Transthoracic echocardiography: a survey of current practice in the UK

Background: Echocardiography is one of the cornerstones of cardiovascular investigation. The escalating demands on echocardiography services necessitate close examination of how we organize our departments on a day-to-day basis, in order to provide a consistent, high-quality service. Aim: To evaluate current transthoracic echocardiography practice in the UK. Design: National postal survey. Methods: A questionnaire was sent to the chief cardiac physiologist (CP) of every hospital in the UK with echocardiographic facilities. Results: Three hundred and thirty six echocardiographic departments were identified. One hundred and twenty six (37.5) completed questionnaires were returned. In 87 of hospitals, CPs both performed and reported over 80 of echocardiograms. Fifty-seven percent of CPs and 22 of doctors performing echocardiography held an accreditation in echocardiography. Only 60 of hospitals had formal criteria that had to be met prior to an operator being allowed to report echocardiograms unsupervised. Fewer than half of hospitals regularly audited their echocardiography service. Both outpatient and inpatient waiting times for echocardiography were highly variable and frequently excessive. Fewer than half of hospitals used modern techniques for assessing diastolic function, mechanical dyssynchrony or severity of mitral regurgitation. Conclusions: In the UK, many transthoracic echocardiograms are performed and reported by operators without formally assessed competence. Fewer than half of hospitals regularly audited their service or used modern echocardiographic techniques. Services are likely to be improved by developing and instituting mandatory national guidelines.