Holding back excellence

In February this year the Command Paper ‘Enabling excellence: autonomy and accountability for healthcare workers, social workers and social care workers’ was published by the Government. It emphasizes the important role of the regulatory bodies in setting standards of training, education and competence for health-care workers, which help to protect the public. It goes on to state that in the current climate of ‘any willing [qualified] provider’ it is more important than ever that professional regulation is enforced. So far so good and I could not agree more. As I read on, I began to think that a serious commitment to regulation for sonographers was finally taking shape. However, my heart sank as I began the next section which talked of the expense and the ‘significant costs associated with statutory professional regulation’. It seems that, purely as a cost-saving exercise, the Government is highly unlikely to regulate any new group of health-care workers in the foreseeable future. Although sonographers per se are not mentioned anywhere in the document, I believe an exception will not be made for sonographers despite the fact that the Health Professions Council (HPC) recommended regulation in 2009. This is disappointing for at least three reasons: firstly the public continues to be put at risk from incompetent and/or unscrupulous ultrasound practitioners who are currently unregulated. Secondly, an absence of regulation, and the setting of associated important educational standards will, in my opinion, continue to impede the development of direct entry ultrasound education programmes. This will, in turn, keep UK workforce numbers low. Finally, I am disappointed because the cost of regulation is funded entirely by registrants and, after a quick calculation based on figures provided in Annex A of the paper, the HPC seems to generate an annual surplus of £600,000, money which arguably could be invested in supporting the start of regulation of the ultrasound workforce. The only chink of light, as I see it, is that the paper proposes that a voluntary register may be a ‘stepping-stone’ to statutory regulation in the future. The United Kingdom Association of Sonographers began such a register some years ago, which is now held by the College of Radiographers since the two organizations merged. Furthermore, they have lobbied consistently for regulation. Let’s hope those efforts may yet pay off in the long run. In the short term, sadly, we probably have to wait for a few high-profile malpractice cases to emerge in the lay press first. Welcome to the May issue of Ultrasound, which starts with a collection of top quality pictorial reviews. In view of their wide ranging breadth I predict the majority of clinical ultrasound practitioners will find at least one of these articles very useful as an educational refresher or to add to their existing knowledge of appearances. A team from Limerick describes the use of ultrasound as a technique to measure accurately adipose layers at different body sites and suggest a detailed scanning protocol. Interestingly, figures from this study indicate that fat thickness changes very little after a given amount of force and that the application of further compression makes no significant difference thereafter. Although this finding is by no means the focus of the study, I can’t help but consider this information when I hear frequently of