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Sufficient anaesthetic sessions should be provided to allow a review of the medical notes or consultations when required between senior anaesthetists and patients at increased risk of mortality and morbidity (>1 in 200 risk of dying within 30 days of surgery). There should also be resources for patients at greatest risk (>1 in 100 risk of dying within 30 days...

Information should be made available to patients, which gives details of the surgery and local and general anaesthesia for ophthalmic procedures, as well as advice on what to expect on the day of admission. The Royal College of Anaesthetists and the Royal College of Ophthalmologists have a range of booklets available on their websites to help to inform patients.^46,47,48

Anaesthetists should be aware of legislation and good practice guidance relevant to children and according to the location in the UK. ^53,54,55,56 These documents refer to the rights of the child, child protection processes, and consent.

An appropriate level of staffing and suitable facilities should be available to deliver a good quality preoperative service. Non-anaesthetist health professionals, such as, specialist nurses, pharmacy staff, allied health professionals and Anaesthesia Associates (AAs) add considerable value to the service.^40,43,44

One or more named senior anaesthetists with appropriate training and expertise, and with an interest in head and neck surgery, should be responsible for directly or indirectly overseeing all complex and/or major head and neck procedures.⁵ All other regular sessions should have either a named consultant or an SAS doctor with appropriate skills assigned to them.⁶

In order to maintain the necessary knowledge and skills, vascular anaesthetists should have a regular commitment to the specialty, and adequate time must be made for them to participate in relevant multidisciplinary meetings and continuing professional development (CPD) activities. This should include the facility and resources to visit other centres of excellence in order to exchange ideas and develop new...

It is recommended that individual vascular anaesthetists register with, and contribute to, the UK national audit database (National Vascular Registry),⁴⁶  which incorporates a section dedicated to ‘anaesthesia’ as developed between the Vascular Anaesthesia Society of Great Britain and Ireland and partnership organisations. The systems needed to provide the necessary data should be available and supported.

Anaesthetists should facilitate surgery within 36 hours of a hip fracture.⁵¹ Surgery should be delayed only if the benefits of additional medical treatment outweigh the risks of delaying surgery. The risks of delay associated with pain and immobility contribute to poor outcomes to a far greater extent than correction of an abnormality to a particular numerical value.⁴⁵

Anaesthetists should be aware of legislation and good-practice guidance relevant to children and according to the location in the UK.^{54,55,56,57,58} These documents refer to the rights of the child, child protection processes, and consent.

Post menarcheal women should be made aware of the need for clinicians to establish pregnancy status before surgery or procedures involving anaesthesia. While obtaining and documenting this information is primarily the responsibility of the operating surgeon or paediatrician, anaesthetists may also feel it necessary to confirm that such checks have been performed. Trusts should have agreed policies and arrangements for...