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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

A Royal College of Anaesthetists/Difficult Airway Society airway lead should be appointed in all hospitals providing anaesthetic services.⁷

Where scheduled procedures cannot be accommodated within normal list times, anaesthesia departments should make arrangements for anaesthetists to be relieved by a colleague.⁸

There should be an appropriately trained theatre team including an on-call consultant or other autonomously practicing anaesthetist 24/7 to provide anaesthesia for emergency head and neck surgery in head and neck cancer centres and in hospitals with an emergency department (ED).⁹

Consideration should be given to identifying anaesthetists with advanced airway experience to support colleagues providing care to patients with complex airway emergencies.

Patients who have had a recent tracheostomy or airway surgery returning to a general ward, should be cared for by adequate levels of nursing staff who are skilled in the care of the surgical airway and be aware of the specific risks involved.^{4,10,11,16,21}

Many head and neck cancer patients have significant comorbidities that may require optimisation prior to surgery. There should be a lead anaesthetist for preoperative assessment who works closely with an appropriate preoperative assessment team.¹²

Where Light Amplification by Stimulated Emission of Radiation (LASER) surgery to the head and neck is performed staff must be appropriately trained in its safe use.^13,14 A LASER protection advisor (LPA) should be consulted or appointed according to devolved administration or local authority regulations, and a local safety officer and/or an operational LASER protection supervisor (LPS) appointed...

Nursing and theatre staff trained to manage patients with a tracheostomy should be available in recovery areas of hospitals.^16,11

Recovery facilities should be staffed and have appropriate anaesthetic support until the patient meets the agreed discharge criteria.³³