Anaesthetic Workforce Census 2025 – Improving Productivity: Perioperative Care, IT, & Pensions
The RCoA’s Improving Productivity: Perioperative Care, IT, & Pensions report is drawn from the 2025 Census data. It explores three areas that relate to anaesthetic workforce productivity: their involvement in perioperative care, the IT systems they use, and the impact of the current pension taxation.
Summary of key findings
- Pre-existing evidence shows that the provision of better perioperative care – all the care that patients receive before and after their operation – can increase NHS productivity by reducing rates of surgical cancellations and complications and shortening the length of time patients need to spend in hospital.
- 78% of anaesthetic staff reported personally delivering at least one perioperative care service, rising to 90% if preoperative assessment on the day of surgery is included in the analysis.
- 85% of anaesthetic staff reported delivering preoperative assessment on the day of surgery, making it the most common perioperative activity.
- 65% reported personally delivering shared decision making, while 34% deliver preoperative assessment in the days or weeks ahead of surgery, 31% enhanced care services, and 29% enhanced recovery services.
- A further 19% reported delivering medical optimisation ahead of surgery, 15% reported involvement in early assessment, 16% in discharge planning and 6% in prehabilitation.
- 24% of anaesthetic staff reported management or supervisory responsibility for at least one perioperative care service, including 33% of consultants, 26% of autonomous SAS doctors and 24% of non-autonomous SAS doctors.
- The specific services that anaesthetic staff most commonly reported managing or supervising were enhanced recovery services (reported by 9%) and preoperative assessment on the day of surgery (8%).
- 89% of anaesthetic staff said improved IT systems would increase their productivity, including 46% who believed the improvement would be “big”.
- The most problematic areas of current IT systems were identified as the loading speed of computers (rated “poor” or “very poor” by 58% of anaesthetic staff) and the ability of software to quickly and easily provide patient information (44%).
- 57% of clinical leaders reported that paper patient records are still in use in their hospitals, suggesting many organisations have not yet fully transitioned to digital systems.
- 57% of all anaesthetic staff were dissatisfied with the pension taxation regime – including 75% of consultants and 49% of specialty, associate specialist and specialist (SAS) doctors.
- 29% of consultants and 14% of SAS doctors (26% combined) reported that they were reducing their working hours due to pension taxation at the time of the survey.
- Of those consultants and SAS doctors who were reducing their hours, on average they said they would work an extra 2.5 additional programmed activities (PAs) per week if pension taxation were not an issue. Securing that extra time would equate to an estimated 7,826 extra PAs per week across the UK – a potential 5.5% increase in anaesthetic capacity.
- This increase in PAs would enable almost 10,000 additional patient cases per week across the UK, equivalent to around 450,000 additional cases per year.
- 24% of all anaesthetic staff who were considering leaving the NHS or unsure about staying said that reform of pension taxation would make them more likely to remain, rising to 49% among consultants.