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A patient’s consent to participate in research projects should be obtained by those conducting the study and not by the anaesthetist providing care for the operation. Consent should be obtained on a separate signed document and approval should be sought from the anaesthetist who will be delivering the anaesthetic to the patient.^79,81

When an awake fibre-optic 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 be advised to bring this to the attention of anaesthetists during any future preoperative assessment. The patient’s GP should also be informed in writing.⁷⁰

Anaesthetists with a substantial commitment to paediatric anaesthesia should have satisfied the higher and advanced level competency based training requirements in paediatric anaesthesia of the RCoA⁴⁸ or equivalent. It is recognised that anaesthetists involved in highly specialised areas such as paediatric cardiac and neurosurgery will require additional training that is individually tailored to their needs.

If a patient is transferred to the post-anaesthesia care unit (PACU) with a tracheal tube in place, the anaesthetist remains responsible for the removal of the tube but may delegate its removal. Delegation should be to an appropriately trained member of the PACU staff who is prepared to accept this delegated responsibility.⁴

The preoperative assessment and decisions regarding the risks of vascular surgery are often complex and time consuming, and require detailed discussions with the patient and other colleagues. Patients undergoing major vascular surgery should ideally be assessed by a vascular anaesthetist. Regular sessional time and programmed activities should be made available for anaesthetists to fulfil these requirements.²²

The preoperative assessment and decisions regarding the risks of vascular surgery are often complex and time consuming, and require detailed discussions with the patient and other colleagues. Patients undergoing major vascular surgery should ideally be assessed by a vascular anaesthetist. Regular sessional time and programmed activities should be made available for anaesthetists to fulfil these requirements.¹²

AAs should be supervised in accordance with the RCoA and Association of Anaesthetists scope of practice.⁴³ The Association of Anaesthetists and RCoA currently do not support enhanced roles for AAs until statutory regulation for AAs is in place and a scope of practice is defined. ^44,45

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