Clinical supervision The department follows the latest RCoA guidance on supervision (2021 version).
All patients requiring anaesthesia, pain management, or perioperative medical or intensive care will have a named and documented supervisory autonomously practising anaesthetist (for planned lists this will be the "mentor" on CLW; for emergency work it will most likely be the on-call consultant or theatre 7 consultant).
Supervisors must at all times be aware of their supervisory responsibilities, and if required to provide assistance be able to do so.
The level of supervision required will depend on the experience and capability of the individual supervisee, and the case mix of the patients being cared for. Supervisees must seek advice and/or assistance as early as possible whenever they are concerned about patient management; both in and out of hours.
The supervisee must note the name and contact method for the supervisor at the Team brief and on the theatre whiteboard.
| 1 | Direct supervisor involvement, physically present in theatre throughout |
| 2A | Supervisor in theatre suite, available to guide aspects of activity through monitoring at regular intervals |
| 2B | Supervisor within hospital for queries, able to provide prompt direction/assistance |
| 3 | Supervisor on call from home for queries able to provide directions via phone or non-immediate attendance |
| 4 | Should be able to manage independently with no supervisor involvement (although should inform supervisor as appropriate to local protocols |
1220 trainees and fellows are experienced anaesthetists for whom level 4 supervision is often appropriate.
High risk cases: As stated above, supervisees should always seek advice and/or assistance as early as possible whenever they are concerned about patient management. For high-risk cases, a consultant should usually be directly involved or immediately available (level 1 or 2A). There is no universal definition for "high-risk". The national emergency laparotomy audit (NELA) sets an audit standard that a consultant anaesthetist should be present for patients with a predicted mortality of 5%.