More guidance that is incompatible with FASP…..
We’ve been supported by some inspiring professionals within the NHS. We’ve been signposted to yet more relevant content that has seemingly been disregarded by around half of the trusts in England. The College of Radiographers (CoR) and The Royal College of Radiologists (RCR) have published “a minimum level of expectation” on Quality Standard for Imaging (QSI). These “expectations” concern CT, MRI, IR, NM and ultrasound imaging (US).
This QSI 2021 publication “represents the judgements of panels of lay representatives, radiographers, radiologists, medical physicists, and sonographers who have overseen its creation and revision. It reflects wide consultation and valuable comments and suggestions received from professional colleagues and relevant UK government agencies, professional and regulatory bodies. The QSI aims to improve the quality of care for people attending an imaging service. It sets out best practice in order to improve patient care and outcomes. Clinical practice is a continually evolving field, and the QSI will be independently reviewed every four years”.
We feel the following are relevant extracts which are contained within the guidance for ultrasound; “Outcome measure; The service has reviewed national and professional guidelines and evidenced-based practice to inform its pathways and protocols. It has evidence that its protocols comply with the requirements for the pathways it provides. Audits show that these protocols and pathways are being followed and reviewed”.
“Indicative inputs –The service should have considered national practice to reflect the local delivery of the service, including but not limited to the guidance from BMUS, SoR, RCR, Fetal Anomaly screening programme, the Society for Vascular Technology of Great Britain and Ireland and the NICE”.
“Notes; Reviewers should expect to see that all guidance has been considered in the context of local delivery and adapted for use within the service. This QS cannot be met by generic reference to national guidelines without local consideration”.
We feel this is yet more guidance that hasn’t been considered by the trusts that aren’t retaining views. It appears trusts are simply relying on the non-prescriptive "generic" national guidance from FASP – and ignoring everything else despite the directions above. It appears that none of the trusts in England have actually considered “national practice” when it comes to fetal cardiac view retention as nobody is aware of what everyone else is doing. It's wrong for trusts like ours to simply quote FASP guidelines whilst ignoring all the additional, more recent guidance from further clinical bodies.
We certainly feel our family didn't receive a quality standard. CoR and RCR have acknowledged clinical practice evolves and there is a need to re-visit guidance and practice - which they do every four years. This ongoing responsibility appears to have been lost on half of the trusts and FASP.