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Older patients should have access to a consultant or other autonomously practising anaesthetist experienced in the management of the older surgical patient to support shared decision making, patient optimisation and perioperative care. Opportunities for joint geriatric and surgical clinical governance should be considered as this model of care is superior to that delivered without this expert support. ^229,244,245

A support system and guidelines developed in conjunction with occupational health professionals should be in place to help anaesthetists returning to clinical work after a period of absence from clinical practice.^{21, 22} These could include, but are not limited to, returning after parental leave, or returning following long-term illness.²³

Intermediate level training as set out in the RCoA 2010 Curriculum⁴¹should be an essential criterion and higher level training a desirable criterion in the person specification for a consultant or autonomously practising anaesthetist with ophthalmic anaesthetic sessions in the job plan. For candidates who are trained on the RCoA 2021 Curriculum, the special interest area in ophthalmic anaesthesia...

Appropriately trained healthcare workers monitoring patients who have undergone regional anaesthesia should be specifically trained with their competencies clearly defined according to the Association of Anaesthetists’ requirements for post-anaesthesia care unit (PACU) recovery nursing.²⁹ This individual should be able to recognise symptoms and signs of local anaesthetic toxicity.²⁵

Some aspects of preanaesthetic assessment and preparation of the emergency patient differ from those of the elective patient. These include severity of illness, fluctuating condition of the patient, and the 24/7 nature of emergency work. Staffing levels and seniority of anaesthetists should be adequate to enable preanaesthetic planning and assessment that is appropriate to the patient’s risks associated with surgery...

Appropriate staffing levels and skill mix should be provided in all units, multispecialty general hospitals, isolated units and large single specialty centres, delivering ophthalmic anaesthesia. For most operating sessions, this should include surgeon, anaesthetist, two theatre trained scrub practitioners, one trained nurse or operating department practitioner to assist with local anaesthesia/patient monitoring, and one theatre support worker/runner.^2,3

All anaesthetists who provide elective or emergency care for infants, children or young adults should have advanced training in life support that covers their expected range of clinical practice and responsibilities.^49,50 These competencies should be maintained by annual training that are ideally multidisciplinary and scenario based.⁵¹