The Ockenden Review into maternity services at Nottingham University Hospitals NHS Trust highlighted heart-breaking accounts from families whose lives have been impacted by avoidable harm during pregnancy.
Published on 24 June, the review describes experiences shared with Donna Ockenden and her team of patients going unheard and being dismissed when raising concerns in pregnancy. Their painful stories have been shared with courage and determination to ensure this does not happen to any other families.
For sonographers, the report highlights the reality of the working conditions they have been working under for years, trying to deliver high quality, safe care while under-resourced and overstretched.
Complex and demanding work
The review was established by NHS England in May 2022, following significant concerns, raised by local families, regarding the quality and safety of maternity services at Nottingham University Hospitals NHS Trust (NUH).
Katie Thompson, president of the Society of Radiographers and a sonographer, said: “Sonographers are highly skilled imaging professionals working under intense pressure, with ever-expanding workloads and chronic staffing shortages to deliver increasingly complex and emotionally demanding work.
“As workloads increase and new initiatives are introduced to improve antenatal and neonatal outcomes, sonographers are often stretched to the limits, impacting their ability to train additional sonographers and access essential training for their own skills development.”
The review emphasises the impact of systemic failings, including weak governance, bullying, leadership failures, inconsistent communication and a lack of psychological safety on conditions within the trust, which let down both families and staff.
Sonographers recognise the importance of their work, the danger of making mistakes, and the impact that has on pregnancies and outcomes. However, they require support from the organisation to provide the level of safe care needed.
Immediate and essential actions
Several of the “immediate and essential actions (IEAs)” directly support improvements to ultrasound service, including:
- Safe staffing levels – ensuring obstetric sonographers are included in workforce models is essential to maintain a sufficient number of trained professionals available to provide timely, high-quality scans
- Consistent onboarding for all staff – including all sonographers involved with providing antenatal ultrasound services
- Protected training time – enabling sonographers to complete additional training needed to perform the role well. This includes all practitioners performing ultrasound growth scans, having appropriate training to undertake and report examinations to meet the standardised methods used in the recommended charts
- Standardised escalation pathways, improved communication and teamworking – providing sonographers with clear, consistent processes for raising concerns about unexpected, uncertain or concerning findings, while ensuring that ultrasound results are acted upon
- Appropriate recording of ultrasound examinations – providing a mechanism to record images and the ultrasound report or findings, regardless of who does the scan or where the scan is carried out. This allows for more consistent oversight of the pregnancy progression and improves quality control processes across different ultrasound operators.
Katie said: “We welcome these actions, as not only are they about preventing harm, they are also about creating a working environment where sonographers feel valued, supported and can practise safely.
“We also recognise that the emotional impact of the report findings on families, sonographers and all staff working within maternity and neonatal care. If sonographers need additional support during this time, please reach out to NHS employee assistance programmes, your HR department, your local SoR representative, Freedom to Speak up Guardians or a trusted colleague or friend.”
Access NHS employee assistance programmes, and find out more information, online here.
Read the Ockenden Review online in full here.
(Image: Photo by Christopher Furlong, via Getty Images)