We have had hundreds of enquiries via our advice line about whether partners should be able to attend scans in person, and if not, whether a partner should be able to take part in a scan appointment remotely. This blog post explores the issues.
Should partners be allowed to attend scans in person?
Yes if at all possible. The NHS England and NHS Improvement guidance published on the 14th December 2020 on visiting restrictions for maternity services recognised that partners are not visitors, and that support from a chosen companion is a “key component of safe and personalised maternity care”, and that this support should be available to women/birthing people at “all stages of their maternity journey”.
Trusts were urged to urgently complete any action required to enable partners to be present at every stage of maternity care including reconfiguring their space if necessary.
Separate guidance has been issued for each of the devolved nations.
How can partners be involved in scans if the Trust/Board decides that partners can’t be present in person at the moment?
The joint guidance from the Society of Radiographers, the British Medical Ultrasound Society), the Royal College of Obstetricians and Gynaecologists (RCOG), and the Royal College of Midwives (RCM) supports “the saving of a 10–30 second cine clip of the fetus at the end of the scan and allowing the woman to record this on their mobile phone to share with family after the examination, if facilities for this allow.”
Can’t the entire scan appointment be filmed or screened?
The latest General Medical Council consent guidance, in addition to advice from the British Medical Association recommends that when patients are asking to record a consultation for their own purposes, doctors should accommodate their request. The recommendation that consultations should be recorded with the healthcare professional and patient’s consent so that the patient can reflect on it later formed part of the “First Do No Harm” (Independent Medicines and Medical Devices safety Review) report published in July 2020. The Medical Defence Union advises that recording an appointment means more information is retained which aids effective communication and benefits both the clinician and the patient.
However the Society of Radiographers have argued that a scan is not a consultation but a clinical procedure. The joint guidance sets out three concerns:
1. Guidance suggests aiming for the shortest possible examination times to reduce risk, as scans are often carried out in small and poorly ventilated rooms, with the woman and sonographer in close contact. It is also important to ensure that examination times are not extended, to keep busy antenatal ultrasound clinics, where there are current staffing pressures, running as smoothly as possible.
2. Holding a mobile phone in this way leads to a taut abdomen, which makes scanning extremely difficult, if not impossible. It might also impede the ultrasound practitioner’s position, making it difficult to acquire some views.
3. It is not usual practice to support filming of entire medical or diagnostic examinations. Filming an entire procedure may increase the risk of distraction for the practitioner and thus lengthen the examination procedure.
Birthrights, National Maternity Voices, and other organisations wrote to the SoR/BMUS in April asking them to engage with service user representatives to look at constructive solutions to address both the concerns of sonographers and women/birthing people and their partners. This offer was declined.
AIMS, Birthrights and a number of other organisations wrote again to SoR in November regarding the points above. In response to the first point, we do not believe there is any reason why participating in a phone call would involve the examination lasting any longer than having the partner or a support person in the room. In addition spending time dealing with questions from the second parent or supporter may be vital to enabling the pregnant woman or person to understand the situation fully and make informed decisions.
In response to the second “taut abdomen” point we see no reason why this cannot be resolved through discussion with the pregnant woman/person or person and asking her/them to place the phone next to them with the phone on speaker.
On the final point, whilst there is no doubt that conducting ultrasound examinations is highly skilled work, the guidance offers no research or evidence to support the claim of increased distraction leading to errors or more lengthy appointments due to video calls or streaming. It could be asserted that it is usual practice in many areas of healthcare to carry out work requiring a high degree of skill and/or concentration whilst continuing a dialogue with the patient, any supporters present and other staff.
The latest NHSE guidance on visiting restrictions for maternity services emphasises that partners are not visitors and should not be regarded as “optional extras”. If a Trust decides that they really are unable to accommodate partners, allowing scans to be filmed or streamed seems a very small concession to make compared to the huge difference it makes to those affected.
Do sonographers have the right to say no to individuals requesting to film or stream their scan?
Sonographers have a right not to appear in any footage (this is their own personal data) and also need to be able to go about their job. However as explained above, we do not believe that this is incompatible with filming or streaming a scan.
Where individuals are filming for their own purposes, this is their own personal data and the General Data Protection Regulations are not engaged, as long as professionals and other service users are not captured.
However, in order to preserve a relationship or trust, we would recommend asking the sonographer for consent before filming/streaming the scan, and having a respectful discussion to resolve any concerns. However it is not an adequate explanation of why an individual cannot film or stream their own scan to simply state that this “is against Trust policy” without further explanation. Arguably, an individual asking permission is simply a matter or courtesy given that the data legally belongs to them. We continue to hope that the SoR will engage constructively with service users to enable filming/streaming whilst addressing any outstanding concerns of staff.
We can see no basis at all for Trusts declining to implement the recommendation set out in the joint guidance that the individual should be allowed to record a short 10-30 second clip at the end of their scan to share with family and friends.
If you would like any further advice do email us at advice@birthrights.org.uk
I think that what it comes down to is these scans aren’t entertainment scans. Pregnant women need this to be conveyed to them by their doctor and midwife. These are diagnostic medical procedures. As a patient, I would do what ever it took not to distract the sonographer/midwife/doctor as mistakes could be made and surely the outcome is more important than the process. Would you ever ,as a passenger of a car, continually distract the driver ?
Just a thought.
Thanks for your thoughts Rachel. Its important to have these discussions but the impact on women/birthing people and their families is not trivial and the evidence shows partner involvement brings clinical benefits not just social benefits. Would you say drivers should never be allowed passengers in a car in case they are distracted? Just like passengers in a car, partners are invested in the sonographer doing a good job too.