A report by the Professional Standards Authority (PSA) has concluded that “there is not currently a clear case for immediate statutory regulation of sonographers as a separate profession.”
Prepared for Health Education England, the document acknowledges that there is “long-term shortage of qualified sonographers in the UK along with increasing demand for ultrasound and radiography services; in part due to their increasing importance in cancer diagnosis.”
The report notes that the “role of a sonographer requires a high degree of skill and clinical knowledge across a range of areas and for individuals to practise with significant autonomy. There are a number of inherent risks arising from sonographers’ practices, including from misdiagnosis and misuse of ultrasound equipment and the risks associated with carrying out what may be intimate examinations.”
The PSA publication continues, “Whilst we have seen evidence of instances of harm occurring, there is insufficient data suggesting widespread prevalence of harm, although this may be partly due to limitations with the data available. It has not been possible… to compare the incidence of harm arising from the practice of regulated and unregulated practitioners.”
The PSA estimates that there are 3000 sonographers practising in the UK, although not regulated as a distinct group, the majority are registered with an existing statutory regulator, generally as a radiographer, nurse or midwife. Most currently work within the NHS, although private provision is increasing, particularly in maternity care.
“Statutory regulation is already mitigating risks due to the fact that the majority of those practising as sonographers are already regulated in other professional roles. Additionally, all diagnostic and screening services are required to be registered with the CQC in England.”
Unregistered sonographers cannot train as supplementary prescribers, administer medicines under Patient Group Directives, or refer patients for clinical imaging involving ionising radiation.
The PSA says that “risks could be managed more effectively by strengthening clinical governance and encouraging the relatively low number of unregulated practitioners to join the Public Voluntary Register of Sonographers, although public protection would be strengthened if the register applied for accreditation or transferred practitioners to an existing Accredited Register.”
Charlotte Beardmore, the SCoR’s director of professional policy, said, “The report’s conclusions are very disappointing. The Society and College, along with the Royal College of Radiologists and the British Medical Ultrasound Society, as well as the Health and Care Professions Council, have been pressing for sonographers to become a statutorily regulated profession for a long time. That is a very substantial weight of professional opinion, which has apparently been ignored.”
She continued, “It is also difficult to understand because the PSA say there is evidence of harm being caused to patients. How they can justify their stance if, by their own admission, the current situation is compromising patient care?
“It cannot be right that a person with no training or standards can buy or rent an ultrasound machine, call themselves a sonographer, and perform examinations on individuals who are unlikely to be aware that they are not a professional.
“We will be talking to Health Education England and the Department of Health and asking them to disregard the PSA’s findings and to press ahead with regulation.”
The document says that regulation should be considered again “if the changes to routes (of) entry to the profession and to the practice of sonography identified in our report materialise. This includes any significant increase in the number entering the role through the undergraduate route and increased vulnerability and complexity of patients undergoing ultrasound procedures.”