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Preoperative assessment should when possible be provided to the same standard as that used for elective day surgery.

There should be no restriction to treating a patient as a day case based on weight alone. Even morbidly obese patients can be safely managed in expert hands with appropriate resources.^36,37

Super morbidly obese patients (BMI >50) should be assessed on an individual basis to ascertain whether additional equipment or staffing are required for their safe management.

Patients should be assessed for their risk of sleep apnoea using tools such as STOP BANG.^38,39

Whilst even morbidly obese (BMI >40) patients can be managed through a day surgery pathway, it may be inappropriate to operate upon them in an isolated environment. In this case, their surgery could be undertaken through a day surgery pathway using the main hospital operating theatres if this environment has the specialist equipment required for obese patients. The patient should...

Where day surgery is performed in isolated units, practice should comply with the RCoA guidelines on anaesthetic services in remote sites.^1,40

The preoperative assessment service should enable multidisciplinary training for medical students, nurses, specialist doctors in training and allied health professionals. Educational materials are available to facilitate this.⁴¹ Training schools should give consideration to establishing specific modules in preoperative assessment for senior trainees.

There should be agreed pathways for patients who require admission to hospital following their day surgery procedure.

All day surgery staff should receive appropriate training for post anaesthesia and postsurgical care. Training should be tailored to meet the needs of the individual staff member and the day surgery unit. ^7,8

Standards and training for clinical staff working within the primary recovery area should be as defined within Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients.