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When the anaesthetist is informed of a request for neuraxial analgesia (and the circumstances would be suitable for this type of analgesia) the anaesthetist should attend within 30 minutes of being informed. Only in exceptional circumstances should this period be longer, and in all cases attendance should be within one hour.  This should be the subject of regular audits.^27,115

Anaesthesia may be required for radiotherapy, to facilitate patient positioning and to alleviate pain. Owing to the unique nature of the procedures involved in radiotherapy, the remoteness of the location and the lack of direct access to the patient, only anaesthetists familiar with the therapy should embark on anaesthesia for these patients.^48,50 The anaesthetic should be provided...

Access for preoperative assessment staff to multidisciplinary teams support from other physicians, medical specialists, anaesthetists, surgeons and pain management teams should be available.¹²

The anaesthetist should have a competent trained assistant immediately available for the duration of any anaesthetic intervention and this practitioner should not have any other duties.³³

Autonomously practising anaesthetists and intensivists should be involved in the planning of local trauma services. Those with defined responsibility for major trauma management should be engaged in the layout and logistics of the resuscitation room, interventional radiology and theatres suites.

Anaesthetists who prescribe sedation for paediatric burn patients should have received appropriate training. ^15,52

A small number of centres perform burn surgery. These centres should offer external training opportunities for anaesthetists, nursing staff, physiotherapists and other members of the multidisciplinary team.⁶⁰

Online imaging results from referring hospitals and within the neuroscience centre should be available locally, and consideration should be given to the provision of remote access for all anaesthetists who provide cover to neuroanaesthesia out of hours.

Consultant anaesthetists who provide out of hours cover to the neuroscience unit but do not provide neuroanaesthesia in working hours should be able to demonstrate the maintenance of appropriate skills and knowledge through regular clinical involvement and CPD.

Cardiac anaesthetists working in non-transplant centres should be familiar with the principles of the anaesthetic management for patients who have previously undergone heart or lung transplantation.⁴²