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The world of medical ultrasound – A President’s perspective

Pamela Parker
8 July, 2021  

Pamela Parker is a consultant sonographer working within radiology of the Hull University Teaching Hospitals NHS Trust. Pamela has over 25 years’ experience in the field of medical ultrasound and is President of the British Medical Ultrasound Society.

There can be no one truly unaffected by the COVID-19 pandemic. This ongoing international health crisis has impacted on lives around the world; arguably, none more so than those of front-line health care workers. Speaking as a sonographer based in a large teaching hospital in the north of England, I have experienced first-hand the significant impact the pandemic has had on service delivery, my colleagues and, most of all, our patients. However, as an optimist, I like to believe that with every dark cloud a silver lining can be sought. Therefore, as an optimist, one opportunity the pandemic presents is the opportunity to reset normal within our clinical and professional landscapes. In some instances, of course, this happened rapidly and without time to pause and reflect. However, there has been an opportunity to review those services that were stopped and an opportunity to redesign as we move to restart planned care. Indeed, in my own institution, entire pathways have been remodelled, placing ultrasound imaging at the very core of where it was once an afterthought and poorly resourced or acknowledged. This has provided an ideal opportunity for modern ultrasound imaging to be showcased; those technological developments that have gradually become integral in diagnostic ultrasound imaging are now being recognised as essential to providing a powerful first-line core test for many patients, particularly those with delayed presentation and for whom swift assessments and management plans are required.

The British Medical Ultrasound Society

The British Medical Ultrasound Society (BMUS) has the core objectives: “to promote the advancement of the science and technology of ultrasonics as applied to medicine” and “to ensure the highest standards in practice are maintained”. Coupled with the changing role of ultrasound in patient pathways, BMUS has developed and provided education and guidance to all professionals working in the field of medical ultrasound. For BMUS, as the premier ultrasound society in the UK, the annual scientific meeting has been the stage to present developing best practice, new and emerging technology, and provide an opportunity to discuss research and development with like-minded professionals. Face to face events have clearly been impossible to hold during the pandemic, and difficult to consider planning in the immediate future. This, too, has led to the organisation pausing, reflecting, and redesigning what can be delivered. The need for support for ultrasound professionals has not diminished; indeed, with increasing role development, it can be argued the need is greater than before. A virtual webinar programme was developed by BMUS during 2020 to provide relevant, and pertinent, education and standard setting in line with the objectives of the organisation; a journal club via Twitter established, and now plans are well underway for a full virtual online conference. None of these are likely to have developed without the dark cloud of the COVID-19 pandemic causing much disruption. 

Webinars and e-learning, in the world of medical ultrasound at least, have developed at a pace in the last 18 months. Having a creative and innovative team supporting an online training programme has been essential and has unearthed hidden talents within the BMUS administrative team as well as the multitude of professionals who have supported and volunteered to provide the education programme. As with many professional charitable organisations, BMUS is reliant on volunteers who are willing and able to share their time and knowledge with peers. Despite the difficulties we have all faced, the willingness of our clinical colleagues to support the ongoing education and professional guidance output of BMUS has been phenomenal, and yet, despite this wealth of readily available material, attracting new members and minimising attrition of existing members remains as very real challenge. It is pleasing to note that the sonographer membership of BMUS has marginally increased recently, but attracting medical colleagues, in particular radiologists, to support the organisation remains difficult. BMUS prides itself on being a multi-disciplinary organisation and there to support any professional using medical ultrasound within their scope of practice. In the UK, by far the largest professional group is sonographers who primarily use ultrasound in their everyday clinical practice. Essentially, a sonographer is medical ultrasound! Radiologists learn ultrasound as a core skill during their training but, and as is common in larger establishments, radiologists are specialty-focused and many use cross-sectional imaging modalities or interventional suites that are now far removed from the hands-on image acquisition, interpretation and reporting of ultrasound imaging. Increasingly, there are numerous non-radiology professions using medical ultrasound as a tool to enhance their clinical practice and to guide patient management. Indeed, many Royal Colleges now have specific ultrasound training programmes and competency assessments that their members are expected to complete to be able to deliver this point-of-care ultrasound (PoCUS). The importance of PoCUS cannot be overstated. As such, publications produced by our emergency medicine, chest, and intensive care colleagues ensured shared learning of the signs of COVID-19 on lung imaging, which became critical as hospital admissions rose in the first and second waves. The aim of BMUS is to bring this multi-disciplinary family together and recognise the benefits of sharing knowledge and skills but, at the same time, not alienating those for whom medical ultrasound is a professional career choice; sonographers, physicists, and radiologists alike. 

