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Are you registering an Independent or NHS Organisation?
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NHS
ACSA Lead
Organisation
Trust / board
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Wales
Northern Ireland
First name
Last name
Job title
Telephone number
Email address
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Choose an option below that most closely describes how anaesthesia services are provided in your organisation
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Directly employ anaesthetists
Contract a consortium of anaesthetists
Contract Individuals on a sessional basis
Other (please describe below)
Other
Clinical director details
Full name
Job title
Telephone number
Email address
Details of the hospital(s) to be accredited by ACSA
Sites
Hospital name
Number of surgical beds
Number of consultants (WTE)
Number of trainees (WTE)
Number of other anaesthetists, including SAS/SD and clinical fellows
Number of operating theatre suites
Total number of operating theatres (excluding day surgery)
Number of day surgery unit theatres
Other locations anaesthesia administered
Specialties
Does the department provide services for:
Preassessment
Emergency department
Obstetrics
Radiology
ECT
Paediatrics
Is the ECT service accredited?
Please provide details of the scope of paediatric services provided
Would you like to accredit this hospital against any of the following domain 5 subspecialty standards:
Neuroanaesthesia
Ophthalmic anaesthesia
Vascular anaesthesia
Cardiothoracic
Other forms of peer review the department participates in
Other information relevant to your registration