Paediatric Anaesthics
Royal Manchester Children's Hospital
Manchester Royal Eye Hospital
Paediatric Anaesthetics at Royal Manchester Children's Hospital
Royal Manchester Children’s Hospital (RMCH) is home to one of the UK’s largest and most advanced paediatric anaesthetic departments, delivering specialist care across an extraordinary breadth of high‑complexity surgical and medical services.
International clinicians joining us for observerships or fellowships gain direct insight into a service renowned for its clinical excellence, multidisciplinary collaboration and innovation in paediatric perioperative care. Our anaesthetists work at the forefront of paediatric airway management, regional anaesthesia, sedation, pain medicine and perioperative optimisation, supported by state‑of‑the‑art theatres, advanced monitoring technologies and a highly skilled theatre workforce. RMCH is also a designated Major Trauma Centre for children, giving clinicians the opportunity to observe trauma anaesthesia, rapid sequence induction, and complex resuscitation pathways delivered by expert teams.
In 2026, the department was re-accredited under the prestigious Anaesthesia Clinical Services Accreditation Scheme (ACSA) by the Royal College of Anaesthetists. This reflects the department's highest standard of care, across a number of areas including patient experience, patient safety and clinical leadership.
The department is deeply embedded in research and education, contributing to national studies, quality‑improvement programmes and national and international paediatric anaesthesia networks. Many of our consultants hold academic appointments, lead national guideline development, and teach on prestigious UK and European training programmes. Their mentorship offers overseas clinicians a rare opportunity to learn from leaders shaping the future of paediatric anaesthesia, while experiencing the culture, pace and precision of a world‑class children’s hospital.
The department comprises 46 consultant anaesthetists, many of whom hold national and international leadership roles. The department also hosts 18 whole time equivalent anaesthetic resident doctors from the Northwest School of Anaesthesia at Stage 2 or Stage 3 of their anaesthetic training, two locally employed senior clinical fellows and clinicians from other specialties including the paediatric emergency department.
For clinicians seeking to elevate their expertise, broaden their exposure to complex paediatric cases, and train within one of the most dynamic anaesthetic departments in Europe, RMCH Anaesthetics offers an exceptional and transformative learning experience.
Fellowships and observerships at Manchester Specialist Health Academy provide international clinicians with structured opportunities to experience high quality healthcare training within a leading NHS environment. Both pathways offer consultant oversight, a clear induction, and access to modern clinical settings that support a strong understanding of advanced patient care. Participants are welcomed into a professional community that encourages learning, collaboration, and engagement with the culture of Manchester.
While fellows take part in more in depth clinical development, gaining exposure to subspecialties, procedures and research, observers focus on shadowing and understanding multidisciplinary practice within NHS services. Both groups benefit from involvement in clinics, team discussions, and wider learning activities such as simulation sessions, CPD opportunities, and quality improvement insight.
Academic contributions and awards
The team is actively engaged in research, quality improvement, and national guideline development, contributing to the advancement of paediatric anaesthesia across the UK and beyond. Consultants regularly publish in peer-reviewed journals on topics such as paediatric airway safety, regional anaesthesia, enhanced recovery, and perioperative care in complex surgical populations.
The department has received recognition for its leadership in simulation-based education, innovation in perioperative pathways, and contributions to national safety initiatives. For international clinicians, this means training in a service that not only delivers world-class care but also shapes the future of paediatric anaesthesia through evidence, education, and innovation.
Explore a selection of our teams academic contributions:
Perioperative medicine in paediatric anaesthesia
CUSUM analysis to assess competence: what failure rate is acceptable?
Rare and complex cases
- It has established expertise in neonatal anaesthesia for both elective and emergency procedures in critically ill neonates.
- Anaesthetists at RMCH started and support the delivery of general anaesthesia services for proton beam therapy at The Christie Hospital.
- RMCH is proud of the anaesthetists' led MAGiC team (Manchester Access Group in Children), a dedicated multidisciplinary team specialising in complex venous access, including the placement and management of long-term central lines and midlines in children with challenging vascular access needs.
- The department is one of the few paediatric centres that delivers a multidisciplinary chronic pain service addressing complex paediatric pain conditions. This includes a seven-day acute pain service providing continuous perioperative analgesia management, including regional anaesthesia techniques and inpatient pain review.
