Statement on standards of care across the NHS and independent sector

The RCoA believes that all patients, irrespective of whether they receive care in NHS or independent sector facilities, are entitled to the same high standards of anaesthetic and perioperative care.  

Our published clinical guidance, safety standards, professional expectations, oversight and governance apply equally across both settings and patients should be able to assume this is so.

The role of the independent sector in delivering NHS‑funded treatment has grown substantially in recent years and an ever‑greater proportion of anaesthetic care for NHS patients is now taking place in independent sector hospitals. Independent providers delivered more than 6 million NHS appointments, tests and operations in the past year, an increase of almost 500,000 on the previous year1. NHS England data also indicate that the independent sector is now delivering around 10% of all NHS elective activity, up from approximately 8% before the pandemic and this proportion is still rising.  

In order to ensure consistency, excellence and the sharing of best practice, the College runs an accreditation scheme - Anaesthesia Clinical Services Accreditation (ACSA) – which now has over 80% of NHS departments of anaesthesia registered as participants. This provides a nationally recognised framework to ensure services are safe, effective and patient‑centred. We strongly encourage all organisations—NHS and independent sector—to participate in the ACSA process as a mechanism for demonstrating their commitment to high‑quality anaesthetic and perioperative care and to reassure patients that this is the case regardless of location.

The RCoA are delighted to have been able to recently award this accreditation to the Sulis Hospital in Bath. Having demonstrated their commitment to high standards of anaesthetic and perioperative care through engagement with our Anaesthesia Clinical Services Accreditation (ACSA) scheme, Sulis joins over 60 NHS anaesthetic departments who have completed the accreditation process, and is the only hospital in the independent sector that is currently ACSA accredited.  

Dr Claire Shannon, President of the Royal College of Anaesthetists, said:  

“Patients should be able to expect the same high-quality anaesthetic and perioperative care wherever they are treated. As more care is being delivered in the independent sector, it is vital that providers work to the same nationally recognised standards.  

“We encourage all providers, across both the NHS and independent sector, to engage with ACSA and with national audit and quality improvement programmes. By working to shared standards, embracing accreditation and contributing to national learning, we can help ensure that every patient receives safe, effective and consistent high-quality care.”

In addition to quality and safety delivered through ACSA accreditation, participation in national audit and quality improvement programmes is essential to maintain and improve standards of anaesthetic care across all settings. As the College’s National Audit Project on Complications of Regional Anaesthesia (NAP8), gets underway, we strongly encourage participation from both NHS and independent sector providers. NAP8 will rely on comprehensive national engagement to ensure its findings are representative and to support meaningful system‑wide learning. Given the increasing volume of NHS‑funded care delivered in the independent sector the inclusion and engagement of independent providers in every NAP project is increasingly important. Full participation will help ensure that every patient, wherever they receive their care, benefits from robust national audit, shared learning and improved safety.

The RCoA is committed to ensuring the highest levels of anaesthetic and perioperative care for all patients and will actively support all providers to meet these expectations. As the proportion of NHS care delivered in the independent sector continues to grow, it is increasingly important that anaesthetic services across all settings align with shared national standards, so that every patient can be confident they will receive consistently high‑quality care, regardless of where their treatment takes place.