time it takes to ask for recording consent if this is part of the recording.

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  • Phil Wilks

    Sonakshi Khorana – The time taken for things like the patient connecting to the video call will be taken into account my the assessor, and the same goes for any time spent getting consent for recording from the patient. However, verifying the identity of the patient is part of "normal life" when performing a remote consultation so this would be included in the 10 minutes and you won't get an extra allowance for the time taken to check their identity. I should say that ultimately the RCGP are setting the rules here so it is best to check the RCGP website or contact their Exams team to be sure.

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  • Phil Wilks

    Simon Smith – You don't need to submit evidence of the patient confirming their consent after the consultation, it's just the initial consent that is required for the RCA.

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  • Dr Raghad Orton

    Hi, for Face to Face consultations, if a patient signs the consent form only before the consultation started but forgot the sign after, do we need to ask the patient by text message to confirm their consent?

    Also, if my practice records all calls for training and I didn't ask one of my patients for consent at the start of the telephone call again, do i need to show further proof of patient's consent like text message?

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  • Phil Wilks

    Raghad Orton – It would be good to check they are still happy to have had it recorded, but you do not need to submit evidence of the second consent.

    In answer to your second question, you would still need to submit evidence that the patient actively consented to having the consultation recorded. Unfortunately evidence that all calls are recorded wouldn't be good enough, it needs to be a text message, paper form or embedded in the recording itself.

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  • Dr Thomas Kelly

    Hi Phil

     

    I have been seeking advice from the RCGP and had an email from them stating that checking the patient details would not be included in the ten minutes of assessment. 

    thanks

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  • Phil Wilks

    Hi Thomas – Please could you forward that email to support@fourteenfish.com ? We may need to update our guidance.

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  • Phil Wilks

    I've also had confirmation that checking the patient details is not included in the ten minutes allowed for the consultation. We will update our guidance shortly.  

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  • Dr Suleman Sami

    Thanks Phil, checking patient details is not included in the ten minites, is that only for consultations recorded outside of14fish or for all types of recordings?

    Thanks

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  • Phil Wilks

    Hi Suleman, yes sorry this applies to all consultations regardless of where they were done. The examiner will basically start a 10 minute timer at the start of the consultation's "clinical content".

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  • Dr Luke Tognarelli

    HI.

    I have done a lot of recordings outside of fourteen fish and up loaded to this platform. I have uploaded them and selected that there is verbal consent obtained in the video. 

    However I now believe that my verbal consent is not adequate enough to be accepted by the new college policy.

    Is there a way to edit current uploaded consultations so we can subsequently upload further evidence of written consent ? As I have deleted the recordings on my recording device and they only exist on this platform now.

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  • Dr Sonakshi Khorana

    Hi Phil,

    Thanks for all the info. Could I please just confirm -
    If we are getting verbal consent for recordings made outside of fourteen fish before the 5th, is this appropriate?
    Name
    DOB
    Address
    Consent - “is it okay with you if our consultation is recorded for exam and training purposes today? If you do change your mind at the end please let me know”
    I just want to make sure this is appropriate as the RCA handbook does not really give an example of verbal consent and what it should contain. Thank you. Look forward to hearing from you.

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