Abstract
The future and sustainability of the anaesthetic workforce is a growing concern with a projected shortfall of 11,000 anaesthetists by 2040. The supply of anaesthetists able to provide safe anaesthesia care does not meet the rising demand of surgical waiting lists. In recent years, changes to recruitment and curricula for anaesthetic specialty training have resulted in significant bottlenecks to training progression, further compounding the deficit in the numbers of fully trained anaesthetists. A rapid expansion the Anaesthesia Associate (AA) workforce has been proposed as one of the solutions to this worsening gap. However, no robust analysis of the impact of the expansion in AA numbers on anaesthetists in training has been conducted. There remain a number of concerns regarding access to training experience, scope of supervision, out of hours workload, equity of pay and cost of training, as well as the impact on future numbers of anaesthetists in training. In order to help shape the future integration of this workforce, we surveyed current anaesthetists in training, asking about their experiences of working with AAs, and their perceptions of the future expansion and regulation of these associate professionals. Through an online survey, we collected both quantitative and qualitative data to give a thorough representation of anaesthetists in training experience. Our results confirm that the impact of AAs on training remains a polarising topic. A third of anaesthetists in training with prior experience of working with AAs reported a negative impact on their training experience. Factors mentioned included lack of case numbers, lack of access to learning and performing regional anaesthesia, and lack of clarity in lines of supervision. Of those with no prior experience working with AAs, there was a strong negative perception towards expansion of the workforce. A small proportion described a positive experience, indicating that with clear role definition, careful implementation along with co-operation, a positive experience in all departments could be achievable. Our findings suggest a need for increased consultation and communication with stakeholders in the anaesthesia workforce, including anaesthetists in training, to ensure smooth and safe integration of the AA workforce.
Competing Interest Statement
Dr Naomi Freeman is the Chair of the Association of Anaesthetists Trainee Committee. Dr Stuart Edwardson is the current Honorary Secretary of the Anaesthetists Trainee Committee. Dr Ben Evans, Dr Leyla M Turkoglu and Dr James Brooks are elected members of the Association of Anaesthetists Trainee Committee. Dr Roopa McCrossan is a past chair of the Association of Anaesthetists Trainee Committee.
Funding Statement
This study did not receive any funding
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.
Yes
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
Yes
I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.
Yes
Data Availability
All data produced in the present study are available upon reasonable request to the authors