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Hospitals should provide scheduled local anaesthesia lists, using a dedicated area for initiating and assessing local nerve blocks. Organising cases in this way fosters the development and maintenance of expertise in the anaesthetists and support staff and minimises delay between cases.

If sedation is performed without an anaesthetist present, a designated, appropriately trained individual should be responsible for monitoring the patient and keeping records. This should be their sole responsibility¹ and should comply with the hospital’s sedation policy.

A multidisciplinary team (MDT) may be required, and this may include plastic, vascular or neurosurgical surgeons for complex head and neck surgery. Anaesthetists may be required to attend MDT meetings preoperatively, and this should be included in their job plan if it forms a regular commitment.

In all hospitals undertaking major vascular anaesthesia a vascular anaesthetist should be appointed clinical lead (see glossary) to manage service delivery. This should be recognised in their job plan, and they should be involved in multidisciplinary service planning and governance within the unit.

Specific local policies pertinent to trauma and orthopaedic surgery should be developed by a multidisciplinary team including an anaesthetist, acute pain nurse, pharmacist, physiotherapist, critical care clinicians, surgeons and other relevant specialties.⁹

Anaesthetists who work regularly within the radiology department should be issued with personal dosimeters by their employer to monitor their radiation exposure and to ensure that levels remain within statutory dose limits.⁵⁸

The anaesthetist’s primary responsibility is care of the woman. A separate healthcare professional should be responsible for neonatal resuscitation and the care of the newborn baby.^167,31

A process should be in place for the formal assessment of anaesthetists before allowing them to join the on-call rota for obstetric anaesthesia with distant supervision.^20,122

Every unit should provide, in early pregnancy, advice about pain relief and anaesthesia during labour and delivery. An anaesthetist should be involved in preparing this information and should approve the final version.¹⁴²

General anaesthesia for dental procedures should be administered only by anaesthetists in a hospital setting as defined by the Department of Health report reviewing general anaesthesia and conscious sedation in primary dental care.³