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Busier units (see Glossary) should consider having two duty anaesthetists available 24/7, in addition to the supervising autonomously practising anaesthetist.²³

In units offering a 24-hour regional analgesia service, the duty anaesthetist should be resident on the hospital site where the regional analgesia is provided (not at a nearby hospital).

The duty anaesthetist should have an effective and rapid means of communication with their supervisor at all times.²³ Staff working in the maternity unit should be aware of their supervisor’s identity, location and how to contact them. The name(s) of the autonomously practising anaesthetist(s) covering the delivery suite and how to contact them should be clearly displayed and easily...

It is recognised that, in smaller units, the workload may not justify having an anaesthetist exclusively dedicated to the delivery unit. If the duty anaesthetist does have other responsibilities, these should be of a nature that would allow the activity to be immediately delayed or interrupted should obstetric work arise. Under these circumstances, the duty anaesthetist should be able to...

Adequate time for formal multidisciplinary team (MDT) handovers between shifts should be built into the timetable. In the case of the anaesthetist being otherwise engaged with work at the time of the MDT labour ward handover, a briefing from the midwifery and obstetric team should be sought at the earliest opportunity to facilitate a shared mental model of the existing...

A structured tool should be considered for handover between shifts and its formal documentation.^23,24,26

The duty anaesthetist should participate in MDT delivery suite handovers and ward rounds.^24,27

Every obstetric unit should have a designated lead anaesthetist (see Glossary) with specific programmed activities allocated for this role.²

The lead obstetric anaesthetist should be responsible for the overall delivery of the service, including:

• ensuring that evidence based guidelines and protocols are in use and are up to date
• monitoring staff training
• workforce planning
• service risk management
• ensuring that national specifications are met
• auditing the service against agreed standards, including anaesthetic complication rates, as set out in the RCoA ...

The lead obstetric anaesthetist should ensure representation of the anaesthetic department at multidisciplinary meetings for service planning and governance purposes, including labour ward forum, risk management groups and incident reviews.^22,24