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Although separate written consent for anaesthesia is not mandatory in the UK, there should be a written record of all discussions, including those of the requesting clinician, with patients undergoing sedation or anaesthesia for diagnostic procedures such as MRI scans. Discussion should include methods of induction, associated risks, side effects and potential benefits of the procedure. It is not the...

The anaesthetist should contribute in the multidisciplinary perioperative care process which focuses on preoptimisation, patient education, standardised enhanced recovery pathways of care aimed at delivering early mobility, discharge, and early return to normal life.^46,62 The option of doing nothing should be considered where relevant.^63,64

In all centres admitting children, one or more anaesthetist should be appointed as clinical lead (see Glossary) for paediatric anaesthesia. Typically, they should undertake at least one paediatric list each week and will be responsible for co-ordinating and overseeing anaesthetic services for children, with particular reference to teaching and training, audit, equipment, guidelines, pain management and resuscitation. There should...

Anaesthetists should be aware of legislation and good practice guidance relevant to children and according to the location in the UK.^{106,107,108,109,110,111,112} These documents refer to the rights of the child, child protection processes and consent.

Any autonomously practising anaesthetist providing cover for the labour ward regularly or on an ad hoc basis must undertake continuing professional development (CPD) in obstetric anaesthesia and must have enough exposure to obstetric patients to maintain appropriate skills. This could be achieved through allocation of supernumerary sessions on the labour ward or in elective caesarean lists while reviewing appropriate CPD...

Fellowship posts should be identified to allow additional training for those who wish to follow a career in cardiac anaesthesia(Including adult congenital heart disease and paediatric cardiac anaesthesia) to ensure that there are adequate numbers of skilled anaesthetists in the specialty. These should be suitable for trainees who wish to take time out of training programmes or for those who...

Where postoperative care is delivered outside of a main ICU (e.g. a level 2 high dependency unit (HDU) or specifically developed PACU), nurse-led, protocol driven care of frequently occurring problems for high risk surgical patients (such as pain, fluid imbalance, nutrition and mild cardiorespiratory compromise) can ensure good patient outcomes.²⁵⁰ Protocols and policies should be agreed between nursing staff...

Departments should have a policy on how to care for patients with additional needs including those covered under the Equality Act, and consider appointing an assigned lead anaesthetist with time in their job plan for the role.^272,273 The policy should incorporate preassessment, deprivation of liberty assessment, consent, pathways to minimise anxiety and considerations for analgesia and discharge planning.²⁷⁹

Local protocols should determine the grade, experience and competency based training of non-anaesthetist healthcare professionals undertaking preoperative assessments.⁴⁹ In addition , all members of the team including administrative, managerial and clinical staff who interact with the patient preoperatively should have skills in motivational interviewing and preoperative optimisation.^50,51 

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