The scope of practice of Physician Assistants in Anaesthesia, PA(A)s is defined in the DoH documents “A toolkit to support the planning and introduction of training for anaesthesia practitioners”
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_074709

and ”The Anaesthesia Practitioner Curriculum Framework”.
http://www.rcoa.ac.uk/docs/PA(A)Curriculum-Framework.pdf

The curriculum is the result of collaborative working between:

• The Royal College of Anaesthetists
• Association of Anaesthetists Great Britain and Ireland
• The Royal College of Anaesthetists Patient Liaison Group
• Clinical leads from the programme sites
• Phase 1 trainee anaesthesia practitioners.
• Association for Perioperative Practice
• College of Operating Department Practitioners
• British Anaesthetic and Recovery Nurse Association
• Group of Anaesthetists in Training

The detail of the curriculum itself is the result of close collaboration between the Royal
College of Anaesthetists, the former NHSU and the University of Birmingham, and builds on early work conducted by Dr David Greaves for the Royal College and overseas nurse anaesthetist curricula. A wider Reference Panel including PA(A) representation has been able to comment on and influence each stage of development of the curriculum.

Core purpose
To provide anaesthetic services to patients requiring anaesthesia, respiratory care, cardiopulmonary resuscitation and/or other emergency, life sustaining services within the anaesthesia and wider theatre and critical care environments.

Responsibilities and scope of practice

1. To work competently, under appropriate supervision, in the role of Physicians’ Assistant (Anaesthesia), within their code of professional practice, being aware of boundaries of the role and referring patients to other healthcare professionals as appropriate.
2. To work as a member of the anaesthetic team.
3. To perform/participate in the preoperative interviewing and physiological and psychological assessment under supervision of the consultant anaesthetist.
4. To evaluate and/or collect patient information from the patients history, physical examination, laboratory, radiographic and other diagnostic data and identify relevant problems.
5. To implement the anaesthesia care plan under supervision of the consultant anaesthetist.
6. To administer and/or participate in the planned administration of general anaesthetic for a variety of surgical and medically related procedures
7. To use a broad variety of techniques, anaesthesia agents, drugs and equipment in providing anaesthesia care.
8. To administer drugs as prescribed and use prescribing mechanisms as permitted by medicines legislation.
9. To interpret and utilise data obtained from the effective use of invasive and non invasive monitoring equipment.
10. To initiate and manage fluid and blood therapy within the plan of care.
11. To recognise and take appropriate actions with reference to complications occurring during anaesthesia management.
12. To position or supervise positioning of patients to assure optimal physiologic function and patient safety.
13. To identify and take appropriate actions related to anaesthesia equipment problems that might lead to patient problems.
14. To identify and take appropriate action in the immediate postoperative period in relation to common postoperative problems.
15. To assess patient responses for readiness to move to the next level of care in relation to common postoperative problems.
16. To serve as a resource person in cardiopulmonary resuscitation, respiratory care and for other acute needs
17. To participate in the education of patients and their carers.
18. To participate in the critical review of audit, complaints, compliments and clinical / non-clinical incidents with a view to improving patient care as part of the wider anaesthetic team.
19. To assist with the implementation of risk management and health and safety recommendations as part of the wider anaesthetic team.
20. To monitor and maintain a safe, clean, and therapeutic environment for patients, staff and visitors, initiating appropriate action to achieve this.
21. To adhere to quality objectives, hospital policies and codes of practice.
22. To be responsible for timely, accurate and complete records both manually and electronically ensuring safety and confidentiality of information and any hospital and statutory requirements are met.
23. To use resources appropriately in order to ensure a high quality and cost effective service.
24. To actively participate in all relevant meetings.
25. To promote and contribute to the development of the new ways of working in anaesthesia, within the trust and other organisations, by taking part in presentations and conferences.
26. To assist the Local Management Team in the research and evaluation of the project, including the collection and analysis of data required.
27. To establish working relationships with rest of hospital and act as an ambassador for the role.
28. To assist in the development and review of protocols and patient group directives within the anaesthetic team.
29. To take part in the teaching, supervision and assessment of other team members.
30. To take part in personal development planning. To maintain a professional portfolio and logbook.
31. To ensure own actions support equality, diversity and rights.

The DoH Curriculum Framework document includes the following points relating to PA(A)s (referred to as APs in the document) upon qualification.

• The AP will work under the direct supervision of a suitably qualified anaesthetist. This may be a consultant; an NCCG, who has been recognised for this role by management, or a senior SpR. Anaesthetists may supervise two APs simultaneously.
• The AP will be under direct supervision (the supervisor will be present) for induction of general anaesthesia and during emergence from general anaesthesia.
• The AP will not anaesthetise children under 15 but may work as assistant to an anaesthetist who is anaesthetising children.
• The AP will not engage in obstetric anaesthesia.
• The AP will not administer regional blocks.
• The AP cannot prescribe drugs.

This job description is intended only as a guide and it can be subject to change as the Anaesthesia Practitioner role develops.

The Association of Physicians’ Assistants supports the cautious development of competencies outside this initial scope of practice by Departments of Anaesthesia through their local Governance Committees.

The DoH KSF profile of the role can be found here.