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The department must establish and maintain a culture of proactively thinking about and questioning equality, diversity and inclusion in all that it does, including recruitment, training, opportunities for extended roles and responsibilities.^4,5,6

The anaesthetic team should be empowered to ensure that their workload is appropriately manageable. Discussions concerning workload should be held in an atmosphere of respectful collaboration.

The department should aim for sustainability in all that it does, in the clinical context, its management and administration and in other activities. The department should contribute to initiatives to improve the environmental sustainability of the system.⁷

A departmental strategy should be developed jointly by all members of the department with proactive engagement from stakeholders, including patients, with all collaborating to develop their vision and plan for the anaesthetic service, linking this to the organisations overall vision and strategy. An inclusive departmental strategy in line with the wider organisational vision should be developed. All members of the...

Clinical leaders within anaesthetic services should be an integral part of system planning including how to deliver planned care and emergency care. They should have influence in all areas in which anaesthetists contribute to service delivery.⁸

The department should have a live, regularly reviewed annual plan describing service changes, estates developments, workforce developments and wellbeing, working conditions, capacity demand modelling and other relevant operational improvements. This will ensure that the department is responsive to requests for additional resources across all areas of activity.

Clinical leadership roles should be designed to be desirable and exciting opportunities for anaesthetists. Appointment processes to clinical leadership roles should be open and transparent.

The department should have a clinical leader for the whole department. The clinical lead should be part of the wider overall hospital management structure. They should lead with compassion and foster a learning culture within the service they manage.⁹

There should be anaesthetic clinical leads with clear and agreed responsibilities for different areas or specialties. The number of leads will depend on the size of the anaesthetic department, their areas of specialisation, workload and any ongoing areas of special focus. The list below is not exhaustive and not applicable to all departments:

• preoperative assessment
• perioperative medicine
• emergency anaesthesia
• remote...

The department should collaboratively review the structure and performance of the leadership team as a whole on an agreed schedule to ensure that it remains effective and fit for purpose.⁸ Clinical leaders should have annual reviews of performance in leadership and management duties. The annual review should by conducted by someone competent to do so with an understanding...