The lead obstetric anaesthetist should ensure that there are ongoing quality improvement projects in place to maintain and improve the care in their units.27
Anaesthetists and anaesthetic assistants working without direct supervision in obstetric theatres and on the delivery suite should be familiar with the environment and working practices of that unit, and work there on a frequent basis to maintain that familiarity.
In units offering a 24-hour neuraxial analgesia service, the duty anaesthetist should be resident on the hospital site where neuraxial analgesia is provided (not at a nearby hospital).
The standard of monitoring in the obstetric theatre should allow the conduct of safe anaesthesia for surgery as detailed by the Association of Anaesthetists standards of monitoring.41
Women requiring critical care in a non-obstetric facility should be reviewed daily by a maternity team including an anaesthetist. 4
If any major restructuring of the provision of local maternity services are planned, the lead obstetric anaesthetist should be involved in that process.24
All major head and neck surgery should be overseen by a named consultant or autonomously practising anaesthetist with a subspecialty interest in this area.77
Service developments outside the operating theatre, e.g. interventional cardiology, often place unintended demands on anaesthetists. The business plans for such services should include provision for anaesthetic services.
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.
The supervising consultant anaesthetist should be easily contactable and should be available to attend within minutes of being requested by the AAs.112
