Core Competency Framework for Anaesthetic Practitioners 2024

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Details regarding the refreshed Core Competency Framework for Anaesthetic Practitioners.

Core Competency Framework for Anaesthetic Practitioners 2024


The Core Competency Framework for Anaesthetic Practitioners 2024 sets out the core competencies that registered nurses, preparing for the role of anaesthetic practitioner in NHSScotland must achieve. This work-based development demonstrates that they are equipped with the knowledge and skills to work at a minimum level of competency.

The core competencies are organised around five sections, representing the patient journey:

  1. Preoperative preparation of the environment 
  2. Preoperative preparation of the patient
  3. Perioperative care of the patient 
  4. Postoperative care of the patient
  5. Emergency care and treatment

It is recognised that in some theatre departments activities relating to anaesthesia in remote and isolated locations, obstetrics and paediatrics may be carried out routinely. Therefore, competencies relating to these areas can be found in the appendices of the Framework for areas to implement locally. Staff should only work towards these competencies if working in these clinical areas.

It is recommended that:

  • Registered nurses preparing for the role of an anaesthetic practitioner complete the competencies within 6-12 months
  • A supernumerary period is facilitated and should be agreed locally
  • On successful completion of the core competencies, anaesthetic practitioners should spend a minimum of eight hours per week practicing as an anaesthetic practitioner to maintain clinical competence

The Framework does not include all the knowledge and skills required for the role, nor mandatory training, rather it should be used as part of continuing personal and professional development, for registered nurses preparing for the role of an anaesthetic practitioner. Additional core knowledge, skills and behaviours are those outlined in the four pillars of practice for NMAHPs at level 5 of the Post-registration Development Framework and the Nursing, Midwifery and Allied Health Professionals (NMAHP) Development Framework and the Career Development Framework for the Perioperative Nursing, Midwifery and Health Professions (NMaHP) Workforce.

The updated Core Competency Framework for Anaesthetic Practitioners 2024 was published in February 2024.

The improved version includes: 

  • learners name in every competencies sign off box 
  • guidance to support sign off and final verification 
  • learners name and NMC pin number on the record of signatories (appendix 4) 
  • record of completion (appendix 5) 

Anaesthetic Practitioner (AP) learners who started using the previous competency framework should continue to complete this. Those AP learners who commenced the Framework from March 2024 onwards should use the updated document

Completion and sign off

Progressing through the framework 

AP learners benefit from support and work-based supervision within their employing Board.  Learning is supported by clinical supervisors who are identified locally. This may include anaesthetists or appropriately qualified and experienced anaesthetic practitioners or operating department practitioners (ODPs). In practice the learner may have several supervisors.   

The learner and supervisors can agree the order in which competencies are completed. All competencies in each section must be evidenced for completion. 

Each competency includes details of the knowledge and skills / abilities required to attain that competency.  Individual knowledge and skills / abilities should be initialled and dated by the supervisor on completion. When this is completed, the sign off box for each competency should be completed by the supervisor.   

It is recognised that in some theatre departments activities relating to anaesthesia in remote and isolated locations, obstetrics and paediatrics may be carried out routinely. Therefore, competencies relating to these areas can be found in appendices 1, 2 and 3 for areas to implement locally. Learners should only work towards these competencies if working in these clinical areas. 

All supervisors who initial or sign off competencies should record their full details in the record of signatories in appendix 4. 

Final Sign off 

Upon completion of the Framework, the supervisor/s should discuss completed competencies with another senior member of the clinical team, for example, a consultant anaesthetist who will act as verifier. Once satisfied with the evidence provided, the verifier should provide final sign off by completing the “Record of Completion” in appendix 5 of the Framework. This will verify completion of the Framework.  

Record of completion  

The completed Framework document including the record of signatories (appendix 4) and the record of completion (appendix 5) should be retained by the anaesthetic practitioner within their professional portfolio, to evidence completion of the Framework.    

