A selective set of reference material for anaesthetic and recovery practitioners — roles, training frameworks, revalidation, FAQs and standards. Not a full archive.
A joint statement on corridor care within the Post Anaesthetic Care Unit, co-signed by six professional bodies.
Download PDFGuidance framework for adult competencies within the Post Anaesthetic Care Unit.
Download PDFBARNA's position on education standards for anaesthetic and recovery practitioners, published 13 August 2025.
Download PDFReference frameworks used across peri-anaesthesia training:
NMC revalidation requires 35 hours of CPD over 3 years, of which at least 20 hours must be participatory learning.
Both the Association of Anaesthetists and the Royal College of Anaesthetists hold that tube removal is the anaesthetist's responsibility, though it may be delegated to an appropriately trained PACU team member prepared to accept it. BARNA supports both positions but notes this remains an area needing further UK-wide investigation — local policy and extubation competency should be in place wherever nurses accept this responsibility.
BARNA's Standards of Practice set out ratios by recovery stage: 1:2 at reception (one patient, two staff), 2:1 during stabilisation, and 3:1 once fit for discharge — always with at least one registered practitioner present, adjusted for patient acuity. The Association of Anaesthetists and RCoA both require at least two staff (one registered) whenever a patient hasn't met discharge criteria. BARNA notes there's no fixed formula: safe staffing depends on the PACU manager's ongoing judgement of case mix and patient flow.
Yes — pulse oximetry and non-invasive blood pressure monitoring are mandatory; ECG monitoring equipment must be available at every bed space, and PACU nurses should be competent in basic rhythm recognition.
No — the UK does not employ Nurse Anaesthetists in that capacity. UK practice uses Anaesthetic Nurses and ODPs, who assist but do not administer anaesthesia. The only non-medical role permitted to deliver anaesthesia is the Anaesthesia Associate/PA(A), a UK-specific qualification (around 27 months, currently offered by a small number of universities). Nurse Anaesthetists trained abroad can work in the UK as Anaesthetic Nurses if their training is NMC-recognised, or can complete the Anaesthesia Associate course.
A 2-year, NMC-validated Foundation Degree role bridging HCA and Registered Nurse, on the NMC register since January 2019. Duties can include venepuncture, ECGs, recording clinical observations, and supporting patients and families — always under the supervision of the Registered Nurse or ODP in charge. The Perioperative Care Collaborative continues to develop guidance on this role's scope in PACU specifically.
Anaesthetic and recovery nursing spans main theatres, day surgery, specialist units (cardio-thoracic, neurological), special procedure areas (cath lab, ECT, endoscopy, radiology, oncology), paediatric units, labour and delivery, pain management, dental clinics, and psychiatric services. Who does what across the team:
| Role | Scope / training |
|---|---|
| Anaesthetist | Leads the anaesthesia team; the only professional who can deliver anaesthesia autonomously (alongside the Anaesthetic Associate, who works under supervision). Remains responsible for the patient throughout the perioperative journey until PACU discharge. |
| Anaesthesia Associate / PA(A) | Trained via a dedicated university programme, works under consultant supervision, typically in a 2:1 model (one consultant covering two AAs, or an AA and a trainee, across adjacent theatres). |
| Anaesthetic Nurse / ODP (Anaesthetic Room) | Works alongside the anaesthetist: checks equipment, prepares drugs, assists with intubation and cannulation, cares for the patient from theatre check-in to PACU handover. |
| Registered Nurse / ODP (PACU) | Takes over patient care from the anaesthetist at handover, manages airway/breathing/circulation, administers analgesia, and assesses for discharge. Scope varies by training and can include cannulation, IV drug administration, supraglottic airway management, and extubation. |
| Nursing Associate | A role bridging Healthcare Assistant and Registered Nurse, on the NMC register since January 2019; can work in PACU under supervision. |
| HCA / Students (non-registered) | Associate/Assistant Practitioners and Healthcare Assistants, plus students and trainees (pre-registration nurses, ODPs, paramedics, midwives) on short placements. |