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There should be a multidisciplinary programme for auditing anaesthesia and sedation in the non-theatre environment.

Audit should be under regular review by a clinical lead and those relating to sedation should be coordinated by a hospital sedation committee.

Regular feedback and improvement of standards should be provided to anaesthetic staff.

Compliance with agreed guidelines should be audited including World Health Organization (WHO) checklists, team brief, and a post anaesthesia discharge checklist.

All patients (and relatives where appropriate and relevant) should be fully informed about the planned procedure and be encouraged to be active participants in decisions about their care. Recommendations about the provision of information and consent processes outlined in chapter 2 should be followed.⁶⁷

Although separate written consent for anaesthesia is not mandatory in the UK, there should be a written record of all discussions with patients undergoing sedation or anaesthesia for diagnostic procedures such as MRI scans about methods of induction, associated risks and side effects.^1,41

In cases when rolling consent is used, e.g. radiotherapy treatment, appropriate documentation should be kept as part of the patient record, including dates for review of consent. This should be included in the trust’s policy on consent.

Information regarding planned procedures outside of the operating theatre and the requirement for sedation or anaesthesia should be given to the patient in advance of their admission. Details on fasting times and medications to continue or omit should be included. The patient needs to be aware that they require a competent adult to escort them home after receiving sedation.¹

Information to patients should include what to expect in the anaesthetic room and treatment room.⁶⁸

Patients from non-English speaking groups may need interpreters. Hospitals should have arrangements in place to provide language support, including interpretation and translation (including sign language and Braille). This information should comply with the NHS England Accessible Information Standard.⁶⁹ Patients with learning and other difficulties may need special assistance and consideration.