Abstract
In this issue there is a timely paper from Parker and Wolstenhulme on career structure for UK sonographers. Sonographers are health professionals who are trained to perform ultrasound examinations in countries including the UK, USA and Australia. On mainland Europe such examinations are performed usually by medical practitioners. Career structure is an important topic for a large proportion of the Ultrasound readership, many of whom are sonographers working in the UK National Health Service (NHS). The article by Parker and Wolstenhulme reviews the possibility of employing sonographers in a limited scope of practice and paying them a salary within the NHS ‘Agenda for Change’ pay band system lower than normally expected. In the UK currently most NHS sonographers are at band 7 or above and there have been lengthy debates on which areas of practice may be appropriate for, and expected of, sonographers in either higher or lower pay bands. Arguably, a satisfactory resolution will not be found until there are radical changes in service delivery and education, which may then support employers’ decisions to pay some sonographers less. The conclusion of the article was that, at the time of writing, no suitable role could be found to justify paying a sonographer less than a band 7 salary. However, in view of the current UK economic climate, that may change rapidly, and not just within ultrasound.
Pay issues are likely to affect other NHS staff as well as sonographers. NHS hospital trusts are under pressure to reduce costs and a significant portion of the NHS budget is spent on staff wages. Re-profiling of current roles within the NHS is a reality which may be faced by not just sonographers but nurses, midwives, vascular scientists and echocardiographers. The impact on medical practitioners is less clear since they are not subject to NHS ‘Agenda for Change’ working terms and conditions. However, it is unlikely they will be immune from all streamlining activities. Although some employers stress that re-profiling exercises will always be aligned to job evaluation and does not necessarily mean that staff will be down-banded, it is clear that economy lies at the heart of proposed changes.
We are all practising in difficult economic times and the number of employer investigations into the potential for restructuring of roles, as described by Parker and Wolstenhulme, is likely to increase considerably in the near future rather than decrease. It may be an appropriate time for all those involved, both managers and sonographers, to review practice and ensure they are providing what is expected of a band 7 sonographer in terms of interpreting, reporting and communicating ultrasound findings. Certainly, sonographers fulfilling these requirements, and providing a high quality service, represent value for money for employers and, ultimately, the tax payer. In the meantime, I continue to hope that pioneering ‘direct entry’ ultrasound courses may emerge soon.
This issue also features an interesting investigation into what may lie behind UK women's desire to find out the sex of their unborn baby. Articles on optimal imaging procedures for renal artery stenosis, ultrasound imaging of skin lesions, and inter-observer reliability in shoulder ultrasound are also included. Finally, reasons for why some ultrasound practitioners appear to be immune to the development of work-related musculoskeletal disorders are offered by Gibbs and Edwards in a short study we did earlier this year. Two letters on the same subject are also featured toward the back of this issue and follow on from debate in last August's Ultrasound.