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There should be access to a range of specialist cardiology services such as imaging cardiology.31

24/7 access to cardiac electrophysiology services should be available.

Children with congenital heart disease undergoing cardiac procedures have special requirements and care should be provided by appropriately trained paediatric cardiac anaesthetists.^32,33

Paediatric cardiac surgical patients should be cared for in a unit designed and equipped to care for paediatric patients and staffed by appropriately trained nurses. There should be facilities and staffing to support parents/carers accompanying children in the an aesthetic environment. Such a unit should meet the standards defined for paediatric critical care, including adequate arrangements for retrieval and transfer...

Anaesthetists should be aware of legislation and good practice guidance relevant to children and according to the location in the UK.^{35,36,37,38,39}

Children currently transition to adult congenital heart disease services at the age of 16–18 years, although transition services are integrated into the care pathway from 12 years of age. Anaesthetists should be aware of legislation and good practice guidance relevant to young and vulnerable adults.^35,41

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

Consultants or autonomously practising anaesthetists providing anaesthesia for heart or lung transplantation should have appropriate training and substantial experience of advanced cardiovascular monitoring and support.

Cardiac anaesthetists working in non-transplant centres should be familiar with the principles of the anaesthetic management for patients who have previously undergone heart or lung transplantation.⁴²

Patients undergoing heart or lung transplantation may be under the age of 18 years. Anaesthetists must be aware of legislation and good practice guidance relevant to young and vulnerable adults.^35,41 Children undergoing transplantation should be cared for in a paediatric centre.