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An appropriately trained and experienced anaesthetist with regular commitments to burn and plastic surgery should be present during the conduct of general and regional anaesthesia for operative procedures, including those procedures requiring intravenous sedation where it has been agreed that this will be provided by the anaesthesia department.

Patients requiring burn or plastic surgery procedures should be managed by anaesthetists who have an appropriate level of training in this field. They should have a regular commitment to the burn and plastic surgery specialty and should have acquired the relevant knowledge and skills needed to care for these patients.

Because burn care is a small specialty with relatively few anaesthetists able to participate in burn care during training, each service should have plans in place to establish and maintain an appropriate anaesthesia workforce.⁵⁹

All anaesthetic equipment should be checked prior to use in accordance with the Association of Anaesthetists’ published guidelines.¹²⁵ Anaesthetic machine checks should be recorded in a log and on each patient’s anaesthetic chart.

If no anaesthetist is present in theatre, an appropriately trained anaesthetic nurse, ophthalmic theatre nurse or operating department practitioner should be present to monitor the patient during establishment of local anaesthesia and throughout the operative procedure. This should be their sole responsibility.²

Clinical leaders within anaesthetic services should be an integral part of system planning including how to deliver planned care and emergency care. They should have influence in all areas in which anaesthetists contribute to service delivery.⁸

Anaesthetists who provide out of hours cover to areas of practice that they do not provide in working hours, should be able to demonstrate the maintenance of appropriate skills and knowledge through regular clinical involvement and CPD. This should be facilitated during working hours where possible.

All anaesthetists completing the 2021 RCoA curriculum should be able to deliver a range of safe and effective central or peripheral regional anaesthetic techniques to cover the upper and lower limb, chest and abdominal wall independently.⁴⁷

All anaesthetists should have access to adequate time, funding and facilities to undertake training in, and update or advance their regional anaesthesia knowledge and skills relevant to their clinical practice.^2,18

For children, a staff member with an advanced paediatric life support qualification or an anaesthetist with paediatric competencies should be immediately available.^32,33,42