Public Affairs

To ensure the anaesthetic voice is heard during policy making, we engage with a range of stakeholders.  

Who we work with 

We have met with a range of key leaders and stakeholders across the UK, including: 

  • ministers for health and social care in England, Scotland, Wales and Northern Ireland
  • members of the UK parliament, Senedd, Northern Ireland Assembly, and Scottish parliament
  • members of the House of Lords
  • senior figures within the NHS, health regulatory bodies, think tanks and charities
  • presidents of medical royal colleges and associations.

In Parliament and devolved nation legislatures

Politicians across the UK have raised our priorities through written and oral parliamentary questions. These include questions from: 

Party Conferences 

Party conferences are annual events where political parties discuss policy and strategy matters. They provide an opportunity to raise the challenges facing the anaesthetic workforce and build alliances.  

  • In all recent years, the RCoA President has attended at least one major party conference.  
  • In 2025, Dr Claire Shannon is attending the Labour Party Conference in Liverpool. 

Consultation responses 

We regularly respond to Government consultations to share our expertise and ensure anaesthetists are considered in health reforms across the UK.

Progress so far 

Anaesthetic training places 

Our engagement work has helped ensure the NHS is getting more anaesthetic training places in each nation of the UK: 

  • England: 70 additional higher training posts per year from 2022 – 2024, extended into 2025 with a further seven places added 
  • Northern Ireland: eight new places in 2025 
  • Wales: six new places in 2023 
  • Scotland: six new places in 2024. 

While these are important gains, they remain well below the numbers needed to meet growing demand.

Pension taxation reform 

The pension taxation regime has been a major problem affecting the anaesthetic workforce. In 2020, our census data revealed that 1,133 consultants were reducing their working hours due to pension taxation, impacting workforce capacity.  

We pushed for reform of the pension taxation regime, and in the March 2023 budget, the Government made changes that helped to reduce pension taxation problems for many doctors. However, we are aware that this did not solve the issue for all doctors.

Advancing perioperative care 

Working with the Centre for Perioperative Care (CPOC), we’ve seen significant advancements in perioperative care delivery across the UK.

NHS England’s plan for ‘Reforming elective care for patients’, January 2025 

NHS England and the Department of Health and Social Care’s plan for Reforming elective care for patients, included several policies we have long advocated for to optimise the surgical pathway, such as: 

  • smoking cessation and weight loss programmes ahead of surgery
  • better prehabilitation for patients about to undergo cancer treatment
  • expanded opportunities for self-management through shared decision-making tools
  • improved discharge processes
  • monitoring productivity metrics including length of stay and short notice cancellations
  • establishing a maximum number of short-notice cancellations due to clinical reasons
  • only give patients a date for their procedure once they’ve been confirmed in their pre-assessment.   

NHS England’s Standard Contract  

In 2022, NHS England updated their Standard Contract, which now requires providers to ‘implement and maintain a system of early screening, risk assessment and health optimisation for all adult Service Users waiting for inpatient surgery, in accordance with Perioperative Care Pathways Guidance’. 

Dr Penny Dash’s review of the Care Quality Commission, October 2024 

Through CPOC, we engaged with Dr Penny Dash to inform her Review into the operational effectiveness of the Care Quality Commission.  We highlighted the opportunities of including perioperative care interventions and outcomes in the CQC’s assessment framework. Her final recommendations included a stronger focus on effectiveness, outcomes, innovative models of care delivery and efficient use of resources.  

NHS Wales Guidelines for the management of Referral to treatment waiting times, April 2025 

The Welsh Government’s Guidelines for the management of Referral to treatment waiting times recommends that all health boards ‘provide appropriate support for patients awaiting surgery’. It suggests all patients should be pre-assessed ahead of surgery, that appropriate patients should be referred to prehabilitation and pre-optimisation services and that patient preferences should be identified through shared decision-making processes.