S5E2 Ultrasound Unwrapped: Driving Standards, Collaboration & Innovation

In this episode of AXREM Insights, Melanie Johnson and Sally Edgington speak with Nicola Fishwick, Ultrasound Business Development Leader at GE Healthcare and AXREM’s new Ultrasound Special Focus Group Convener. Nicola reflects on her 19-year journey in the ultrasound field, from clinical radiography into industry, highlighting how the profession has evolved. She notes the shift from collaborative sonography environments to more isolated working, and shares insights into the growing demands and challenges in ultrasound, especially post-COVID. Nicola also discusses the group's key initiatives, including the landmark “Manifesto for Medical Ultrasound” and the push for enhanced recruitment, training, and appropriate equipment access amid the modality’s expanding reach across clinical settings.

The conversation also delves into the group's collaborative ethos—working alongside organisations such as BMUS, SOR, and IPEM to develop critical resources like the transducer decontamination poster and a used equipment checklist. Nicola emphasises the importance of quality assurance and the group’s next priority: developing standardised QA protocols to ensure ultrasound equipment performs optimally. She passionately advocates for industry collaboration, citing the benefits of AXREM’s non-competitive, collective approach in driving change and building a strong professional community. The episode ends on a light-hearted note as Nicola shares who she’d switch lives with for a day—Victoria Beckham, of course!

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Transcript

Mel: Hello and welcome. I'm Melanie Johnson and I'm here with Sally Edgington. Today we have the pleasure to be speaking to Nicola Fishwick, Ultrasound Business Development Leader at GE Healthcare, and also Axrem's Ultrasound Special Focus Group Convener.
So welcome Nicola and thank you for being on our show today. Now let's get started by handing over to you to tell us a little bit about yourself and what's your story.
Nicola: Thanks Mel and thanks Sally. Thank you for inviting me to be on the Axrem podcast. Oh, so where to start?
I am a diagnostic radiographer by background and so started in a radiography career which I really loved and soon went to an ultrasound career.
And just because I really enjoyed the patient contact and being in control of the scanner and having that interaction.
And I think that soon developed into an interest in ultrasound applications. I was always that person who could, back in the day, change the time on the ultrasound scanner and you know do all the little fiddly things that needed doing.
So that was always me. So it sort of progressed really into a career in applications and sales, which I've been doing now for, I think this is my 19th year in the industry now after clinical.
So yeah, so currently with GE Healthcare in a business development role, but I have worked all over the UK and also in Europe as well in previous roles.
So really exciting actually seeing ultrasound, not only in the UK health service, but also in those other countries and the applications and the different setups as well.
So yeah, a little bit of variation across the board. 

Mel:And do you think it's changed a lot in the 19 years that obviously you've been within this area?
Nicola: Yeah, I do. I think there are some things that have remained constant. So patients coming through the door and always staff working so hard and diligently to support their patients and do a great job, but the pressures are very different now.
When I first started in ultrasound, we often had two sonographers for every scan room and there was more sonographers than, you know, more scan rooms than sonographers.
So it used to work almost in partnership really, somebody could take a little look over your shoulder, you know, have a little input onto something you were doing, give you an opinion, help you with writing a report and you would do the same for colleagues.
Whereas I think now sometimes in ultrasound, I think the sonographers can somehow feel a little bit more isolated because they have their own room, their own work list and schedule.
And, you know, sometimes they're in and out, in and out, so busy all day. And, you know, it's hard to get those touch points with other people sometimes.
So I think that's probably the main area of change.

