Ultrasound scans for fetal monitoring and assessment purposes currently fall outside of the assistant practitioner scope of practice.
Ultrasound assessment of fetal growth is typically carried out when pregnancies are deemed to be high risk – either because of maternal factors such as diabetes or high blood pressure, but also to monitor fetal growth restriction suspected during antenatal visits. Growth scans in pregnancy require considerable training, experience and expertise as they include critical and often difficult to obtain measurements, including fetal head circumference. Sonographers are highly skilled experts in ultrasound who undertake these scans.
The need for a position statement
In 2015, severe workforce shortages within ultrasound led to discussions as to whether assistant practitioners (APs) could perform fetal growth scans to help alleviate pressures on the stretched sonographer workforce.
Following concerns raised by the Ultrasound Advisory Group, the SoR were asked to draft a formal position statement on assistant practitioner practice in relation to fetal growth monitoring and assessment with ultrasound. It outlined reasons why conducting such scans fell outside of AP's scope of practice.
Recent updates reflect changes in practice
This position statement has been updated in 2024 in light of on-going challenges with sonographer workforce capacity and changes to practice. It also aligns with the statement from CASE (the Consortium for the Accreditation of Sonographic Education) around focused ultrasound education.
Gill Harrison, professional officer for ultrasound explains: “The importance of ultrasound to assess growth and fetal development in pregnancy, and to reduce mortality and morbidity rates cannot be underestimated. Much work has been undertaken to improve outcomes in the third trimester of pregnancy by the introduction of NHS England’s Saving Babies' Lives care bundle.
Due to the complexity of the growth scan, the need for complex decision making, communication and the use of Doppler in fetal assessment, the SoR feel that growth scans for fetal monitoring and assessment purposes currently fall outside of the assistant practitioner scope of practice.”