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This Report was prepared by members of the National Emergency Laparotomy Audit Project Team on behalf of the Royal College of Anaesthetists. It covers the care received by NHS patients in England and Wales who underwent an emergency laparotomy between 1 December 2017 and 30 November 2018.

This leaflet explains what accidental awareness is during an anaesthetic. During a general anaesthetic your anaesthetist decides how much anaesthetic you need to keep you unconscious during your procedure. He/she then monitors your condition throughout the procedure.

Churchill House, the home of the Royal College of Anaesthetists since 2006, is a versatile venue in Holborn, a vibrant and evolving district at the heart of London. Churchill House offers a tiered auditorium plus a variety of flexible meeting, workshop and conference spaces close to the West End and the City.

2016 saw the Royal College of Anaesthetists launch our first ever strategy. This revised strategy will continue to guide our decision-making and resource allocation while providing patients and the wider public, as well as our staff, members and partners, with a clear understanding of our values and purpose.

The Audit Recipe Book has provided a popular manual of audit topics for anaesthetists since the first edition in 2000. The strapline for the past two editions has read ‘a compendium for continuous quality improvement in anaesthesia’. The emphasis has been on the provision of audits focused mainly on measurement against defined process standards. The latest edition was published in 2012.

In this letter the Secretary of State for Health and Social Care, Matt Hancock MP pays tribute to anaesthetists for the work we have been doing to care for our patients over the past year. He thanks us for our dedication and the care we have shown and, in reference to perioperative care, praises us for the pioneering work being done to help improve the patient experience.

Mastocytosis is a very rare disorder affecting mast cells. In people who do not have mastocytosis, mast cells are triggered during allergy attacks. They release substances that cause the symptoms of allergy. These substances are stored in granules within the mast cells and are released into the body during an allergy attack. This is called ‘mast cell degranulation.’

This leaflet is for patients with mastocytosis who are preparing to have an anaesthetic. It will also be useful to anaesthetists and other healthcare professionals who would like an update on safe anaesthesia practice for patients with mastocytosis.