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DOI: 10.1101/2023.05.22.23290109

The experiences and perceptions of working with Anaesthesia Associates: a survey of UK anaesthetists in training.

B.Evans L. M. Turkoglu J. Brooks ...+4 D. J. N. Wong
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.