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Wherever possible, anaesthesia in remote ophthalmic surgical sites should be delivered by an appropriately experienced consultant or autonomously practising anaesthetist. Where a trainee or non-consultant grade is required to provide anaesthetic services at a remote site, the recommendations of the Royal College of Anaesthetists should be followed.¹⁰

If inpatients are cared for in isolated/single-specialty units, there should be medical cover and nursing care appropriate to the medical needs of the patients.¹¹

Where inter- or intrahospital transfer is necessary, patients should always be accompanied by appropriately trained staff.¹²

All members of clinical staff working within the recovery area should be certified immediate life support providers and mandatory training should be provided.^7,13

For children, staff should hold an equivalent paediatric life-support qualification.^7,13

It is the responsibility of those leading departments of anaesthesia, together with their constituent consultants or autonomously practising anaesthetists, to ensure that AAs work under the immediate supervision of a consultant or autonomously practising anaesthetist at all times. ¹⁴

There should be a dedicated trained assistant (i.e. an operating department practitioner or equivalent) in every theatre in which anaesthesia care is being delivered by AAs.¹⁵

Clinical governance is the responsibility of individual institutions and, for AAs, this should follow the same principles that apply to medically qualified anaesthetists, ensuring:¹⁵

• training that is appropriately focused and resourced
• supervision and support in keeping with practitioners’ needs and practice responsibilities
• practice centred audit and review processes.

In areas where ophthalmic surgery is performed, resuscitation equipment and drugs should be immediately available, including a standardised resuscitation trolley and defibrillator. The manufacturer’s instructions must be followed regarding use, storage, servicing and expiry of equipment and drugs.⁸

Where paediatric ophthalmic surgery is performed, appropriate paediatric anaesthetic equipment and monitoring should be available. Equipment should be checked regularly.¹⁶