NES recommends a log or register be maintained by the employing Board, detailing anaesthetic practitioners who have successfully completed the core competency framework. This log may include the practitioner's name, NMC pin number, competencies and appendices achieved, work base, clinical supervisor/s, verifier and completion date. A digital copy of the completed Framework document which includes the record of signatories and record of completion should be held by the employing Board.   

This change is part of the revisions NES has undertaken to enhance educational governance of this process and to support clinical supervisors and those involved in verification.

An overview of the revised sign off process can be seen below: 

Anaesthetic Practitioner sign off process
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We hope you find this updated version of the Framework useful. We welcome your feedback, ideas or suggestions to help inform future revisions of this document. Please let us know by completing the feedback form.

Anaesthetic Practitioner Frequently Asked Questions

Q.  I understand a revised core competency framework was published in February 2024. I had already started completing the 2022 version of the Framework. Which document should I now use? 
A. If you started using the Core Competency Framework for Anaesthetic Practitioners 2022 you should continue to complete this. The updated Core Competency Framework for Anaesthetic Practitioners 2024 was published in February 2024. Anyone commencing the Framework from March 2024 onwards should use this revised Framework. 

Q.  I have completed over 90% of my competency framework but there are one or two competencies that I am unlikely to be able to physically demonstrate/ complete in my region. Is it sufficient to discuss these techniques with my clinical supervisor or must I seek out opportunities to demonstrate competence outside of my region?  
  
A. The competency framework should be completed in full wherever opportunity exists to do so. However, in some circumstances, particularly for remote, rural or peripheral sites and providing the skill in question is not critical to the anaesthetic practitioner role, this may be acceptable. This decision would be at the discretion of your clinical supervisor who understands the needs of the role you will adopt after sign off. You would wish to demonstrate any research and learning that you have performed on the subject in question and the shared discussion should acknowledge the need to seek appropriate training should these techniques be introduced to your clinical area, or service requirements change and need this. 
 
Q. I have completed historical modules specific to anaesthetics and recovery- Are they recognised at the same level as the framework? Do I still need to complete the framework?  
 
A. All practitioners wishing to work in the role of AA in Scotland must have completed the framework. However previous education and experience with your clinical team should provide a valuable foundation which expedites completion of the work-based competencies. Your clinical supervisor may be prepared to recognise and acknowledge your prior experience. The framework provides opportunity to ensure all aspects of contemporary anaesthetics practice are accounted for.  
 
Q. We work in specialised theatres. We have or intend to build local competency frameworks in anaesthesia specific to our clinical speciality (e.g. cardio-thoracic/ neuro-surgery/ maxillo-facial/ burns etc.). Can/should we integrate the NES core competency framework with our own framework for consistency?  
 
A. Yes. The core framework is designed to provide a general foundation of the skills required for fulfilling the anaesthetic assistant role. Specialist competencies fall out with its remit. The core concepts within the framework can be used as a foundation for practice and must be covered. 

Q. Why has the role of ‘anaesthetic assistant’ changed? 

A. Directors Letter (DL 2023 10) from the Director of Health Workforce Gillian Russell and the Chief Nursing Officer Professor Alex McMahon was issued on 13 April 2023 advising of the title change for the current role of Anaesthetic Assistant in Scotland. The DL sets out in detail the background and rationale for the role name change. It includes: 

Anaesthesia Associate, is a protected role title in law 

use in NHS Boards of the role title Anaesthetic Assistant (AA) means there is “a likelihood of two distinct yet related roles, with the same initials but different scopes of practice, working together in theatre services” 

given the potential risks to patient safety it has been agreed that the alternative role name of Anaesthetic Practitioner would be appropriate 

The DL therefore asks that NHS Boards in Scotland “replace the Anaesthetic Assistant title with Anaesthetic Practitioner, as soon as practicably possible, to ensure patient safety.