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Anaesthetists who care for children should have received appropriate training and must ensure that at annual appraisals competence in anaesthesia and resuscitation is deemed adequate for the cases undertaken by that individual.^3,4

An appropriately trained and experienced anaesthetist should be present throughout the conduct of anaesthesia for all procedures, including those procedures requiring intravenous sedation (where provision of this service has been agreed by the anaesthetic department). In exceptional circumstances, for example, where urgent treatment for another patient requires the anaesthetist to leave the patient, they should delegate responsibility to another appropriate...

Within hospitals there should be multidisciplinary agreement on the level of anaesthetic staffing requirements and competence for the local provision of surgical services based on the clinical need, surgical and anaesthetic experience and training, children’s ward facilities and paediatric medical provision. Organisations should liaise with regional ODNs to develop in partnership a framework for local hospitals to follow.

All patients requiring anaesthesia, pain management, or perioperative medical or intensive care should have a named and documented supervisory autonomously practising anaesthetist (see Glossary) who has overall responsibility for the care of the patient. To ensure the safety of patients, anaesthetists in training, staff grade, associate specialist and specialty (SAS) doctors who are not autonomously practising and anaesthesia associates...

There should be a locally agreed policy on the level of consultant supervision required, based on the age, complexity and co-morbidities of the patient.^3,8,9

In the period immediately after anaesthesia, the child should be managed in a recovery area, staffed on a one-to-one basis at least until the child can manage their own airway. The staff in this area should have paediatric experience and current paediatric competencies, including resuscitation.^10,11 An extra member of staff in the recovery area can be extremely...

An additional member of staff with advanced training in life support for children should always be available to assist where required.^12,13,14

All paediatric patients undergoing anaesthesia should have immediate access to a consultant paediatrician either in person or via telephone/videocall.¹⁵