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Ultrasound scans are used to detect anything from gallstones to musculoskeletal problems. They are a standard part of medical diagnostics, increasingly delivered outside an acute hospital setting.

But when things go wrong, it can take a long time for the issues to come to light. West Sussex Clinical Commissioning Group is this week speaking to a number of patients who had non-obstetric ultrasounds between two and a half and three years ago, carried out by a private company with any qualified provider status.

The company has gone into liquidation but work carried out by two sonographers in the old Coastal West Sussex CCG area has been re-examined. Of 1,800 scans, those involving 29 patients have revealed severe or moderate harm.

Sonographer is not a protected title and sonographers are not regulated by the Health and Care Professions Council (although individuals doing sonography may be registered as radiographers). There is a voluntary register but statutory regulation has been sidestepped. According to the British Medical Ultrasound Society, there is no legal requirement to hold an ultrasound qualification in order to work as a sonographer.

Most hospitals would expect applicants to have a postgraduate certificate or diploma in sonography but many CCG AQP contracts seem only to mention “staff qualified to appropriate levels of skill and experience”. Whether this was relevant in this case may only be clear once the full clinical harm review is published.

Worrying silence for sector

Social enterprise bosses fear the sector has been forgotten in the Department of Health and Social Care’s recent white paper on integration and transformation in the health service.

They’re worried commissioners will take this as a signal to move some of the services they provide in-house. With £97m worth of social enterprise contracts up for renewal over the next 12 months, Social Enterprise UK has asked Matt Hancock to make it clear these organisations are part of the integration agenda. In fact, some social enterprises fear they have already lost contracts because of a lack of clarity over their role.

The role of these organisations in supporting the health service is wide-ranging, with roughly £1bn in contracts currently in place with NHS providers, and about 100,000 people employed. A large chunk of these contracts are for community services – the role of which is a key area of focus for integrated care systems.

Five days later and the DHSC is yet to respond to the letter – which also asks for existing contracts to be extended whilst proposals make their way through Parliament – or to HSJ’s request for comment. Until Mr Hancock explains exactly what “integration” means for social enterprises, bosses fear for their future.