If appropriate resources are not available, the level of clinical activity should be adjusted to ensure a safe provision of care while maintaining quality, education and training and wellbeing.
The department should have a rota with sufficient flexibility in job planning to ensure that the usual day to day changes in urgent and emergency clinical activity can be safely covered by appropriate staff, using a clear prioritisation plan.17
Departments should have a process in place to prioritise clinical service delivery without compromising safety. They should monitor which clinical activity is cancelled and should ensure that cancellations are primarily based on clinical need and where appropriate are spread across the breadth of the department’s service.30
Scheduled lists that are planned to take longer than three sessions (e.g. where a patient requires prolonged time in theatre) must be staffed appropriately to ensure that no single anaesthetist works longer than three elective sessions. Adequate rest periods during sessions must be provided. 31, 32, 33
Arrangements should be considered so that if an elective list overruns this should not delay the start of an emergency list.
Departments should collect data on duration of both planned two session and three session days and should demonstrate how staffing is managed to maintain safety.
Departments should ensure that their anaesthetic rotas are working time regulation (WTR) compliant, achieving the minimum 11 hours rest between consecutive periods of work (both direct clinical care and supporting professional activities (SPA).34This rest time should be unambiguous, so that clinicians are neither required to self-assess fatigue levels, nor be influenced by the clinical needs of the department...
The out of hours rota should be published a minimum of six weeks in advance. If any changes are made to the rota there should be a clear and transparent method of informing staff.36
Departments should ensure that they manage employee absences due to sickness proactively, reasonably and fairly in accordance with hospital procedures, contractual and legal obligations.21
The department should ensure that there are clear and timely procedures for applying for and gaining approval for annual leave and other types of leave including study or professional, carers leave etc. The processes in place should be transparent and should provide equity of access to leave.
