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Wednesday, September 23, 2015, Issue 135

Assistant Practitioners ‘not the answer’ to shortage of obstetric sonographers

Assistant practitioners

Proposals that Assistant Practitioners (APs) could be used to help address the shortage of sonographers by undertaking fetal growth scans has prompted the SCoR to restate its position that such examinations fall outside AP's scope of practice. 

The organisation is, however, prepared to review detailed proposals for pilot studies should these be put forward.

A newly-issued SCoR position statement acknowledges that whilst close to one in five sonographer posts are vacant and demand for ultrasound services is increasing, a comprehensive and rigorous case would have to be made that could justify a reappraisal of current practice for fetal growth monitoring and assessment scans.

Comparisons have been made to the abdominal aortic aneurysm screening programme which makes extensive use of APs but the Society points out that there are no meaningful comparisons between the two examinations because fetal growth scans are significantly more complex.

The SCoR position statement says, “(Fetal) growth scans require considerable training and experience and include critical and often difficult to obtain measurements such as the fetal head circumference, abdominal circumference and femur length. Estimated fetal weight is derived from these measurements which are also displayed on a growth chart. 

“Sonographers are also required within standard examination protocols to assess liquor volume, fetal presentation/lie and placental position. Operators need to be alert to any possible anomalies and Doppler ultrasound assessment will usually be included.”

The document goes on to note that the examination “requires a ‘holistic’ assessment by the sonographer. Interpretation of fetal growth profiles and decisions over onward referral are also required.”

Richard Evans, the SCoR’s chief executive officer, said “We have to keep our minds open to proposals that could help relieve the severe shortage of sonography practitioners but patient safety must be paramount.

“The SCoR supports developing practice and innovation and we would welcome being involved in pilot studies which look at developing the workforce across ultrasound but to have our support they must fulfil a range of criteria which are set out in the position statement.”

Amongst the criteria is the proviso that sonographers who are required to take part in a study must be consulted fully and that there is no compromise with the safety of service users, or with members’ professionalism.

“We have not at this time approved or been formally asked to approve any pilot studies,” Richard said.

Click here to read the ‘Assistant Practitioners and Ultrasound Scans for Fetal Growth Monitoring and Assessment Position Statement’.

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