Sally:Yeah, great. Thanks, Nicola. And obviously you've recently taken over as convener of our ultrasound special focus group. So welcome to the role. And this is a really great timing for this podcast to kind of introduce you as the convener of the group.
And I know that the group has been particularly active in the last three to four years, where we published the manifesto for medical ultrasound, the modern day stethoscope. So I wondered if you wanted to just touch on what some of the manifesto and special focus group priorities are?
Nicola: Sure. Yes, thanks, Sally. And I think it was a really great achievement of the group to first publish that manifesto, really setting out our group intentions and, you know, declaring what we wanted to do, you know, as a special focus group and how we would be working.
And really, I think that, you know, when you read through the manifesto, it goes through talking about the increase in demand, certainly that ultrasound has been under in the past few years.
And talks about staffing challenges and recruitment and, you know, our desire as an industry body to make sure that the training of new staff and the funding for equipment and to make sure that those areas are fully driven through and supported.
And, you know, we speak with one voice on those topics, and I think that's really, really important to deliver on that message is to really help drive that recruitment and training and the alignment as well of education within ultrasound.
It's so important. I think, you know, we see the diversification really of the modality, you know, there's so many people who use ultrasound now as a tool.
I think it references around that modern day stethoscope, but, you know, it's often more than that, you know, it can be used to guide a needle, it can be used to gain information on physiology of an organ.
You know, there's so many different applications and touch points now that, you know, robust education and the right equipment for the right job, all of those things are so important.
And as an industry, no matter which company or, you know, company you're representing or working for, we would all have that same drive.
So I think that's a really, you know, important part of that manifesto document.
Sally: Yeah, and I think one of the points you touched on, which is really key here is the increase in demand.
So especially since COVID, we've seen that ultrasound is being used in almost every department of a hospital.
You know, it's not just a sonographer using an ultrasound device now.
And we see it, yeah, like I say, A&E, on wards, you know, and different healthcare professionals are using it.
So I would imagine that kind of brings its own challenges.
And I know we've had discussions in our special focus group meetings around the role of a sonographer and the role of an ultrasound user, because actually that's two very different things.
Nicola: Yes, yes, yes, I totally agree.
And I think there is a place for everybody in that space.
You know, there are these different roles and they're all valid.
They're all very important.
And the jobs are quite different, you know.
So many people who use ultrasound, you know, as part of their job role are using it, as mentioned, as a tool to guide a needle or to find a specific piece of information for that patient.
So it's just as important that that is done correctly and to the correct protocol with the right equipment as it is a full diagnostic scan where you may be looking at certain organ measurements and, you know, really looking for a diagnosis.
So I think that's the great thing about ultrasound as a modality.
You know, it does have that span.
And I think that's something that as a new sonographer or a new person entering the profession, you know, this is a really exciting element to think about.
Sally: Absolutely. And just to highlight at this point for our listeners that the group have also worked in recent years on a used equipment checklist.
And this is meant for procurement colleagues who are procuring a used piece of ultrasound.
So they make sure they ask all the right questions and they've got a checklist of everything that they should be checking because we hear from our members that when you buy a used piece of equipment, often it looks like a brand new piece of equipment being delivered.
So I wanted to highlight that and that's in the resource library on the AxREN website.
And also in that resource library, we've got the transducer decontamination best practice summary and an accompanying poster.
So if you haven't seen those, please do check out those on our website and you can download them and print them, etc.
So that actually leads me quite nicely onto my next question.
So on all of those documents we've mentioned, we've collaborated with other organizations.
So in this group, we do collaborate quite extensively, actually, with a number of other organization.
Why do you think this is important for the ultrasound group?
Nicola: Oh, I think it's super important for the ultrasound group for many reasons.
But primarily, I think that working in that way really mimics the way we work in health care.
So there isn't any one single thread within health care.
If you follow a patient journey or a care pathway, you will see that that patient or that diagnosis has many, many facets
and many different multidisciplinary teams involved, diagnostic tests, follow ups, treatments, surgical planning, interventions.
And it's a little bit the same on our side in that we can bring in different bodies to get opinion, to get feedback.
We can also involve others with dedicated expertise.
So I think there's also special focus groups now involved around things like AI and the up and coming people in our industry.
And it's great to work and communicate and learn from each other with a shared intention.
And I think that's where you get real change because everybody becomes involved and feels responsible for the topic.
So, yeah, it's an absolute must.
Sally: Absolutely. And we must pass our thanks on to some of the organizations that we've previously worked with and continue to,
which is the Society and College of Radiographers, British Medical Ultrasound Society,
and also the Institute of Physicists in Engineering and Medicine.
