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The sonographer degree apprenticeship journey

15 October, 2019

Author: Trudy Sevens, Professional Lead for Diagnostic Imaging and AHP Lead for new models of education, Sheffield Hallam University

Ultrasound machine

The journey for developing a degree apprenticeship begins by submitting an expression of interest to form a trailblazer group to the Department for Education.

This took place in November 2016 for sonography, following initial discussions between Sheffield Hallam University and the South Yorkshire Working Together Vanguard site, led by Mid Yorkshire Hospitals NHS Trust.

Following an open consultation, approval was gained in March 2017 with a launch event later that month at Sheffield Hallam University, where the initial trailblazer constitution was established. The trailblazer group included a wide range of representatives:

  • A chair person and deputy chair
  • 12 employer organisations (NHS, independent and private providers)
  • Higher education institutions (universities)
  • Society and College of Radiographers (SCoR)
  • British Medical Ultrasound Society (BMUS)
  • The Consortium for the Accreditation of Sonographic Education (CASE)
  • Society for Vascular Technology
  • Skills for Health
  • Institute for Apprenticeships and Technical Education
  • Health Education England (HEE)

The remit of the trailblazer group was to develop and write the occupational standard and end point assessment (EPA) for sonography. However, despite the wide range of stakeholders involved, engagement with the group was variable, creating challenges around consistency.

The first step was to agree the typical length of the proposed degree apprenticeship route (36 months) as well as the academic level (level 6). The occupational standard writing began and included the skills, knowledge and behaviours relating to sonography, mapped against the expected duties of a sonographer on completion of a degree apprenticeship.

The first draft of the occupational standard was circulated to the wider trailblazer group for consultation in June 2017 and received 37 responses. During this time, HEE's work, relating to the graduate sonographer scope of practice and career framework, gained momentum. Meanwhile, the required format of the standard for the Institute for Apprenticeships (now the Institute for Apprenticeships and Technical Education (IfA&TE)) changed, creating additional challenges.

The occupational standard was finally approved for delivery in September 2018 and work commenced on the end point assessment (EPA), which was submitted in February this year and gained approval with amendments in April 2019, with final approval in August.

The EPA proved challenging because the IfA&TE does not accept reflective pieces or a portfolio (which are common within health profession degrees) as the methods of assessment for the EPA. So the sonographer EPA has two separate assessment methods:

  • An observation of practice, including report writing and a question and answer section, and
  • A professional discussion.

The apprentice must complete both of these within a three month period, after verification that the gateway for entry to the EPA has been achieved. The gateway is attainment of the educational credit for the award, a level of English language, and consistently performing at or above the required level.

The assessment methods are pass or fail and the apprentice cannot gain the end award, for example BSc in Diagnostic Ultrasound, unless all have been passed; this makes the degree apprenticeship for sonography an integrated degree.

With the exception of one existing BSc for ultrasound nationally, this model is completely new for sonography education and will revolutionise the training. Currently, sonographer education is at academic level 7 (Masters) and is typically undertaken by professionals registered under a different title, such as Diagnostic Radiographer or Midwife, wanting to extend or advance their role.

The new model will allow direct entry students to train as sonographers, eliminating the need to train in a different profession first. This direct entry route will also allow for more gradual training over three years to develop the required skills, knowledge and behaviours which are aligned to the sonographer career pathway.

However, there are still challenges ahead. A recent Professional Standards Authority report (commissioned by HEE) to assess the means of managing the risk of harm to the public by sonographers concluded that, currently, there is no case for the statutory regulation of sonographers as a separate profession in England.

Therefore, the title 'Sonographer' remains an unregulated and unprotected title allowing anyone to call themselves a sonographer, even without formal training. Concerns relating to the decision have been raised by professional bodies such as the SCoR and Royal College of Radiologists, as well as BMUS and CASE. The situation may change in the future as increasing numbers of unregulated sonographers emerge from new direct entry training routes.

An additional challenge relates to the funding band (university course fees), allocated by government for degree apprenticeship routes. For sonography, this has been set at £19,000 for a three year course (£6333 a year). This is a drop of £8750 over the three years for universities with current annual student fees of £9250, raising concerns over the financial viability of offering sonography degree apprenticeships.

Despite these ongoing hurdles, the success of reaching final approval for delivery should be celebrated as a major achievement for all involved. The journey has included many twists and turns but has resulted in a new model of education for sonographer training to secure the future of the profession.

It is now time for the workforce to embrace the change.

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