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A nurse led sedation service should be supported by an immediately available burn anaesthetist.⁴¹

Specialist anaesthetists should be involved in the discussion of referrals and planning when this is conducted in the setting of a multidisciplinary team. This should be recognised in job plans.

Consideration should be given to identifying anaesthetists with advanced airway experience to support colleagues providing care to patients with complex airway emergencies.

Anaesthetists undertaking major vascular surgical cases should be supported by adequately trained assistants who work regularly in the vascular theatres.

There should be a duty anaesthetist immediately available for the obstetric unit 24/7. As their primary responsibility is to provide care to those in labour or who require medical or surgical interventions, ante or peripartum, the role should not include undertaking elective work during the duty period.²²

The lead obstetric anaesthetist should ensure representation of the anaesthetic department at multidisciplinary meetings for service planning and governance purposes, including labour ward forum, risk management groups and incident reviews.^22,24

Non-specialist tertiary paediatric centres should have a multidisciplinary committee for paediatric care to formulate and review provision. This committee should involve anaesthetists, paediatricians, surgeons, emergency department representatives, senior children’s nurses, managers and other professionals, such as paediatric pharmacists. In some hospitals, this will also include critical care physicians.

Parents and carers should be involved throughout the care process. With the agreement of the anaesthetist in charge of the case on the day, they should be able to accompany children to the anaesthetic room, remain present for induction of anaesthesia and be able to gain easy access to the recovery area. In special circumstances, such as with some small...

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 appropriately experienced anaesthetists familiar with the therapy should embark on anaesthesia for these patients.⁷³

There should be a system in place for antenatal anaesthetic review by a senior anaesthetist for women who are morbidly obese.¹⁰³ Assessment should be arranged to ensure that timely delivery planning can take place.¹⁰⁴