I think hopefully that's IPEM and there's such long acronyms because they've been really instrumental in some of the work
and actually having their expertise and guidance is really helpful.
And it's been a really useful, collaborative and engaging relationship that we have with those organizations.
Mel: So looking ahead and horizon scanning. So what's next for the special focus group, Nicola?
Nicola: What's next for the special focus group? Well, I think at our last meeting, which was in person,
we had some discussion around the standardization of QA.
So around quality with regards to ultrasound equipment, it's so important to get this right.
It's something that should be done on acceptance of the ultrasound equipment before it is put into clinical use.
And there's elements of quality assurance that can be done on a weekly,
even daily, but a weekly basis, monthly basis, annual basis.
And it really allows you to track the performance of your scanner, make sure it is working as expected
and that there hasn't been any kind of drift in those settings or any kind of anomalies
that are going on with things like measurements and resolution.
And as we talked about thinking about different users now in the ultrasound profession,
this used to be something that a sonographer could have the time to do.
It could be something that would be routed in the department.
I think it's more tricky now to do that.
We spend a lot of time dedicated to patient care and making sure the scanners are used to their capacity.
But we need to still think about that quality assurance.
And we need to be able to educate people who are using those scanners just on an ad hoc basis
about some of the checks that they can make just to make sure that that piece of equipment is safe to use and performing at its best.
So I think we'd really like to reach out to BMUS on the topic
and to see if there was some interest there around developing some standardisation.
That could be something that would have a real positive impact on the department.
So I think that's our next big topic to tackle as a group.
Most definitely a big topic, I think.
Yeah.
Sally: Great, thanks. From your personal perspective, Nicola,
I know you've been involved with the group previously to taking over as the convener.
What do you think are the benefits of being involved in the special focus group, but also as Axrem as a whole?
Nicola: Oh, hugely beneficial, Sally, yeah.
So beneficial to be part of Axrem and also a special focus group.
I think just to be able to network with your peers across industry
without those barriers of the competition and having that separation on companies.
It's great to network with like-minded individuals who really want to drive forward the profession
and to drive positive change for our members and for the people who we represent
and also for patients ultimately.
By being together, that's what we can do.
And I think we've already shown that, as you mentioned, with the other documentation,
such as the manifesto and the used equipment documentation.
These are super useful documents that couldn't be produced in isolation
and couldn't be produced by somebody just trying to do that in their day job.
You have to have that support of the industry body and the special focus group.
So, yeah, I would really recommend being a part of Axrem
and also joining an area that you're interested in
because there are several different special focus groups available now.
So anybody who's got a real interest and passion can find something there
and be part of a really meaningful group.
Sally: Thanks, Nicola.
And I have to say, one of the things I always say to a potential member
is you get out of Axrem what you put in.
Nicola: Yeah.
Sally: And it is one of those things if you join and you don't participate, you wouldn't see the value.
But actually, I think the more meetings and events you attend,
the more you can build up contacts in terms of networking.
You can be part of that industry voice and like you say, help drive change.
I love to see all of the very highly competitive companies coming together in a safe space
and actually seeing how you can collectively engage and work together
on setting best practice within the industry.
And I think that's a really, I see it as quite a unique place to be.
And it's a really positive group, which some people find quite odd
that it can be so positive, but it really is.
I always say that I feel like these days, especially Axrem is like one big happy family
the majority of the time, which is fantastic.
Thank you very much.
And it's really good to hear your positive feedback.
Nicola: Thanks, Sally.
Mel: Yeah, good. Right. So going on to my quirky question.
So if you could switch lives with anyone for a day, who would it be and why?
Nicola: Oh, wow. Thanks, Mel. That is a quirky question.
So if I could switch lives with anyone for a day, who is it going to be?
I think I would have to say Victoria Beckham.
Yeah, not from her Spice Girls days.
I would have to pick the Victoria Beckham of here and now.
Just because actually, when you look at what she's achieved,
again with a different background, she's a great example of a female entrepreneur.
She's had really successful fashion and beauty businesses,
really international kind of global brands with the Beckhams themselves.
She can travel anywhere at the drop of a hat.
She can eat in the most amazing restaurants whenever she wants.
I think that would be a great day to spend in her shoes,
although the heels would be a little bit high for me, I think.
Mel: I thought you might drop in David Beckham as well as a reason.
Nicola: Definitely would be a bonus.
Definitely would be a bonus.
Sally: Yeah, I was just going to say that I'd be quite happy to be Victoria Beckham
just to be married to David Beckham.
Nicola: Yeah, just for a day. That'd be nice, wouldn't it?
Sally: That's a great, great, great point.
So thank you so much for joining us today, Nicola, on our Axrem Insights podcast.
I know we've learned a lot more about yourself and the ultrasound special focus group.
So a big thanks to Nicola.
Thanks for joining us and thanks to all of our listeners.
Mel: Join Sally and I again next week when we will be speaking to Richard Coldrick
and Declan McGregor about the Axrem Service and Operations Special Focus Group.