Scheduled lists that are planned to take longer than three sessions (e.g. where a patient requires prolonged time in theatre) must be staffed appropriately to ensure that no single anaesthetist works longer than three elective sessions. Adequate rest periods during sessions must be provided. 31, 32, 33
Arrangements should be considered so that if an elective list overruns this should not delay the start of an emergency list.
Departments should collect data on duration of both planned two session and three session days and should demonstrate how staffing is managed to maintain safety.
Departments should ensure that their anaesthetic rotas are working time regulation (WTR) compliant, achieving the minimum 11 hours rest between consecutive periods of work (both direct clinical care and supporting professional activities (SPA).34This rest time should be unambiguous, so that clinicians are neither required to self-assess fatigue levels, nor be influenced by the clinical needs of the department...
The out of hours rota should be published a minimum of six weeks in advance. If any changes are made to the rota there should be a clear and transparent method of informing staff.36
Departments should ensure that they manage employee absences due to sickness proactively, reasonably and fairly in accordance with hospital procedures, contractual and legal obligations.21
The department should ensure that there are clear and timely procedures for applying for and gaining approval for annual leave and other types of leave including study or professional, carers leave etc. The processes in place should be transparent and should provide equity of access to leave.
Departments should have a nominated anaesthetist immediately available to provide cover in clinical emergencies, as well as advice and support to other anaesthetists.37
Departments should consider having flexibility in the day-to-day rota so that there are more anaesthetists working in a clinical area, such as a theatre suite, than there are procedures being carried out to ensure that this cover is always immediately available. The size of the additional staffing resource is dependent on the number of anaesthetic procedures underway simultaneously and the...
The department should positively encourage an overt culture of seeking support regardless of grade if working solo, or if a second opinion or some practical help would improve the situation. There should be transparent, robust systems to support this culture.38
