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To act as duty anaesthetist without direct supervision from a consultant, the anaesthetist should meet the basic training specifications and have attained the RCoA’s Initial Assessment of Competency in Obstetric Anaesthesia.²²

At all times, there should be an on site anaesthetist who has the ability and training to undertake immediate clinical care of all emergency surgical patients. Explicit arrangements should be in place to provide support from additional anaesthetists appropriate to local circumstances.

Anaesthesia departments should have a nominated anaesthetist immediately available and free from direct clinical responsibilities to provide cover in clinical emergencies, as well as providing advice and support to other anaesthetists.³⁹

The anaesthetist should not be responsible for performing the cardioversion; an appropriately trained physician, cardiologist or supervised nurse specialist is responsible for this role. Wherever possible, the anaesthetic should be administered by an appropriately experienced anaesthetist.³³

A named anaesthetist should be responsible for liaising with consultants in other departments with responsibility for sedation, to establish local guidelines and training for the provision of safe sedation by non-anaesthetists.^1,65

Anaesthetists with a specific interest in orthopaedics and trauma should deliver regular theatre sessions to ensure the maintenance of their skills and experience.

Patients undergoing sedation or general anaesthesia by an anaesthetist should have appropriate preoperative assessment with appropriate risk stratification.

There should be a forum for discussion of matters relevant to both surgeons and anaesthetists, for example protocol development and critical incidents.

All obstetric departments should provide and regularly update multidisciplinary guidelines. A comprehensive list of recommended guidelines can be found in the Obstetric Anaesthetists' Association (OAA)/Association of Anaesthetists guidelines for obstetric anaesthesia services.⁵⁵