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Adoption of national initiatives, for example ’Hello my name is’ should be encouraged and evaluated.⁷⁵

Multidisciplinary audit and morbidity and mortality meetings relating to paediatric anaesthesia and procedures, including resuscitation, should be held regularly. Perioperative death in infants and children is rare. When a death occurs within 30 days of surgery, a multidisciplinary meeting should be convened and a note made in the clinical record.¹⁵ In the event of any unexpected child death...

Audit activity should include the regular analysis and multidisciplinary review of untoward incidents. Serious events and near misses need to be thoroughly investigated and reported to the relevant national agency, in line with national requirements.⁷⁷

There should be ongoing audit of all children transferred between hospitals for surgery, and this should be monitored by the referring hospital’s paediatric surgical committee. Delays should be critically examined by the regional network.

The NHS Modernisation Agency outlined measurable key performance indicators in theatre management and preoperative assessment. These are still applicable.⁷⁴

Anaesthetic research in children should be facilitated when possible, and should follow strict ethical standards.⁷⁸

Anaesthetists who care for children and young people should be familiar with relevant patient safety issues.⁷⁹

Families should be provided with written or web-based resources that provide information specific to anaesthesia before the planned surgery/procedure,⁸⁰ and contact details for the preassessment team should be provided in case they have further questions or need to speak directly with their anaesthetist. The leaflet ‘Information for teenagers, children and parents’ is available from the RCoA website, and...

Information provided preoperatively should include:

• anaesthetic technique; analgesia plan, including regional blockade; any additional procedures, e.g. invasive monitoring, blood transfusion; and planned postoperative care in a critical care environment
• a statement that the ultimate decision making will take place on the day of surgery, according to the needs and safety of the child and as judged by the attending anaesthetist...

Information provided postoperatively should include the safe use of analgesia after surgery and discharge from hospital, and what to do and who to contact in the event of a problem or concern. This should include telephone numbers where advice may be sought 24 hours a day.