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In a designated major trauma centre, the receiving trauma team should include an anaesthetist with appropriate airway and damage control resuscitation competencies to manage trauma patients.^48,49

Anaesthetists should have specialised knowledge of the effect of concurrent medications, anaesthetic agents, anaesthetic techniques and equipment on the conduct and efficacy of ECT, as well as the specific anaesthetic contraindications.^70,71

Protocols should be developed to ensure that accurate clinical information is available in a timely manner to the anaesthetist to avoid any delays in treatment. There should be an agreed process for alerting the mechanical thrombectomy team if anaesthetic provision is unavailable to allow referral to another mechanical thrombectomy centre.

The children’s IPS should be delivered by an appropriately trained and experienced MDT, with specific skills in paediatric pain management and paediatric anaesthesia. The team may include clinical nurse specialists, anaesthetists, paediatricians, surgeons, pharmacists, child psychologists and physiotherapists. 

Prioritisation of cases based on their clinical urgency is not the sole domain of any single specialty. It requires a team approach involving discussion between different surgical groups, anaesthetists and, in some cases, critical care.⁴

Standards of accommodation for doctors in training should be adhered to.²⁹ Where a consultant or other autonomously practising anaesthetist is required to be resident, on-call accommodation should be provided.²⁸

There should be an appropriately trained theatre team including an on-call consultant anaesthetist 24/7 to provide anaesthesia for emergency head and neck surgery in head and neck cancer centres and in hospitals with an emergency department.⁹ 

Many patients with head and neck cancer have significant comorbidities that may require optimisation prior to surgery. There should be a lead anaesthetist for preoperative assessment who works closely with an appropriate preoperative assessment team.¹⁴

Where possible, surgery should be postponed until after delivery. If this is not possible, for example in cases of head and neck cancer, a multidisciplinary team approach is highly recommended, typically involving anaesthetists, surgeons, oncologists, obstetricians, midwives and paediatricians and, in cases of thyroid malignancy, endocrinologists.

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