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Young people have additional needs and may wish to speak to the anaesthetist or another member of staff without direct parental presence.^62,89 Anaesthetists should make it clear that they are willing to speak with young people on their own, on request.

Inpatient pain services (IPS) should be staffed by multidisciplinary teams led by appropriately trained consultant or SAS anaesthetists. The minimum training requirement for new appointments to IPS lead roles is Royal College of Anaesthetists higher pain training.³²  Advanced pain training, or its equivalent, should be considered optimal.

Anaesthesia for all patients undergoing major vascular surgery should be provided by or directly supervised by an anaesthetist suitably qualified, trained and experienced in vascular anaesthesia. This will be a consultant or other autonomously practicing vascular anaesthetist, who has overall responsibility for the patient’s care. ¹⁸

High-quality anaesthesia is pivotal to achieving successful outcomes following day surgery. The majority of anaesthesia for day surgery should be delivered by consultants or autonomously practising anaesthetists. Staff grade, associate specialist and specialty doctors and experienced trainee anaesthetists may also provide anaesthesia for day surgery. However, these doctors should be suitably experienced and skilled in techniques appropriate to the practice...

In units offering a 24-hour regional analgesia service, the duty anaesthetist should be resident on the hospital site where the regional analgesia is provided (not at a nearby hospital).

The lead obstetric anaesthetist should ensure that there are continuing quality improvement projects to maintain and improve the care in their units.²⁸

There should be specific consultant or autonomously practising anaesthetist programmed activity time for burn anaesthesia in hospitals where burn surgery is undertaken.⁴

Anaesthetic assistants whether nurse or operating department practitioners, should be trained in the preparation of this specialist equipment to be able to support the anaesthetist in the delivery of lung isolation and one lung ventilation.

Robust procedures should be in place to report and investigate adverse incidents involving equipment, staff or patients. The published outcomes of these investigations should be disseminated to all relevant anaesthetists and others.