Anaesthetists should be involved in audit cycles, preferably using a rapid-cycle quality improvement approach. These cycles benchmark standards of care and may be effective change drivers. This approach is an excellent way of providing evidence of good practice as defined by the GMC and mapping the contribution that individuals make to any service within their hospitals.27,199
RA-UK recommend that, under certain strict criteria and as defined in RA-UK supervision guidelines, intraoperative patient monitoring may be delegated to a suitably trained health care worker who has been specifically trained in patient monitoring according to Association of Anaesthetists guidelines. This recommendation pertains to awake surgery under peripheral regional anaesthesia but excludes patients undergoing shoulder surgery in the deck...
High quality anaesthesia is pivotal to achieving successful outcomes following day surgery. The majority of anaesthesia for day surgery should be delivered by consultant anaesthetists.15,16 staff grade, associate specialist and specialty doctors (SAS) grade doctors and experienced trainee anaesthetists may also provide anaesthesia for day surgery. However, these doctors should be suitably experienced and skilled in...
An appropriately skilled and experienced resident anaesthetist should be available at all times to care for postoperative and emergency patients. The experience and skills necessary to provide this cover are not usually found in training grades below ST3.5
Patients requiring burn or plastic surgery procedures should be managed by anaesthetists who have an appropriate level of training in this field, have regular commitment to the burn and plastic surgery specialty, and have acquired the relevant knowledge and skills needed to care for these patients.
Hospitals should provide scheduled local anaesthetic 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.
Cardiac and thoracic anaesthesia is a ‘key unit of training’ for intermediate level training in anaesthesia.61 Trainee anaesthetists should be of appropriate seniority to be able to benefit from this area of training.
There should be sufficient time before an operation for the anaesthetist to conduct a satisfactory preoperative assessment. If this does not happen, it is possible that surgery may be delayed or postponed. The provision of a good preoperative assessment and preparation process should minimise this.