BMUS has had, as do many societies, sub-committees whose roles are to ensure the objectives of the organisation are met. Longstanding and hardworking committees such as the physics and safety, publications and education committees have been the workhorses of the society since its inception. Latterly, new committees have been set up to reflect the changing professional landscape and, the now more diverse, users of medical ultrasound. PoCUS and obstetric clinical imaging groups have been established to support improvements in these critical fields of medical ultrasound. The professional standards group was established to better nurture and enhance working relationships with like-minded professional bodies and organisations. A consultant sonographer interest group has been established to promote career development for non-medical ultrasound practitioners and show case the very best in ultrasound innovation. However, membership of the society and an engaged workforce, from whatever background, is essential to the future success of these committees and the wider BMUS family. BMUS upholds the highest standards of practice and, it is with this aim, that the society engaged with Health Education England (HEE) in a project to increase the sonography workforce. BMUS, in collaboration with the Consortium for Accreditation of Sonographic Education, the Royal College of Radiologists  and the Society of Radiographers has been integral member of this HEE sonographer workforce project group and progress is slowly being made.  Every arm of health care is under pressure to increase activity, improve turn-around-times, and deliver safe and effective care. There is no profession that is not struggling with workforce capacity, with vacancy rates well documented; radiology and sonography are no different, and solutions have needed. While BMUS has no remit to act as a trade union or provide workplace advice, it does have a remit to ensure standards of practice are optimised, safe and of high standards. The multi-disciplinary nature of its membership ensures BMUS is well-placed to offer opinion, advice and guidance as part of this collaborative approach to HEE as the path of defining and developing an ultrasound / sonography career framework emerges. 

Whilst there have been significant challenges, in the workplace, professionally and personally over the last 18 months there has been opportunity to reflect and set a new or revised course for the future. The publication of the Richards Report in 20201 and NHS Long Term Plan in 20192 has provided an opportunity for the role of sonography, and the role of medical ultrasound within healthcare, to be established as essential in first line investigations in critical, acute and planned care, the improvement of obstetric outcomes, and in guiding interventions within an out-patient setting. Professionals working with medical ultrasound, as a career path or using it as a tool, have the opportunity to embrace new ways of working and new pathways. Supporting national organisations, such as the BMUS, provides the opportunity for professional societies to have a voice around the table at national discussions and highlight the benefits of a highly trained, well-motivated, recognised workforce. There are challenges ahead but none that cannot be faced together. 

I am proud to represent BMUS and my multi-disciplinary ultrasound colleagues and will work hard in my tenure as President to turn those challenges into golden opportunities as we head into the new normal of 2021 and beyond.

About the author

Pamela Parker is a consultant sonographer working within radiology of the Hull University Teaching Hospitals NHS Trust. Pamela has over 25 years’ experience in the field of medical ultrasound. Her specialist interests are uro-genital ultrasound, contrast and fusion-guided imaging. She has established the first sonographer-delivered fusion and transperineal prostate biopsy service within radiology in the UK. Pamela is studying part-time for a PhD investigating the role of ultrasound within the active surveillance of prostate cancer.

References

  1. Diagnostics: Recovery and Renewal – Report of the Independent Review of Diagnostic Services for NHS England. www.england.nhs.uk/publication/diagnostics-recovery-and-renewal-report-of-the-independent-review-of-diagnostic-services-for-nhs-england/ (accessed June 2021).
  2. NHS Long Term Plan. www.longtermplan.nhs.uk/ (accessed June 2021).