Quality statement 2: Duplex ultrasound

Quality statement

People with varicose veins who are seen by a vascular service are assessed with duplex ultrasound.

Rationale

Duplex ultrasound is a non-invasive scan used to image the blood vessels of the body. It provides detailed information that helps to confirm the diagnosis and pattern of venous disease and determine the most appropriate treatment option. The handheld doppler is still used in some services, but it is outdated and does not provide the detailed, accurate information produced by duplex ultrasound.

Quality measures

Structure

Evidence of local arrangements to ensure that people with varicose veins seen by a vascular service are assessed with duplex ultrasound.

Data source: Local data collection.

Process

Proportion of people with varicose veins seen by a vascular service who are assessed with duplex ultrasound.

Numerator – the number in the denominator who are assessed with duplex ultrasound.

Denominator – the number of people with varicose veins seen by a vascular service.

Data source: Local data collection. NICE clinical guideline 168 clinical audit tool, standard 1.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (secondary care) ensure that vascular services have adequate numbers of duplex ultrasound machines and that staff have undergone appropriate training, so that all people with varicose veins referred to a vascular service are assessed with duplex ultrasound.

Healthcare professionals working in a vascular service ensure that people with varicose veins are assessed with duplex ultrasound.

Commissioners (CCGs) ensure that they commission vascular services that have sufficient capacity, equipment and skilled staff to assess varicose veins using duplex ultrasound.

What the quality statement means for patients, service users and carers

People with varicose veins who have been referred to a vascular service have a duplex ultrasound scan (a scan that uses high-frequency sound waves to produce a picture of the veins). The scan shows the blood flow and helps the vascular service team locate any damaged valves that might be causing the varicose veins.

Source guidance

Definitions of terms used in this quality statement

Vascular service

A vascular service is a team of healthcare professionals who have the skills to undertake a full clinical and duplex ultrasound assessment and provide a full range of treatment. [NICE clinical guideline 168, recommendation 1.2.1]

Duplex ultrasound

A device utilising doppler ultrasound that permits colour-coded visualisation of blood flow in the superficial, perforating and deep veins, as well as grey-scale imaging of the veins and surrounding tissue. It can also be used to image blood flow in arteries. [Full guideline on varicose veins in the legs, glossary]