Guidelines for the Provision of Anaesthetic Services (GPAS) 2014

Guidelines for the Provision of Anaesthetic Services 2013

‘Guidelines for the Provision of Anaesthetic Services’ (GPAS) is now well established, and forms the basis of recommendations produced by the Royal College of Anaesthetists for anaesthetists with managerial responsibilities for service, as well as other healthcare managers. It was first published in 1994 and entitled ‘Guidance for Purchasers’. It was revised under the current title in 1999, 2004 and 2009. The 2014 edition is based upon revisions made by authors to their chapters during the autumn of 2013, and incorporates the newest developments in clinical practice, service delivery and education. Sections on transplant surgery and sedation, plastics and burns are in preparation for later in 2014. Each section can be downloaded separately from the College website, beginning with the general principles for delivering anaesthetic services, followed by subspecialist areas of practice.

Guidance and standards documents should always be seen as works in progress in which a balance must be struck between general principles and fine detail, between expert opinion and evidence, and between minimal and aspirational standards. They do not replace the need for experienced clinical judgment exercised by individual anaesthetists in the best interests of their patients. Anaesthesia was one of the first clinical disciplines to set standards of practice supported by audit of outcomes, and GPAS is one of three parts of the audit cycle, which also includes Raising the Standard: A Compendium of Audit Recipes, and Anaesthesia Clinical Service Accreditation (ACSA).   Together they form the model that the RCoA wishes to promote for the delivery of professional standards, and will allow the College to share best practice between departments, as well a gathering information on a national level about trends in the delivery of anaesthesia in the UK.

Far reaching changes to the inspection process have been introduced in 2013 by the Care Quality Commission (CQC), under Professor Sir Mike Richards, and as part of the response to the Francis Enquiry.  The CQC now inspects organizations (because not all are hospitals) using five domains underpinned by standard Key Lines of Enquiry (KLOEs).  The organization must now be able to demonstrate that it is :

  • Safe
  • Effective
  • Caring
  • Responsive
  • Well led

During 2014, the standards that underpin ACSA will be mapped to these domains, thus integrating further GPAS and ACSA with the requirement for compliance as laid down by the CQC.

We welcome comments and advice from clinicians and managers which will enable new information obtained from audit and research to be incorporated into GPAS, so that the College’s guidance reflects and supports best practice.

This guidance has been written by well regarded specialists, specialist organisations and societies, and is based upon current best practice supported by evidence and national recommendations where available. The editorial process has been managed by the Clinical Standards Directorate on behalf of Council. The Royal College of Anaesthetists is grateful to the authors for their work on behalf of the profession and the patients whom we serve.

Statement of intent

This document is for guidance only. It is not intended to replace the clinical judgement of the individual anaesthetist, and the freedom to determine the most appropriate treatment for individual patients in a particular place at a specific moment should not be constrained by a rigid application of this guidance.

The document is presented as a collection of guidance chapters, each written with best practice in mind, referenced to recommendations from national bodies. recommendations. It is the view of the Royal College of Anaesthetists that it must be the responsibility of the individual reader to take into account particular local circumstances when applying the recommendations of each chapter.

Every chapter within the guidance document has been prepared on the strength of the best information available at the time of writing, and will be updated to include changes in guidelines from all sources each calendar year, before posting on the College website. Hard copies are no longer available.

The document forms the basis for the standards required for departmental accreditation with the Royal College of Anaesthetists, and these be updated yearly to coincide with each revision of GPAS.

Dr Peter J Venn
Chairman, Professional Standards Committee

January 2014

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