NHS England has released updated guidance on supporting people using maternity services during the Covid-19 pandemic.
This replaces the document published in October and further aims to facilitate the safe return of a support person to all antenatal and postnatal care settings.
The aim of the new document is to provide women with ‘access to support at all times during their maternity journey... Trusts should facilitate this, while keeping the risk of transmission of the virus within NHS maternity services (including to pregnant people, other service users and staff) as low as possible’.
The document highlights the challenges in some Trusts but states that ‘it is important that trusts should find creative solutions to overcome them while ensuring the safety of their staff and that they can access support and advice to do so’.
The SoR is supportive of people being accompanied to all medical examinations, however we recognise there are significant challenges as a result of the pandemic in enabling this to be universally implemented, with significant challenges being faced by some services.
Ultrasound scans are highly complex clinical examinations and an essential component in the maternity pathway. While the SoR is keen to support the principles of the guideline whereby people can be accompanied for their scans, this must only happen if the safety of the patient and sonographer is not compromised.
The document states that all services must make every reasonable adjustment to comply. The SoR cannot support this principle if there remains a risk to the safety of the patient, staff and other service users.
Risk assessments must be carried out. Any identified risks must be addressed in consultation with sonographers and infection prevention and control teams. The SoR has suggested solutions for some common problems identified in risks assessments around this issue (visit: https://covid19.sor.org/diagnostic-radiography-faqs/ultrasound/). There are also particular areas of concern which must be addressed (see below).
The SoR will continue to support members in ensuring they are able to deliver safe services for patients and staff. If the recommendations from the risk assessment cannot be implemented safely within a service, we will support our members in raising concerns.
Members or Representatives who continue to face challenges should contact the SoR for support and advice directly by emailing [email protected].
To download the guidance, click here: Supporting pregnant women using maternity services during the coronavirus pandemic: Actions for NHS providers.
Key issues for sonographers
The particular areas of concern which must be addressed are:
Room size
- If the room is not large enough to maintain a 2 metre distance or the support person has to move closer because appropriate equipment is not available, eg there is no second monitor, then it is not safe to proceed with the additional numbers present.
- If the room is not large enough to meet government guidance, it must not be used or numbers in the room need to be reduced. It is important to ensure safe facilitation of an extra health care professional if a second opinion or confirmation of unexpected findings is required.
Covid-19 testing requirements
- If rapid Covid-19 testing for patients and their support person is used prior to ultrasound scan appointments, Trusts need a policy in place to comply with legislation on mandatory isolation for anyone testing positive for Covid-19.
- Clear information will be required for patients and the support person to minimise the risk of delays, scheduling challenges and /or overcrowding in the waiting rooms if implementing rapid testing.
- Space is required to undertake the testing and wait for the results, thus minimising the risk to other vulnerable patients at increased risk from virus transmission.
Risk assessment
- The risk assessment must recognise and highlight the support mechanisms for sonographers in managing any conflict. The Trust must have a policy in place to manage non-compliance with trust and government guidance.
Information policy
- SoR supports ultrasound departments developing a policy to clarify the arrangements in advance of the examination, to ensure that all parties are fully aware of the requirement for enabling a support person to be present. If there is a risk of safety being compromised the sonographer should be supported in managing this appropriately in line with agreed policy.
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