All patients undergoing anaesthesia should be under the overall care of a consultant or other autonomously practising anaesthetist whose name is recorded as part of the anaesthetic record. 278
In an emergency situation involving a child requiring anaesthesia for an airway or head and neck procedure, the most experienced available anaesthetist and surgeon would be expected to provide life-saving care when transfer to a specialist facility is not feasible.
Local policies should be in place to define the scope of intraoperative monitoring by non-anaesthetist health care workers. These policies should meet the criteria proposed by RA-UK.16
Hospitals should consider providing specific regional anaesthesia lists for awake procedures, staffed by an anaesthetist with a special interest in regional anaesthesia. However, alternative lists for patients unable or unwilling to undergo awake surgery should be available.
Critically ill patients are complex and hold unique particularities that makes them more susceptible to side effects and complications of regional anaesthesia techniques. Experienced regional anaesthetists should perform/supervise regional anaesthesia techniques in these patients.
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The fast-paced environment, heavy workload and burden of exams and portfolio, can leave little time for trainees to engage in the necessary discussions or meetings to advocate for change. Additionally, the hierarchical structure of medical training can inhibit resident doctors from voicing their ideas as they may not feel respected enough to have influence.
‘Safety and Quality Improvement’ is one of the generic professional domains throughout the anaesthetic training programme. Trainees are expected to conduct local quality-improvement projects, in addition to participation in regional or national projects.
