Where major elective reconstructive surgery requiring postoperative critical care provision is undertaken, the funding for, and provision of, these beds should be planned to meet the demands of the service, so that unnecessary cancellations can be minimised.
All major head and neck surgery should be overseen by a named consultant anaesthetist with a subspecialty interest in this area.63
When very long surgical procedures are scheduled on a regular basis, appropriate funding and resources should be in place to support long duration lists.
All anaesthetic equipment should be checked before use in accordance with the Association of Anaesthetists published guidelines.32 Anaesthetic machine checks should be recorded in a log and on the anaesthetic chart.
Anaesthesia for burn and plastic surgery should be included in regular anaesthetic department mortality and morbidity meetings, audit meetings and quality improvement programmes.
Multidisciplinary audit meetings involving surgical teams should be encouraged, where mortality and morbidity should be discussed alongside all serious untoward incidents relative to the service.
Anaesthetic departments should be integrated into the overall clinical audit and governance structure of the hospital. Each anaesthetic department undertaking anaesthesia for burn and plastic surgery should have a system in place for the routine audit of important areas such as:
Burn services should undergo regular peer reviews within the national burn care network.11
Departments of anaesthesia should be encouraged to develop local key quality indicators relevant to their activity, which will assist in the process of supporting quality improvement.11
