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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. 

Departments should have a nominated anaesthetist immediately available to provide cover in clinical emergencies, as well as advice and support to other anaesthetists.³⁷

Departments should consider having flexibility in the day-to-day rota so that there are more anaesthetists working in a clinical area, such as a theatre suite, than there are procedures being carried out to ensure that this cover is always immediately available. The size of the additional staffing resource is dependent on the number of anaesthetic procedures underway simultaneously and the...

The department should positively encourage an overt culture of seeking support regardless of grade if working solo, or if a second opinion or some practical help would improve the situation. There should be transparent, robust systems to support this culture.³⁸

Every department should have a named trained SAS mentor who has the responsibility to oversee the wellbeing, career needs, educational and professional needs of the SAS doctors in the department.^19,39

All patients requiring anaesthesia, pain management or perioperative medical or critical care should have a named and documented supervisory autonomously practising anaesthetist (see Glossary) who has overall responsibility for the care of the patient.

At all times trainees should be supervised at an appropriate level (1-4) of sessional supervision, which varies depending on both the level of the trainee, including their stage of training, their previous experience and capability, and the case or cases for which they are being supervised.⁴⁰

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