A selective set of reference material for anaesthetic and recovery practitioners — roles, training frameworks, revalidation, FAQs and standards. Not a full archive.
SEDAR's clinical practice recommendations, with the slides and animations from the ICPAN webinar of 10 October 2026.
See all the materialThe first national multidisciplinary guideline on caring for people with Parkinson’s before, during and after surgery, from the Centre for Perioperative Care (CPOC). BARNA is one of its endorsing organisations. It covers time-critical medication, swallowing and nil by mouth, delirium, mobilisation and Parkinsonism-hyperpyrexia syndrome.
Download PDFBARNA's national guidance on safe staffing and establishment for PACU and Recovery units — baseline standards, nurse to patient ratios, skill mix, uplift and acuity based planning.
Download PDFA 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 PDFPreviously healthy patients of Venezuelan maternal ancestry have suffered serious neurological injury, and in some cases died, after general anaesthesia with halogenated agents such as sevoflurane. A variant in mitochondrial DNA, mtND4 m.11232T>C, has been identified in a subgroup of them. The Spanish Society of Anaesthesiology (SEDAR) set up a working group on it and has published clinical practice recommendations: ask every patient about Venezuelan maternal ancestry, arrange genetic testing where possible, avoid volatile agents and use TIVA, and monitor closely after surgery.
Elena Méndez Martínez, Consultant Anaesthetist and Intensivist at University Hospital Central of Asturias and lead of the SEDAR mtND4 Working Group, presented the evidence at an ICPAN webinar on 10 October 2026.
Reference 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.
The full position is in BARNA's National Workforce & Establishment Guidance for PACU, which covers establishment, skill mix, uplift and acuity based planning. In short: never fewer than two registered staff, and lone working is not permitted. Adult patients are 1:1 until airway control is regained and they are stable, and paediatric patients 2:1 until awake and with their parents. Anyone needing airway support or IV opioids, or giving acuity concerns, stays 1:1 — that one is non-negotiable. Ward ready patients may be cohorted to a maximum of 1:4, and only so that higher acuity patients keep their 1:1 care.
The guidance has the rest: the registered lead being fully supervisory and outside the numbers, a supernumerary Band 6 in each recovery area, remote site recovery, transfer times and the RCN's 27% uplift. It replaces the ratios previously quoted here from the 2012 Standards of Practice, which remain BARNA's wider standards for practice.
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. |