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Busier units should consider having two duty anaesthetists available 24/7, in addition to the supervising consultant.²⁴

Locum anaesthetists should be assessed to ensure their competence prior to undertaking work without direct supervision.²⁴

There should be a named consultant anaesthetist and obstetrician responsible 24/7 for all women requiring a higher level of care.¹⁶

There should be a clear line of communication between the duty anaesthetist, theatre staff and anaesthetic assistant once a decision is made to undertake an emergency caesarean delivery. 

The preassessment clinic should be predominantly led by suitably trained nurses or other extended role practitioners using agreed protocols and with support from an anaesthetist.

A dedicated, skilled anaesthetic assistant should be available in all locations outside the operating theatre where anaesthesia is undertaken by an anaesthetist.³

Anaesthetists in an IPS post need to demonstrate an ongoing significant interest in acute pain management by involvement in continuing professional development (CPD), appraisal and job planning.

A Royal College of Anaesthetists/Difficult Airway Society airway lead should be appointed in all hospitals providing anaesthetic services.⁷

Training should be provided as part of employment induction and should be repeated at regular intervals thereafter for anaesthetists, ward staff, doctors in training and other registered healthcare professionals.

Additional programmed activities for consultant or autonomously practising anaesthetists should be allocated for elective caesarean birth lists and antenatal anaesthetic clinics (or to review referrals if no formal clinic is in place).²³ Time is required to identify and follow up potential anaesthetic morbidity and to arrange continuing investigation and referral.