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Anaesthetists should be trained in the use of, and be familiar with, all equipment they use regularly. The anaesthetist has a primary responsibility to check such equipment before use.¹⁹

MTC and TU anaesthetic departments should consider appointing anaesthetists with an interest in prehospital care. Anaesthetists who provide prehospital care in the field should be qualified to do so.⁵

In busier units, increased levels of consultant or other autonomously practising anaesthetist cover may be necessary and should reflect the level of consultant obstetrician staffing in the unit.²⁹ This may involve extending the working day to include senior presence into the evening session and/or increasing numbers of autonomously practising anaesthetists.

When an awake fibreoptic intubation is required, patients should be informed. As part of a difficult airway follow-up, patients should be informed verbally and in writing about any airway problem the anaesthetist encountered, and should be advised to bring this issue to the attention of anaesthetists during any future preoperative assessment. The patient’s general practitioner should also be informed in...

Specialist anaesthetists should be involved in the discussion of referrals and planning when conducted in the setting of a multidisciplinary team. This involvement should be recognised in job plans. Anaesthesia for complex adult congenital heart procedures should be undertaken by suitably trained adult congenital anaesthetists. Appropriate support from ACHD cardiologists and other cardiologists with suitable expertise in ACHD is necessary.³³

At all times SAS anaesthetists who are not autonomously practising anaesthetists should be supervised at an appropriate level(1-4) of sessional supervision, varying depending on both their level, including their previous experience and capability, and the case or cases for which they are being supervised doing.^37,41,42

Structured training in regional anaesthesia should be provided to all anaesthetists in training and any other anaesthetists who wish to learn any of these techniques. The training should include an understanding of the relevant anatomy, physiology, pharmacology, ultrasound physics, non-technical skills and the prevention and management of complications. Part-task trainers may be used to improve practical skills.⁴⁸