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Anaesthetists returning to paediatric practice after a period of absence should have a structured plan of induction and supervision in place which supports their learning needs so that they are competent to provide safe perioperative care for common non-complex elective and emergency procedures in children aged one year and older.⁶⁴

Anaesthetists should help to organise and participate in regular multidisciplinary courses and ‘skills and drills’ for emergencies.^{8,25,88,129,130,131}

Anaesthetists should be aware of legislation and good practice guidance relevant to children and according to the location in the UK.^{35,36,37,38,39}

Patients undergoing heart or lung transplantation may be under the age of 18 years. Anaesthetists must be aware of legislation and good practice guidance relevant to young and vulnerable adults.^35,41 Children undergoing transplantation should be cared for in a paediatric centre.

All cardiac units should have regular multidisciplinary morbidity and mortality meetings. These should have a list of patients to discuss in advance, an attendance register, and minutes with learning points. Consultant or autonomously practising anaesthetists should attend these meetings and, where possible, inclusion in job plans should be considered. Trainees should be encouraged to attend during their attachments.

Anaesthetists should be aware of legislation and good practice guidance²¹ relevant to children and according to the location in the UK.^22,23,24,25

There should be a dedicated trained assistant (i.e. an ODP, anaesthetic nurse or equivalent) who holds a valid registration with the appropriate regulatory body, immediately available in every location in which anaesthesia care is being delivered, whether this is by an anaesthetist or an AA.^41,119

Complex ophthalmic surgical cases often require specialised anaesthetic input. This may include patients having repeated ophthalmic procedures, long and difficult cases, and those potentially requiring specialist intravenous drug therapy, such as intravenous steroids, acetazolamide or mannitol. An anaesthetist of appropriate experience should have dedicated responsibility for operating lists containing such complex cases.

Hospitals should have well integrated arrangements that ensure anaesthetists covering long neurosurgical procedures or overrunning lists are regularly relieved by an appropriate colleague for refreshment and comfort breaks.