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Nursing staff caring for children should be skilled in paediatric and day surgical care and trained in child protection.^33,42

There should be access to a paediatrician. Where the day surgery unit does not have inpatient paediatric services, robust arrangements should be in place for access to a paediatrician and transfer to a paediatric unit if necessary.³²

A preadmission programme for children should be considered, to decrease the impact and stress of admission to the day surgery unit on the day of surgery.^43,46,47,48

Children requiring day-stay anaesthesia for non-surgical procedures such as imaging, endoscopy, laser treatment to skin lesions, radiotherapy, and oncology investigations and treatments should have the same standards of care as those having surgical procedures.

Special considerations for younger children undergoing day case tonsillectomy/ adenoidectomy surgery should be made depending of expertise at the centre and current national guidelines. Skilled preoperative assessment services, including thorough assessment of children with obstructive sleep apnoea (OSA) and experienced anaesthetists and surgeon are required to deliver this safely. Surgery and perioperative care, including care on the post-anaesthetic care unit...

Patients who have begun menstruation should have their pregnancy status ascertained on the day of surgery. Departments should have a policy for pregnancy testing and documentation in line with the Royal College of Paediatrics and Child Health 2012 guidance for clinicians.^33,49

Emergence delirium is more common in young children having short procedures; it is distressing for parents and staff, and impairs the quality of recovery. Anaesthetic techniques should be modified to minimise the risk of emergence delirium in susceptible children to facilitate smooth recovery and discharge.^5,50,51

Pathways and policies for treating prisoners as day cases should be agreed with the local prison services.⁵² This should include a risk assessment and information required to determine whether adjustments are needed to maintain the privacy and dignity of the patient and the safety of staff and other patients. The preoperative assessment team must highlight these requirements to...

The hospital should ensure that prisoners have adequate access to postoperative analgesia. Some prisons do not have the facility to provide analgesia if the medical officer is not on duty. In these cases, arrangements are required to enable the prisoner to access the required postoperative medication within the prisoner’s cell or for additional arrangements to be made to enable patients...

The hospital should consider making an agreement on the safe provision of privacy and dignity for prisoners with the local prison governor regarding the use of restraints.⁵⁰