- RMCH is one of two centres in the UK providing care for children with congenital bladder or cloacal exstrophy, and anaesthetists form an important part of the multidisciplinary care for these complex children.
- The hospital also functions as a tertiary burns referral centre, requiring sophisticated airway, fluid, and pain management strategies.
- It serves as a quaternary referral centre for paediatric metabolic disorders, where anaesthetic management demands precise metabolic control, tailored pharmacology, complex airway management and close perioperative coordination with specialist teams.
Why Manchester?
Manchester is a city of innovation and progress, renowned as the world’s first industrial city and still leading in science, healthcare, and technology. With excellent transport links and a vibrant, multicultural atmosphere, it offers an inclusive environment for learning and professional growth.
Beyond your placement, Manchester offers something for everyone - from watching the iconic Manchester derby to exploring world-class museums and galleries. With vibrant music, sport, and culture, the city truly has it all. Combining heritage and modernity, it creates a unique setting for personal enrichment and memorable experiences whilst you develop professionally.
Meet our expert supervisors
Our team consists of highly qualified and motivated professionals, who are all experts in their field. With many years of experience in the industry, they have the expertise to provide comprehensive, first-rate services to our clients.
Dr Jai Sivaprakasam
Dr Sivaprakasam is the Lead Paediatric Anaesthetist Consultant at RMCH.
Dr Anju Anne Bendon
Dr Bendon is a Consultant Paediatric Anaesthetist at RMCH.
Dr Rachel Davison
Dr Davison is a Consultant Paediatric Anaesthetist at RMCH.
Our signature programmes
Observership
Paediatric Anaesthetics
Observers are able to gain unparalleled insight into the full breadth of paediatric anaesthesia delivered at RMCH — from complex airway management and neonatal surgery to neurosurgery, oncology, orthopaedics and emergency trauma. Candidates will shadow consultant anaesthetists in main theatres, peripheral lists and emergency settings, observing real‑time decision‑making, governance processes, and multidisciplinary collaboration. Patient consent and ethical boundaries are central to the experience, ensuring a respectful, professional environment. With 10 main theatres and multiple specialist lists running daily, observers benefit from a rich, diverse caseload that few centres globally can match.
This observership is designed for clinicians who want to deepen their understanding of advanced paediatric anaesthesia without needing hands‑on training. You will learn how expert teams manage challenging airways, optimise high‑risk children, and deliver safe anaesthesia for rare and complex conditions including some procedures that are only performed in a handful of centres worldwide. The value lies in translational learning: understanding how RMCH structures its pathways, policies and processes, and taking those insights back to strengthen your own service.
We welcome one observer at a time to ensure a focused, high‑quality experience.
Objectives
- Gain insight into the structure, flow and governance of a major UK children’s hospital, including theatre scheduling, perioperative pathways, emergency responses and safety processes.
- Develop a deeper understanding of how expert teams approach challenging airways, high‑risk children, neonatal surgery, craniofacial reconstruction, major trauma and rare congenital conditions.
- See how anaesthetists work alongside surgeons, intensivists, specialist nurses and allied health professionals to deliver safe, coordinated care.
- Identify policies, procedures and clinical approaches that can be adapted to improve services in your own hospital or healthcare system.
- Enhance your understanding of evidence‑based paediatric anaesthesia without the pressure of hands‑on clinical responsibility.
Learning outcomes
By the end of the observership, participants will be able to:
1. Describe how a major UK paediatric anaesthetic service is structured and delivered including theatre workflows, perioperative pathways, emergency responses, governance processes and safety systems.
2. Explain the principles underpinning the management of complex paediatric cases through observation of challenging airways, neonatal surgery, craniofacial reconstruction, major trauma and rare congenital conditions.
3. Reflect on differences between UK practice and their home healthcare system identifying transferable approaches to service design, patient safety, perioperative optimisation and multidisciplinary collaboration.
4. Demonstrate enhanced understanding of evidence‑based paediatric anaesthesia by observing consultant‑led decision‑making, risk assessment, and guideline‑driven care in high‑acuity environments.
