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There should be a formalised integrated pathway for non-elective adult general surgical care, which should be patient centred and include:^2,5,19,29,40

• a clear diagnostic and management plan made on admission⁴¹
• early identification of comorbidities (including diabetes, dementia, cardiac pacemakers and internal defibrillators) and their management according to hospital guidelines
• medicine...

All patients undergoing anaesthesia should be under the care of a consultant anaesthetist whose name is recorded as part of the anaesthetic record. A staff grade, associate specialist and specialty doctors (SAS) anaesthetist could be the named anaesthetist on the anaesthetic record if local governance arrangements have agreed in advance that, based on the training and experience of the individual...

It is the responsibility of those leading departments of anaesthesia, together with their constituent consultants or autonomously practising anaesthetists, to ensure that AAs work under the immediate supervision of a consultant or autonomously practising anaesthetist at all times.¹⁵

An appropriately skilled and experienced resident anaesthetist should be available at all times to care for postoperative and emergency patients. The experience and skills necessary to provide this cover are not usually found in anaesthetists in training in stage 1.³