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Appropriate investigation should be ordered at preassessment, according to a locally agreed protocol. A mechanism for review and interpretation of the results of tests ordered before the day of surgery should be in place.^21,22

The patient should be provided with verbal and written information or directed to available electronic media outlining the day surgery pathway, planned procedure and anaesthetic, and expectation of postoperative recovery, to reinforce the day surgery message.12,17

A consultant or autonomously practising anaesthetist should be available to review an individual patient’s suitability for day surgery and to assist with preoperative optimisation, in discussion with medical specialists as appropriate. A referral service for nurses or appropriately trained allied health professionals to allow complex patients to have anaesthetic review should be developed.^5,12,13

Consideration should be given to the optimisation of waiting lists so that patients are ready to be listed once they reach the date for surgery.^17,23

Mixed inpatient and day surgery lists may increase flexibility, but this practice should be minimised, as conflicting priorities can compromise the care of both groups.⁹

If it is occasionally necessary to undertake daycase surgery on inpatient operating lists, the day cases should be prioritised at the beginning of the list to allow time for postoperative recovery and discharge. Starting the list with a daycase patient may improve efficiency (no delay to starting list) in times of bed pressures.

Daycase patients should ideally be cared for in dedicated day surgery ward areas to ensure safe and timely discharge.

Locally agreed guidelines and policies should be in place for preoperative management on the day of admission. This should include assessment for risk of venous thromboembolism, pregnancy, premedication and pathways for major surgery (e.g. daycase arthroplasty).^3,9,24

Locally agreed policies should be in place for the management of postoperative pain after day surgery. This should include pain scoring systems in recovery and a supply of pain relief medication on discharge, with written and verbal instructions on how to take medications and what to take when the medications have finished. Information on over-the-counter analgesics to have at home...

There should be agreed protocols for the care of patients who require unplanned hospital admission following their daycase procedure.