CASE Position Statement

CASE Programme Equivalence

Issued April 2023

The Consortium for the Accreditation of Sonographic Education (CASE) is often asked about the ‘equivalence’ of ultrasound programmes which are not themselves CASE accredited, predominantly from outside the UK and Ireland. 

It is not within the remit of CASE to comment on ‘equivalence’ of non-CASE accredited programmes or individual practitioner’s qualifications. As ultrasound

is not a registered profession in the UK, the ultimate responsibility for assessing

the equivalence of an award held by any employee, and ensuring that the knowledge, skills, and competence of sonographers are appropriate for UK

practice, resides with the employer. This applies to any sonographer with or

without a CASE accredited award and regardless of the country of qualification.

Clinical managers may wish to consider the following points when reviewing equivalence:

CASE appreciate that employers may be concerned about the suitability of staff with non-CASE accredited qualifications to meet standards of clinical ultrasound practice in the UK and commissioning expectations of national bodies such as the NHS Fetal Anomaly Screening Programme (NHS FASP).^1,2

The Society of Radiographers³ advise:

“Clearly the normal checks that an employer must perform on the background, English language proficiency and likely competence of an employee need to be carried out before any offer of employment is made.”³

Employers may want to consider competency assessment as part of a probationary period of employment. It should also be noted that, independent reporting skills are rarely taught or assessed outside of UK based training programmes. Overseas qualified sonographers commonly have clinical experience in a breadth of applications (for example: general medical, gynaecology, obstetrics, vascular, and musculoskeletal ultrasound). However, this range of clinical experience may not translate into competency to ‘independently… interpret, analyse and report ultrasound scan findings’ at a level to meet CASE standards.

The following considerations might support employers prior to employing an individual with a non-CASE accredited award.

1. The level of the award e.g. equivalent to certificate [CertHE] or diploma in higher education [DipHE], ordinary degree, Honours degree [BSc (Hons], post graduate level award [PgC PgD, Master’s degree] can be checked with UK ENIC. These can be compared with the level of award in the UK.⁴
2. For entry to the Register of Clinical Technologists (RCT) sonographers have to meet the minimum requirements for English Language proficiency. Employers may want to mirror this and consider RCT registration for non-statutorily registered ultrasound practitioners.

The UK Government provide advice on which countries students applying for a visa do not require proof of English language proficiency, if they completed a “qualification equivalent to a degree”.

3. Consider how long the course was and compare this with the course content from the syllabus. Was the course long enough to gain competencies in the clinical areas studied?
4. A review of the award certificate, detailed transcript and syllabus may be required. Compare the learning outcomes and syllabus of the course with the CASE Standards for Sonographic Education and map these to the CASE learning outcomes.
5. Some countries have registers or credentialing that can be checked, for example the American Registry for Diagnostic Medical Sonography (ARDMS), Australian Sonographer Accreditation Registry (ASAR). Asking an applicant for details of any registration and/or credentials, including registration number can enable an employer to check the register and level of credentialing or membership/registration. Due diligence is still required by the employer to determine whether CASE standards have been met, particularly in relation to UK standards of practice and reporting.
6. Compare the standards of practice for any clinical modules completed and determine whether the clinical assessments are carried out in a similar way to that of a CASE accredited award. If not, explore whether the individual has completed any additional training either formally or informally to demonstrate their competent to scan to the expectations of the local department.
7. Did the award ensure the individual met CASE standards and was proficient to independently undertake, interpret, analyse and report ultrasound scan findings? If not, an employer will need to consider what support will be needed to upskill the individual to work to the level of practice expected within the UK.
8. Consider the level of physical principles and technology covered in the respective award, particularly ultrasound safety, to ensure that the individual will have a good understanding of UK and international ultrasound safety standards, guidelines and requirements. This could also be assessed at interview.
9. During the syllabus review, application and interview process it would be helpful to review the level of understanding of professional, legal and ethical issues related to UK practice. Employers may need to consider how to provide education on current UK standards of practice and guidelines to meet CASE standards.  
10. The NHS FASP require a CASE accredited qualification or equivalent for undertaking the screening ultrasound scans.^1,2 Employers will need to determine the level of screening in the country of training and/or employment to ensure that the equivalent level of practice and competency has been achieved. In some cases, further education such as a negotiated module may be required in the UK by a CASE accredited education provider.
11. It may be helpful for employers to liaise with, and gain support from, their local higher education provider(s) when reviewing and mapping learning outcomes and syllabi.
12. Employers might also want to approach local imaging academies to determine whether support for clinical skills development can be provided within the academy.
13. A preceptorship⁵ period should be planned when a new employee begins work in the UK. The preceptorship period may need to be longer than that required for someone who has completed a CASE accredited award, to ensure that all CASE learning outcomes and equivalent standards are met. Preceptorship guidance for the UK is available and can be applied to applicants without a CASE accredited qualification, as would be applied to a newly qualified sonographer from a CASE accredited programme. 

References:

1.        NHS England NHS public health functions agreement 2019-20. Service specification No.16 NHS Fetal Anomaly Screening Programme-Screening for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome (Trisomy 21, 18 & 13).

2.        NHS England (2019). Service specification No.17 NHS Fetal Anomaly Screening Programme-18 +0 to 20 +6 week fetal anomaly scan. Available at: https://www.england.nhs.uk/wp-content/uploads/2017/04/Service-Specification-No.17-FASP-Fetal-Anomaly-Scan.pdf [Accessed August 24, 2022].

3.        Society of Radiographers (2021). Ultrasound training, employment, registration and professional indemnity insurance Available at: https://www.sor.org/learning-advice/professional-body-guidance-and-publications/documents-and-publications/policy-guidance-document-library/ultrasound-training-registration-employment [Accessed December 9, 2021].

4.        UK Government What qualification levels mean: England, Wales and Northern Ireland . Available at: https://www.gov.uk/what-different-qualification-levels-mean/list-of-qualification-levels [Accessed August 24, 2022].

5.        British medical Ultrasound Society (2023).  Preceptorship and Capability Development Framework for Sonographers https://www.bmus.org/media/resources/files/PC_with_CPF_app_A_and_explanatory_notes_FINAL_Mar2023.pdf