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Background The complexity of fetal medicine (FM) referrals that can be managed within obstetric units is dependent on the availability of specialist ultrasound expertise. Telemedicine can effectively transfer real-time ultrasound images via video‐conferencing. We report the successful introduction of a fetal ultrasound telemedicine service linking a specialist fetal medicine (FM) centre and a remote obstetric unit. Methods All women referred for FM consultation from the obstetric unit were seen via telemedicine, excluding cases where invasive testing or cardiac anomalies were anticipated. The image quality was rated following each consultation. Women's experiences and family costs were evaluated by a questionnaire completed following the first telemedicine appointment during the first phase of the project. Results Overall, 297 women had a telemedicine consultation during Phase 1 (pilot and evaluation) and Phase 2 (embedding and adoption) of the project, which covered a four year period. There were 154 new and 143 follow-up consultations. Thirty-four women completed questionnaires during the Phase 1 of the study. Travel to the telemedicine consultation took a median time of 20 minutes (4,150), in comparison to an estimated journey of 229.8 minutes (120,450) to the FM centre. Women were generally satisfied with the service and valued the opportunity to have a FM consultation locally. Conclusions We have demonstrated that a fetal ultrasound telemedicine service can be successfully introduced to provide FM ultrasound of sufficient quality to allow fetal diagnosis and specialist consultation with parents. Furthermore, the service is acceptable to parents, has shown a reduction in family costs and journey times.

Supplemental material, sj-pdf-1-dhj-10.1177_2055207620925929 for Service user and staff acceptance of fetal ultrasound telemedicine by Elaine Bidmead, Mabel Lie, Alison Marshall, Stephen Robson and Vikki J. Smith in Digital Health

GNVQs epitomise one strand of contemporary philosophy of education. However, a\ud question that arises is whether GNVQs, having built on the ethos of NVQs, abandon all\ud earlier educational philosophies in favour of the competence movement endorsed in the\ud USA. A question central to this study revolves around whether earlier, alternative\ud philosophies of education also have something of value to offer.\ud \ud \ud To answer this, traditional approaches to educational provision are identified and\ud explored in terms of their possible 'ideal types'; these ideal types being seen to be\ud represented by liberal, general and vocational education. To give such ideal types\ud relevance in modern society they are related to significant educational provision, in this\ud instance educational provision for 16 - 19 year olds. A curriculum criticism of A Levels,\ud BTEC Diplomas, RSA, NVQs and GNVQs is therefore conducted, taking into account\ud the historical development, philosophy, aims, the content and the teaching and learning\ud methods of each approach. To achieve parity of comparison the field of Business\ud Studies was used as an exemplar. The culmination of this stage of the research requires\ud that the findings of the curriculum criticism are mapped against the established ideal\ud types, the purpose being to identify elements that could be said to embody liberal,\ud general and/or vocational education. For example, GNVQs are clearly linked to the\ud vocational, their breadth can also be said to contribute to the general, but are they liberal\ud in any way? The findings indicated that the inclusion of Key Skills and the student\ud centred approach did offer some potential for a liberal education.\ud \ud \ud To support these findings interviews and an attitudinal survey were conducted. The\ud rationale for this was to explore and reveal the extent to which staff and students\ud concerned with GNVQ Business held the same beliefs as those generated by the desk\ud research; both sets of findings were in concordance. The final stage of the research\ud programme was concerned with the future direction of GNVQs. Interviews were\ud conducted with education policy makers and industry representatives. They were\ud concerned with what the 'ideal' post-1 6 education programme would entail in the light of\ud perceptions of liberal/vocational/general education. Staff and students were again\ud consulted by way of vedfication of the conclusions drawn.\ud \ud \ud The research concludes that liberal education was considered by many as the ideal way\ud forward for post-16 education. GNVQs were seen as predominantly offering general\ud education. From this one could infer that GNVQs are not, therefore, seen as the ideal\ud post-1 6 programme. However, when 'ideal' elements of post-1 6 education are discussed\ud some consideration of the world of work was deemed essential (though not a concern of\ud traditional liberal education) and the inclusion of Key Skills were deemed important, as\ud was a student centred approach to learning. In the light of this GNVQs have some\ud potential for meeting the desired/essential components of an ideal post-16 education\ud programme. Greater consideration, however, is required with regard to self-development\ud and social awareness in order to promote liberal aspects of post-16 education. A\ud combination of these factors within a GNVQ programme would represent a marriage of\ud liberal, vocational and, general education philosophies and approaches to education; an\ud 'ideal'post-16 education programme.