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There should be local systems in place to disseminate national safety alerts.

There should be access to the ‘British National Formulary for Children’.²⁶

There should be a fully resourced acute pain service that covers the needs of children.^27,28 In hospitals with a smaller paediatric caseload, this may be provided by the adult acute pain service liaising with the paediatric anaesthetic team, rather than a dedicated paediatric service.

Analgesia guidance appropriate for children²⁹ should be readily available, including protocols for pain scoring using age-appropriate validated tools.²⁸

Children should be separated from, and not managed directly alongside adults throughout the patient pathway, including reception and recovery areas. Where complete physical separation is not possible, the use of screens or curtains, whilst not ideal, may provide a solution.

The appearance of the anaesthetic induction and recovery areas should take into account the emotional and physical needs of children.

Operating lists should include details of the patient’s operation, date of birth, hospital identification number, any alerts and the ward in which they are located.⁷²

Parents and carers should be allowed ready access to the recovery area or, if this is not feasible, children should be reunited with their parents or carers as soon as possible.

Services and facilities should take account of the specific needs of adolescents where these are different from those of children and adults.^30,31,32,33

Arrangements should be in place to enable at least one parent or carer to stay with children who require overnight admission to hospital.