The most common ultrasound enquiries

Published: 18 October 2018 Advanced practitioners

The SCoR receives many telephone and e-mail enquiries relating to ultrasound. We try and provide as detailed and individualised a response as we can and will often include references to documents published by the Society and other organisations such as BMUS and NICE.

For #MUAM I thought it would be worthwhile identifying the five most common enquiry themes and where further information can be found.

1. Workload and the numbers of sonographers available 
Sonographers are being asked to reduce examination times so that more patients can be seen.

The SCoR has an advice document relating to this. A key point is that a sonographer has a professional responsibility to ensure that the time allocated for an examination is sufficient for it to be carried out and reported on competently, and for critical and urgent findings to be dealt with appropriately. 

This is vital for safe patient management. The document discusses the factors that need to be taken into account when determining examination times. There are three types of examination where recommendations or guidance by others exists. These are the two obstetric screening scans, which are the responsibility of the Fetal Anomaly Screening Programme (England), and equivalent organisations in the devolved countries.

NICE has a recommendation for examination times for growth scans for multiple pregnancy. The SCoR advice document provides links to an NHS Improvement tool for assessing examination times which takes account of all local circumstances. SCoR advice is that if this is not carried out, that there should be a minimum of 20 minutes for a ‘general abdominal’ scan. The full document should be read for context.

2. How to avoid work related musculoskeletal disorders (WRMSD)
The Society published some of the earlier research on sonographer WRMSD with The Causes of Musculoskeletal Injury Amongst Sonographers in the UK in 2002 and this has been added to over subsequent years.

There has also been a study by the Health and Safety Executive in 2012.

Click here for all current SCoR documents relating to this topic.

There are also documents and further information available published in other countries such as Australia and the USA. The following are for example only:
http://www.sonographers.org/our-profession/workplace-health-and-safety/
http://www.sdms.org/docs/default-source/Resources/work-related-musculoskeletal-disorders-in-sonography-white-paper.pdf?sfvrsn=8

There are from time to time articles published in the British Medical Ultrasound Society journal Ultrasound on sonographer WRMSD.

There is a section (1.9) on ergonomic practice and on ‘scanning the high BMI patient’ in the SCoR/BMUS Guidelines for Professional Ultrasound Practice.

3. Problems with distractions in obstetric ultrasound
These include family members present in the ultrasound room, requests to record on devices such as mobile telephones, fetal sexing, and ‘social’ activities such as preparing for ‘gender reveal’ parties.

This is a difficult area for obstetric sonographers as they try to balance what is a medical examination requiring very high levels of concentration and skill in a highly litigious area of practice, with the natural hopes, wishes and expectations of the parents and their family.

It is this implicit, yet not commissioned, ‘social’ element that makes these scans very different to other types of examinations. There can be pressures on sonographers to have, for example, young children in the room, provide an opinion of the fetal sex when this is not a screening programme requirement, and to allow filming of the examination as it proceeds.

There are sometimes requests to facilitate gender reveal parties. The sonographer may be included in the audio or video recording and these can be posted on social media without the sonographer’s consent.

Sonographers (including departmental managers) have also contacted us when there has been a complaint about the ‘social’ aspects and have felt that they have not been supported by higher trust management. A sonographer must be able to feel comfortable in their own working environment. The following two documents are available in the document library. New editions are being drafted which should be available by the end of 2018.
https://www.sor.org/learning/document-library/sale-images-determination-fetal-sex-and-commercial-aspects-related-nhs-obstetric-ultrasound-4
https://www.sor.org/learning/document-library/recording-images-patients-during-diagnostic-imaging-including-screening-and-radiotherapy

In 2015, the SCoR conducted an on-line survey into the themes of this common enquiry topic.

4. Statutory registration for sonographers 
The Society has been at the forefront of the bid for sonography to be a statutorily registered profession and for the title of ‘sonographer’ to be protected. Click here for a full history.

Sonographers were recommended for statutory registration to the Secretary of State for Health by the then Health Professions Council in 2009 but this did not proceed. 

Health Education England are preparing a new bid. If the case (which we feel is compelling) is accepted, it will start a process leading to statutory registration for sonographers. We will keep members informed about progress.

5. Suitability of an applicant for employment
Department managers regularly contact us with enquiries relating to the requirements for working as a sonographer in the UK and the registration situation. Sonography is listed under Tier 2 of the Migrations Advisory Committee (MAC) shortage occupations.

Our advice document applies. NHS Employers also provides advice.

Employers will need to take many factors into account and links to the documents above will help them with their decisions. Also see the Health and Care Professions Council requirements for English proficiency for international (non- European Economic Area) applicants for registration as a radiographer.