A reflection on the development of the advanced scrub practitioner

From the time in 1990 when I began my career in the operating theatre it has been the unwritten assumption that a member of the theatre team will assist the surgeon with his work. This has always been done on an ad hoc and, some might say, casual basis, as no member of the team was qualified to take this role upon their shoulders. There was the assumption that these 'first assistant' activities were performed with accountability and liability. But where was the evidence for this practice? This article considers the evolution of the Advanced Scrub Practitioner (ASP) role from its beginnings to the position it is today.