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Pathways should be multidisciplinary, starting at preoperative assessment and involving a learning difficulty nurse specialist, if appropriate, the patient’s usual care team, the day surgery team anaesthetist for the list and a surgeon, as appropriate.¹²

Families should be provided with written or web-based resources that provide information specific to anaesthesia before the planned surgery/procedure, and contact details for the preassessment team should be provided in case they have further questions or need to speak directly with their anaesthetist.⁸⁸ The leaflet ‘Information for Teenagers, Children and Parents’ is available from the RCoA website...

If responsibility for care is transferred from one anaesthetist to another, a ‘handover protocol’ should be followed, during which all relevant information about the patient’s history, medical condition, anaesthetic status, and plan should be communicated.⁶

Routine anaesthesia monitoring according to the Association of Anaesthetists standards of monitoring should be available for all areas where anaesthesia is undertaken.¹⁰² Departments should follow national clinical guidelines for the use of monitoring equipment, or local guidelines when national guidelines are not available.

An anaesthetist should preoperatively assess all patients undergoing emergency surgery who require anaesthesia. This should take place outside of the theatre complex if possible and adequate time should be available for this to occur as clinical urgency allows.¹⁸¹

If no anaesthetist is present in theatre, an appropriately trained anaesthetic nurse, ophthalmic theatre nurse or operating department practitioner (ODP) should be present to monitor the patient during establishment of local anaesthesia and throughout the operative procedure. This should be their sole responsibility.²