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Trainees planning to embark in a career in cardiac anaesthesia should undertake training and accreditation in transoesophageal echocardiography.⁵⁰

Consultant or autonomously practising anaesthetists intending to undertake anaesthesia for cardiac surgery should have received training to a higher level in cardiac anaesthesia for a minimum of one year in recognised training centres.⁴³ Those providing critical care for cardiothoracic surgical patients should have received training as described by the Faculty of Intensive Care Medicine (see Cardiothoracic Critical Care, Guidelines...

Consultant or autonomously practising anaesthetists intending to follow a career in paediatric cardiothoracic anaesthesia should have higher training in general paediatric anaesthesia of at least one year followed by a specialist training period of an appropriate duration in the subspecialty.

All staff should have access to adequate time, funding and facilities to undertake and update training that is relevant to their clinical practice, including annual mandatory training such as basic life support.

Fellowship posts should be identified to allow additional training for those who wish to follow a career in cardiac anaesthesia(Including adult congenital heart disease and paediatric cardiac anaesthesia) to ensure that there are adequate numbers of skilled anaesthetists in the specialty. These should be suitable for trainees who wish to take time out of training programmes or for those who...

Departments should consider providing all newly appointed consultants or autonomously practising anaesthetists, particularly those with limited experience, with a mentor to facilitate their development in cardiac anaesthesia.

Anaesthetic involvement in the leadership of cardiac units should be considered.

There should be a joint forum for discussion of matters relevant to both surgeons and anaesthetists, for example protocol development and critical incidents.

Clinical protocols should be developed from national and international guidelines and reviewed and implemented on a regular basis. This may include, for example, guidance for coagulation management, venous thromboembolism treatment, and treatment for anaemia and patient blood management.

Anaesthetists should be part of the multidisciplinary team engaged in development and implementation of enhanced recovery programmes in cardiac surgery.^50,51