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Patient characteristics, anaesthetic workload and techniques in the UK: an analysis from the 7th National Audit Project (NAP7) activity survey

Kane, A. D.; Soar, J.; Armstrong, R. A.; Kursumovic, E.; Davies, M. T.; Oglesby, F. C.; Cortes, L.; Taylor, C.; Moppett, I. K.; Agarwal, S.; Cordingley, J.; Dorey, J.; Finney, S. J.; Kunst, G.; Lucas, D. N.; Nickols, G.; Mouton, R.; Nolan, J. P.; Patel, B.; Pappachan, V. J.; Plaat, F.; Scholefield, B. R.; Smith, J. H.; Varney, L.; Cook, T. M.; Hood, Julian; Collaborators; Deane, Marie; George, Richard; Qadri, Shabir; Chaurasia, Sunil; Gohil, Bhavesh; Yogarajah, Amieth; Ross‐Anderson, Davina; Chitre, Sadanand; Kaliappan, Agilan; Namjoshi, Gyanesh; Nain, Naveen; Kaliappan, Agilan; Kohli, Gagan; Carver, Ed; Murali, Naveen Canchi; Pilsbury, Jane; Zabauski, Dzmitry; Corsan, Sarah; Craske, David; Size, Matthew; Stott, Denise; Hutchings, Peter; Georgieva, Milena; Dunn, Juliet; Kotecha, Ami; Harrison, Stephen; Hutchison, Graham; Perritt, Elizabeth; Gibson, Kim; Thimapa, Jothika; Janarthanan, Chandrasekar; Hamilton, David; Ashok, Sundar; Ail, Dhiraj; Bassilious, Baher; Farid, Ashraf Fakhry; Gra...

Patient characteristics, anaesthetic workload and techniques in the UK: an analysis from the 7th National Audit Project (NAP7) activity survey Thumbnail


A. D. Kane

J. Soar

R. A. Armstrong

E. Kursumovic

M. T. Davies

F. C. Oglesby

L. Cortes

C. Taylor

Professor of Anaesthesia and Perioperative Medicine

S. Agarwal

J. Cordingley

J. Dorey

S. J. Finney

G. Kunst

D. N. Lucas

G. Nickols

R. Mouton

J. P. Nolan

Director of Clinical Communication Skill S

V. J. Pappachan

F. Plaat

B. R. Scholefield

J. H. Smith

L. Varney

T. M. Cook

Julian Hood


Marie Deane

Richard George

Shabir Qadri

Sunil Chaurasia

Bhavesh Gohil

Amieth Yogarajah

Davina Ross‐Anderson

Sadanand Chitre

Agilan Kaliappan

Gyanesh Namjoshi

Naveen Nain

Agilan Kaliappan

Gagan Kohli

Ed Carver

Naveen Canchi Murali

Jane Pilsbury

Dzmitry Zabauski

Sarah Corsan

David Craske

Matthew Size

Denise Stott

Peter Hutchings

Milena Georgieva

Juliet Dunn

Ami Kotecha

Stephen Harrison

Graham Hutchison

Elizabeth Perritt

Kim Gibson

Jothika Thimapa

Chandrasekar Janarthanan

David Hamilton

Sundar Ashok

Dhiraj Ail

Baher Bassilious

Ashraf Fakhry Farid

Martin Gray

Ewe The

Andrew Gorman

Ritoo Kapoor

Katyayani Katyayani

Michele Pennimpede

Timothy John Clarke

Joe Adams

Siobhan King

Kieran Hills

Martin Akioyame

Tasneem Katawala

Martin Gardner

Geoff Thorning

Arif Moghal

Burhan Shawki

Sharon Pickworth

Husam Kaskos

Ian McClintock

Robert Devlin

Manoj Ravindran

Tom Knight

Caroline Price

Marc Cohen

Julian Stone

Katy Nicholson

Benjamin Blaise

Kariem El‐Boghdadly

Danny Wong

Heena Bidd

Samantha Wilson

Alicia Ibbotson

Abhinav Kant

Shenouda Farag

Priya Shinde

Steve Roberts

James Burrow

Pungavi Kailainathan


Detailed contemporary knowledge of the characteristics of the surgical population, national anaesthetic workload, anaesthetic techniques and behaviours are essential to monitor productivity, inform policy and direct research themes. Every 3–4 years, the Royal College of Anaesthetists, as part of its National Audit Projects (NAP), performs a snapshot activity survey in all UK hospitals delivering anaesthesia, collecting patient-level encounter data from all cases under the care of an anaesthetist. During November 2021, as part of NAP7, anaesthetists recorded details of all cases undertaken over 4 days at their site through an online survey capturing anonymous patient characteristics and anaesthetic details. Of 416 hospital sites invited to participate, 352 (85%) completed the activity survey. From these, 24,177 reports were returned, of which 24,172 (99%) were included in the final dataset. The work patterns by day of the week, time of day and surgical specialty were similar to previous NAP activity surveys. However, in non-obstetric patients, between NAP5 (2013) and NAP7 (2021) activity surveys, the estimated median age of patients increased by 2.3 years from median (IQR) of 50.5 (28.4–69.1) to 52.8 (32.1–69.2) years. The median (IQR) BMI increased from 24.9 (21.5–29.5) to 26.7 (22.3–31.7) kg.m–2. The proportion of patients who scored as ASA physical status 1 decreased from 37% in NAP5 to 24% in NAP7. The use of total intravenous anaesthesia increased from 8% of general anaesthesia cases to 26% between NAP5 and NAP7. Some changes may reflect the impact of the COVID-19 pandemic on the anaesthetic population, though patients with confirmed COVID-19 accounted for only 149 (1%) cases. These data show a rising burden of age, obesity and comorbidity in patients requiring anaesthesia care, likely to impact UK peri-operative services significantly.

Journal Article Type Article
Acceptance Date Feb 6, 2023
Online Publication Date Mar 1, 2023
Publication Date 2023-06
Deposit Date Mar 7, 2023
Publicly Available Date Mar 7, 2023
Journal Anaesthesia
Print ISSN 0003-2409
Electronic ISSN 1365-2044
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 78
Issue 6
Pages 701-711
Keywords Activity survey; anaesthesia; ASA; BMI; comorbidity; COVID-19; NAP7; obesity; processed EEG; regional anaesthesia; surgical activity; TIVA
Public URL
Publisher URL
Additional Information Accepted: 2023-02-06; Published: 2023-03-01


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