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An anaesthetic preoperative assessment service should involve consultant anaesthetists and staff grade, specialty and associate specialist (SAS) doctors.^39,40,41 Dedicated anaesthetic presence in the preoperative assessment and preparation clinic is required for:

• the review of results and concerns identified by preoperative staff
• consultations with patients identified using a triage process to allow optimal delivery of preoperative...

The safe management of unstable patients depends on close liaison between emergency physicians, anaesthetists and intensivists.^50,51 Local collaboration and leadership through committee structure or working groups should ensure the following:

• clear guidelines are easily accessible to all staff regarding fixed contact points for anaesthetic support, channels of escalation, equipment availability, medication use and periprocedural care.⁵² Major...

Guidelines containing standards about the following subjects should be held and easily accessible²⁵:

• provision of information to patients
• care of the obstetric patient with an elevated BMI
• resuscitation of the pregnant patient
• management of epidural haematoma
• management of severe local anaesthetic toxicity⁸²
• management of high regional block
• higher levels of care for the critically ill obstetric patient...