7. Staffing

• Departments of anaesthesia should provide a system for staffing that works locally and is acceptable to staff [4]. The following comments may be equally applicable to surgical staff.


• Clinical Directors must ensure that departmental staffing matches clinical activity, is sufficient to cover elective and emergency operating lists, and to deal with the unexpected. Departments should therefore not plan to run to 100% capacity.


• Fixed sessions of variable content facilitate cover for absences, although unavoidable absence at short notice remains a problem. Consideration should be given to including at least one such session in job plans.


• If cross-cover within the department is used, it is important that the anaesthetist has the appropriate range of skills [5].


• A robust system of booking leave must exist within the department of anaesthesia to enable the 'rotamaker' to plan ahead.


• Booking arrangements in the outpatient clinic should anticipate problems such as pre-arranged holidays.


• During normal working hours, an identified consultant anaesthetist should be available in the complex to support trainees and the theatre management team.


• Anaesthetists and surgeons must have dedicated skilled assistance. Many hospitals are currently experiencing severe shortages of suitably-trained staff due to high workload, low pay and poor morale. Hospital management must be made aware of these problems and be asked to facilitate local pay or benefit agreements.


• Being made to feel a valuable part of the team, working in a well managed, efficient theatre will improve morale and increase staff retention.


• Adequate orientation time should be made available for all agency and locum staff.


• Adequate staffing must be provided to cover the tasks of data entry (see section 12) and transcription of operative notes.