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Anaesthetists with a job plan that includes emergency anaesthesia should demonstrate ongoing continuing education in emergency anaesthesia, and continuing professional development as required for this aspect of their work. Departments have a responsibility to enable this with local teaching where appropriate and by facilitating access to other education and training.³³ Hospitals should provide a comprehensive training programme and support...

Each DSU should have a system in place for the routine audit of important basic parameters such as unexpected admissions following surgery, non-attendance (DNA) rates, patients cancelled on the day of operation, postoperative symptoms e.g. pain and PONV and patient satisfaction.⁵⁵ The Royal College of Anaesthetists has also issued guidance for audits in day surgery.⁵⁶

Any non-trainee anaesthetist who undertakes anaesthetic duties in the labour ward should have been assessed as competent to perform these duties in accordance with OAA and RCoA guidelines.^31,55,89 Such a doctor should work regularly in the labour ward but should also regularly undertake non-obstetric anaesthetic work to ensure maintenance of a broad range of anaesthetic skills.

Women who refuse transfusion of blood or blood products, whether because of adherence to the Jehovah’s Witness faith or for other reasons, should be identified early in the antenatal period. They should meet with an anaesthetist to discuss their specific restrictions, and should receive information about the potential risks associated with their decision.^142,143 Their decision should be...

Some aspects of preoperative anaesthetic assessment and preparation of the emergency patient differ from those of the elective patient. These include severity of illness, fluctuating condition of the patient and the 24/7 nature of emergency work. Staffing levels and seniority of anaesthetists should be adequate to enable preoperative anaesthetic planning and assessment that is appropriate to the patient’s risks associated...

Special considerations for younger children undergoing day case tonsillectomy/ adenoidectomy surgery should be made depending of expertise at the centre and current national guidelines. Skilled preoperative assessment services, including thorough assessment of children with obstructive sleep apnoea (OSA) and experienced anaesthetists and surgeon are required to deliver this safely. Surgery and perioperative care, including care on the post-anaesthetic care unit...

The Royal College of Anaesthetists has published guidance for audits and quality improvement projects in day surgery.⁶ Each day surgery unit should have a system in place for the routine audit of important basic clinical and organisational parameters such as:

• clinical: unplanned inpatient/overnight admissions following surgery, postoperative symptoms (e.g. pain, nausea and vomiting) 
• organisational: non-attendance rates, patients cancelled...