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Independents' Day

What are the pros and cons of buying an ultrasound?

Q - We made a substantial saving in the last two years of fundholding, and have more than £50,000 to spend on improving patient care. Some of the partners are keen to buy an ultrasound machine. What do we need to consider when assessing whether or not this is a feasible proposition?

Performing and interpreting ultrasound scans is relatively straightforward to learn, and several practices have successfully introduced in-house ultrasonography. You should be able to buy a good ultrasound machine for under £50,000, but you do need to consider factors other than the purchase price.

 · Do you have a room in which you could permanently accommodate this relatively bulky and

immobile piece of machinery along with an examination couch, a

trolley for equipment, and filing space?

 · Who will do the scanning and write the reports? If one or more partners or practice nurses will be involved, they must be trained properly. The medicolegal implications of a GP or practice nurse performing a diagnostic test without evidence that they are competent to do so could be devastating if the diagnosis of a fetal abnormality or cancer was missed. If training is not readily available, it would be safer to employ a trained ultrasonographer.

 · What types of ultrasound will you offer? Obstetric and abdominal ultrasound are standard, but will you include echocardiography?

 · How will you run the ultrasound service? Practices that use in-house ultrasound effectively have found it is better to organise clinics to which patients can be referred rather than doing scans opportunistically during normal consultations.

 · Can you provide a PCT-wide community ultrasound service? This may make the idea far more practicable, as your PCT may be prepared to fund training or provide an ultrasonographer, and pay rental and utility costs for the scan room, if other local practices can refer patients to be scanned at your surgery.

In medicine, demand always rises to exceed supply, so you will need to draw up referral protocols to avoid the service being swamped by patients with non-specific abdominal pain and pregnant women curious for an extra look at their unborn babies.

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