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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...

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 

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.^274,275 The policy should incorporate preassessment, deprivation of liberty assessment, consent, pathways to minimise anxiety and considerations for analgesia and discharge planning.²⁸¹

Some aspects of preoperative anaesthetic 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 preoperative anaesthetic planning and assessment that is appropriate to the patient’s risks associated...

A minimum of two members of staff should be present (of whom at least one should be a registered practitioner) when there is a patient in the PACU who does not fulfil the criteria for discharge to the ward. If this level of staffing cannot be assured, an anaesthetist should stay with the patient until satisfied that the patient fulfils...

There must be the ability to provide the patient with the appropriate chaperone, as per GMC guidance on intimate examinations and chaperones.¹¹ When examining a patient, anaesthetists must be sensitive to what the patient may consider as intimate, which could include any examination where it is necessary to touch or even be close to the patient.