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In order to maintain the necessary knowledge and skills, vascular anaesthetists should have a regular commitment to the specialty, and adequate time must be made for them to participate in relevant multidisciplinary meetings and continuing professional development (CPD) activities. This should include the facility and resources to visit other centres of excellence in order to exchange ideas and develop new...

It is recommended that individual vascular anaesthetists register with, and contribute to, the UK national audit database (National Vascular Registry),⁴⁶  which incorporates a section dedicated to ‘anaesthesia’ as developed between the Vascular Anaesthesia Society of Great Britain and Ireland and partnership organisations. The systems needed to provide the necessary data should be available and supported.

Thoracic anaesthesia is a ‘key unit of training’ in both the 2010 intermediate level training in anaesthesia³⁴ and in the newer 2021 Curriculum Stage 2.³⁵of training. Trainee anaesthetists should be of appropriate seniority to be able to benefit from this area of training. Stage 3 training of the 2021 Curriculum also requires trainees to be proficient...

Consultant or autonomously practising anaesthetists intending to deliver anaesthesia for thoracic surgery should have received training to a higher level in thoracic anaesthesia. This should be undertaken as a Special Interest Area in Stage 3 training for a period of 3 - 6 months in a recognised training centre.³⁶ Those providing critical care for cardiothoracic surgical patients should...

Anticipated difficulty with anaesthesia should be brought to the attention of the anaesthetist as early as possible before surgery.⁸⁰ This includes planned admission to a critical care unit, the potential need for special skills such as fibre optic intubation, obesity, complex pain problems, a known history of anaesthetic complications or patients with learning disabilities who may require additional resources...

The experience and expertise of the anaesthetist assessing the patient preoperatively should be appropriate for the complexity and level of risk of the patient.⁴⁶ The decision to operate on high risk patients should be made at a senior level, involving surgeons and those who will provide intra and postoperative care.^3,14,33

Each DSU should have a clinical director or specialty lead. This will often, but not always, be an anaesthetist with some management experience. The role of the clinical director is to champion the cause of day surgery and ensure that best practice is followed. This role may involve the development of local policies, guidelines and clinical governance and should be...