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Anaesthetists with an appropriate level of training should attend patients undergoing major elective vascular surgery.

Nationally agreed key performance indicators should be used to monitor the performance of the pathways for hip fractures and major trauma and reviewed by a multidisciplinary committee including a trauma lead anaesthetist. In addition, local quality indicators should be developed proactively, to support continuing improvement of these services within organisations.

Anaesthetists must undertake at least level 2 training in safeguarding/child protection,¹¹⁰ and must maintain this level of competence by regular annual updates on current policy and practice and case discussion.114

Anaesthetists should always be supported by dedicated, appropriately skilled and trained assistants. Recovery facilities should be staffed during all operating hours and should have appropriate anaesthesia support until the patient meets agreed discharge criteria.¹²

If responsibility for care is transferred from one anaesthetist to another, a ‘handover protocol’ should be followed, during which all relevant information concerning the patient’s medical history, medical condition, anaesthetic status, and plan should be communicated.¹⁸⁰

If a patient is transferred to the recovery unit with a tracheal tube in situ, the anaesthetist remains responsible for the removal of the tube but may delegate its removal. Delegation should be to an appropriately trained member of staff who is prepared to accept this delegated responsibility.¹⁷⁸

The anaesthetist should invite and answer questions from the patient or, if appropriate, the patient’s relatives.

The anaesthetist should be part of a burns multidisciplinary team.¹¹

The duty anaesthetist should be informed as soon as a woman with a BMI above a locally agreed threshold is admitted.

An anaesthetist should be involved in all case reviews where the case includes anaesthetic input.