Sonography and the regulation of workforce

A page covering sonography recruitment and regulation.

20 December 2023

Sonographers have previously been taught medical ultrasound at postgraduate level in the United Kingdom (UK).  Many sonographers have a healthcare background in, for example, diagnostic radiography, nursing or midwifery.  Developments in direct entry postgraduate and undergraduate ultrasound education have enabled non-healthcare professionals to enter the sonographer workforce. This includes the approval of an integrated BSc (Hons) apprenticeship in sonography by the Institute for Apprenticeships and Technical Education.

Most ultrasound programmes in the UK are accredited by the Consortium for the Accreditation of Sonographic Education (CASE). A programme typically lasts between 12 and 24 months, and leads to a postgraduate certificate (PgC), diploma (PgD) or MSc. Programmes leading to a BSc (Hons) award typically take three years. There are approximately 18 Higher Education Institutions offering CASE accredited ultrasound programmes in the UK and Ireland. 

Many sonographers working in the UK are educated and trained overseas. There is no comparative list of ultrasound qualifications from around the world available and clinical practice and education in other countries may vary from that in the UK. Employers must make their own assessment of competency.

The title of sonographer is not legally protected. These newer entry methods into the sonography workforce alongside recruitment of sonographers who originally trained overseas add to the existing complexity around sonographer regulation. Many sonographers are statutorily registered as they originally trained for example as a diagnostic radiographer, nurse or midwife but through no fault of their own statutory registration is not possible for all sonographers. 

What this means in practice for employers

When recruiting to sonographer vacancies, it is important for employers to carefully consider their registration requirements.

Many employers prefer their sonographers to be statutorily registered i.e. as a radiographer with the HCPC, or nurse/midwife with the Nursing and Midwifery Council (NMC) and this is a local decision. It is fair to expect individuals who are able to register with a regulatory body such as the HCPC or NMC to do so, however, we would urge employers to consider that for some otherwise well qualified sonographers who have trained from different professional backgrounds where regulation doesn't exist or who are direct entrants into sonography training, statutory registration is not possible. By insisting on statutory registration you could be further limiting your pool of candidates in what is recognised as a shortage specialty by the UK Government Migrations Advisory Committee.

When considering your registration requirements for a sonography position, please be aware that there are some legal restrictions for sonographers who are not statutorily registered, which prevent them carrying out elements of a role:

  • Sonographers who are not statutorily registered cannot act under Patient Group Directions for the administration of drugs and medicines, or train to become supplementary prescribers. They are allowed to act under Patient Specific Directions but those requiring them to do so must ensure their competence.
  • Sonographers who are not also statutorily registered cannot act as a referrer for clinical imaging examinations involving the use of ionising radiation.

Voluntary registration

Sonographers may apply to be registered on the Professional Standards Authority accredited (voluntary) Register of Clinical Technologists (RCT). The RCT replaced the Public Voluntary Register of Sonographers which was run by the College of Radiographers and closed at the end of February 2021.

NHS Jobs

When posting adverts for sonographer vacancies on the NHS Jobs service consider your use of the pre-application filtering question for registration. This question will automatically prevent otherwise well qualified sonographers for whom statutory registration is not possible from applying to your vacancy.

Employment and workforce practices

There are several areas where employers can provide assurance of the competency of their workforce.

  • Recruitment - clear expectations and the use of NHS Employment Check Standards in addition to recruiting for values and behaviours.
  • Preceptorship – provide structured support in the initial stages of employment.
  • Supervision - ensure appropriate supervision of individuals where it is required.
  • Continuing Professional Development - ensure staff continue to meet the professional requirements of their role and are up to date in their practice.
  • Clear standards, expectations and boundaries - ensure appropriate delegation so that individuals do not operate outside of their competence.
  • Effective appraisal - embed organisational values and behaviours into individual objectives.
  • Policies - embed into day to day practice and support staff to challenge issues of concern appropriately.

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