These guidelines were launched in August 2010 and contain guidance for fetal monitoring including ultrasound.
Key message: Trusts responsible for implementing changes.

National 18-20 week ultrasound Standards

The standards around the fetal anomaly scan have been launched by the NSC.
Key message: Trusts must meet the minimum standards by 1 April 2011.

This survey is similar to that undertaken in 2002. The West Midlands had a 100% response rate from Trusts.
Key message: No implications at this stage

Recommended criteria for measurement of fetal crown rump length.
Key message: Trusts to review and implement.

The resource cards devised by the NSC on screening programmes have been revised for sonographers to use.
Key message: Supplies are available for sonographers in the West Midlands via Local Screening Co-ordinators.

The audit of referrals has been published on the FASP website. Good Hope Hospital was the only West Midlands unit who submitted data to this project.
Key message: No implications at this stage.

The NSC FASP has produced a specification for obstetric ultrasound machines used to undertake screening scans (1st & 2nd trimester).
Key message: Trusts to use specification when purchasing new machinery and to review current machinery against it, to inform upgrade/replacement schedules.

The NHS Supply Chain is willing to facilitate the purchase of ultrasound machines, even for single items. When provided with a specification they will contact machine manufacturers to secure discounts. The benefits to Trusts (inc PFI units) are that they will not have to undergo a tendering process and they are able to state a preferred supplier.
Key message: Trusts to contact NHS Supply Chain (Ewan Bond) when purchasing new ultrasound machines.

The Health Professions Council has given further consideration to the application for sonographers to be regulated (this will allow direct entry training). It was agreed that the HPC will write to the Secretary of State for Health recommending a form of regulation, and those issues requiring further exploration would be detailed.
Key message: Managers should encourage everyone practising as a sonographer to apply to be entered on the public voluntary register.

New CRL charts for dating have been developed by the NSC. They are based on Robinson & Fleming (current RUG and BMUS standard); however, they vary from the equation used previously. A West Midlands chart/table has been produced to assist the implementation and supplies will be circulated to Superintendent Sonographers.
Key message: Ultrasound Depts to update their software by Apr 2009.

Published by NSC in Oct 2008. Supplies sent to West Midlands units in Sep 2008, copies to be distributed via Local Antenatal Screening Co-ordinators.
Key message: Ultrasound Depts to give sheet to all mothers arriving for 18-20 week scan.

A national screening programme for vasa praevia is not recommended. Click on the link to see rationale behind this policy decision.
Key message: Units should NOT be screening routinely for vasa praevia.

Regional guidance on the plotting of ultrasound parameters from 3rd trimester growth scans is available here.
Key message: Ultrasound depts to read new guidance.

The BCU courses in medical ultrasound will be submitted for CASE accreditation in May 2010.
Postgraduate course will have one intake per year (Sep only), the clinical and theory modules will be combined to form a double module.
Focussed courses - (Sep & Feb intake) new modules are being developed including dating for family planning, early pregnancy transvaginal ultrasound, and transvaginal ultrasound for infertility.

Subgroup Workforce
Chair J McHugo

A successful workforce investment bid has been submitted to the SHA for 18 extra postgraduate training places for sonographers over 3 years. The first cohort of trainees have qualified, and the second cohort started their training in Feb 2010.

Subgroup
Decreased
fetal movements
Chair J Gardosi

A RUG subgroup is to be established to generate a regional policy for ultrasound investigations for decreased fetal movements.
Key message: Interested parties to contact Jason Gardosi.

It had been agreed at a RUG meeting in May 2007 that the region would move away from dating pregnancies by BPD after 14 weeks to using head circumference (HC). The NICE antenatal guidelines recommend using CRL for dating, and when it is > 84 mm to use HC.
Key message: Trusts to stop measuring BPD.

The Regional Fetal Medicine service at Birmingham Women's will provide echocardiography at 16 weeks for referrals with abnormal tricuspid regurgitation (normal karyotype or low-risk screening results). Cases are being audited to establish the prevalence of cardiac abnormalities in this cohort.
Key message: Referrals are accepted by Regional Fetal Medicine.

Birmingham City University

National Institute for Health and Clinical Excellence

National Screening Committee

Royal College of Obstetricians and Gynaecologists

Strategic Health Authority