Women's Scan Clinic

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This is the first assessment for this service since registration in January 2022. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing their health and communication needs with them.

Women were involved in the assessment of their needs, and the service used the information gathered to support the care provided. The service provided ultrasound scans and, when requested, Non-Invasive Prenatal Testing (NIPT). Appointments were booked online or by telephone. Women booking by telephone could discuss their individual needs, but when booking online it was unclear whether the process allowed for individual care needs to be recorded. When women attended the service, they were asked their relevant medical history and the reasons for making an appointment for a self-funded scan. The 5 records we reviewed were complete and scan images were appropriately stored. With consent, ultrasound scan images and reports were shared with other healthcare professionals if needed, for example a woman’s GP or midwife.

We scored the service as 1. The evidence showed significant shortfalls. The service did not follow legislation and current evidence-based good practice and standards.

The service did not evidence it applied current legislation, national standards and evidence-based good practice guidance. Staff did not have effective systems to ensure policies, procedures and clinical guidance remained aligned with current best practice. We reviewed several policies that had not been updated to reflect current national guidance, including guidance relating to ectopic pregnancy and miscarriage management.

The service could not demonstrate a structured process for reviewing clinical guidance and ensuring documentation remained current. Because governance processes were limited, leaders could not demonstrate how they monitored compliance with clinical standards or assured themselves that evidence-based practice was consistently embedded across the service.

We scored the service as 3. The evidence showed a good standard. The service worked well with other relevant services to support people.

The service worked effectively with other healthcare providers to support continuity of care. Where scan findings required further investigation or urgent review, sonographers contacted relevant healthcare professionals directly and shared reports and scan images to support onward care.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control.

The service provided some information to support women to make informed choices about their health and pregnancy. Feedback confirmed staff discussed subjects such as vitamin supplementation and available NHS screening pathways with women.

As the service provided short, episodic appointments, opportunities to promote wider health and wellbeing were limited. While information promoting healthier lifestyles was not displayed in waiting areas, we considered this a missed opportunity rather than evidence of significant shortfalls.

We scored the service as 1. The evidence showed significant shortfalls. The service did not routinely monitor women’s care and treatment to continuously improve it. Staff did not ensure outcomes were positive and consistent, or that they met both clinical expectations and the expectations of women themselves.

The service did not monitor outcomes according to national standards and evidence-based good practice. There was no established governance process to review and evaluate the accuracy and consistency of record keeping or the outcomes of the scans provided. For example, there was no routine audit to confirm the accuracy of gender scans.

The service did not follow its own guidance for audit or benchmarking the service. After our onsite visit, the service submitted a document ‘Benchmarking Service Improvements’, dated December 2025 and for review in December 2026. However, there was no evidence the service had been routinely audited against the standards and guidelines in the document.

We scored the service as 1. The evidence showed significant shortfalls. The service did not tell people about their rights around consent or respect these when delivering care and treatment.

The service did not ensure valid consent was consistently obtained, recorded, or stored. Appointments were booked online or by telephone. Online bookings required completion of a digital consent form, while telephone bookings relied on paper consent completed at the appointment. However, paper consent forms were not scanned into women’s electronic records and were destroyed after one year, meaning a reliable contemporaneous record of consent was not maintained.

A review of 19 paper consent forms found significant issues: 6 were incomplete and 2 were unsigned. During an observed scan, consent was not obtained until after the procedure had taken place. Furthermore, when consent was discussed post-procedure, the sonographer did not adequately explain the risks involved.

Staff demonstrated a lack of understanding of the Mental Capacity Act 2005. Staff were unable to describe how they would assess a woman’s capacity to give consent, and the registered manager stated that women must have capacity because they were “lucid to look online.”