5. Articulate key learning points for future professional development including insights into complex case management, MDT communication, and the operational design of a world‑leading children’s hospital.
Eligibility
Candidates should hold a post graduate qualification in Anaesthesia from their host country and have a minimum of 3 years experience in anaesthesia for consideration as an observer.
Fellowship
Paediatric Anaesthetics
Our supernumerary fellowship model is designed for senior anaesthetic trainees who are ready to deepen their subspecialty expertise within one of Europe’s most advanced paediatric surgical centres. This model allows senior trainees to focus on complex case management, advanced airway strategies and subspecialty development, and is tailored to individual goals, ensuring each clinician gains targeted experience aligned with their future career trajectory.
Fellows train within Royal Manchester Children’s Hospital, an environment that is fast‑paced, consultant‑led and deeply collaborative, giving fellows the opportunity to observe and contribute to world‑class perioperative care in a setting that blends clinical excellence with innovation and compassionate practice.
Fellows will, however, share lists and training opportunities with incumbent resident doctors and locally employed senior clinical fellows.
Fellows benefit from direct exposure to the department’s active research and quality‑improvement culture. RMCH anaesthetists contribute to national studies, guideline development and service‑improvement initiatives across paediatric airway safety, perioperative optimisation, enhanced recovery and complex case pathways. Fellows may observe research governance processes, attend departmental QI meetings, and engage with ongoing academic activity where appropriate.
Multidisciplinary collaboration is central to paediatric anaesthesia at RMCH. Fellows participate in MDT discussions across major trauma, oncology, spinal deformity, neonatal surgery, complex airway management, and burns. They gain insight into how anaesthetists work alongside surgeons, intensivists, radiologists, specialist nurses, theatre teams and safeguarding professionals to deliver safe, coordinated care for high‑risk children.
For fellows, there is the opportunity to attend the Advanced Trainees Teaching Programme, a multi-centre teaching programme for residents that attempts to cover the paediatric anaesthesia curriculum through 7 study days over a year, run by various tertiary paediatric centres, but led from RMCH. Opportunity to participate in the weekly trainee-led journal club and in house teaching is also available, as well as the monthly departmental Morbid and Mortality meetings.
Objectives
- Gain structured exposure to major trauma, neonatal surgery, craniofacial reconstruction, oncology, orthopaedics and rare congenital conditions — including procedures performed in only a handful of UK centres.
- Work closely with consultants to strengthen judgement, situational awareness and clinical reasoning in high‑stakes environments.
- Observe or contribute to departmental academic work, national studies, guideline development and service‑improvement initiatives.
- Participate in MDTs across trauma, burns, oncology, spinal deformity and neonatal care, developing the skills needed to lead collaborative decision‑making.
- Use protected supernumerary time to focus on the areas most relevant to your long‑term goals, supported by consultant mentorship and a personalised development plan.
Learning outcomes
By the end of the fellowship, participants will be able to:
1. Demonstrate advanced subspecialty competence in paediatric anaesthesia through structured exposure to high‑complexity cases across trauma, neonatal surgery, craniofacial reconstruction, oncology, orthopaedics and rare congenital conditions.
2. Apply evidence‑based principles to complex perioperative decision‑making showing increased confidence in independent judgement, situational awareness and leadership in high‑stakes clinical environments.
3. Contribute meaningfully to research, audit or quality‑improvement activity gaining experience in study design, data interpretation, service evaluation and academic dissemination within a research‑active department.
4. Work effectively within multidisciplinary teams understanding the roles, perspectives and contributions of surgeons, intensivists, specialist nurses, allied health professionals and safeguarding teams in delivering safe, coordinated care.
5. Develop a clear subspecialty identity and future career trajectory supported by consultant mentorship, reflective practice and targeted exposure aligned to personal learning goals.
Eligibility
Candidates should hold a post graduate qualification in Anaesthesia from their host country and a minimum of 5 years experience in anaesthesia at a postgraduate level.
This programme cannot offer any paediatric cardiac anaesthesia experience, but some exposure to children with cardiac problems for non-cardiac surgery. If the fellow expresses explicit interest, there is potential for a 2-week secondment for paediatric cardiac anaesthesia, subject to contractual agreements.