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The staff should ensure that patients have sufficient information and autonomy to give informed consent, including access to translation where appropriate.

The hospital staff should ensure that aftercare and observation is as adequate as for a patient returning home with a carer and the security service staff must have some understanding of the procedure performed and provide aftercare in accordance with clinical advice.^3,17

A number  of urgent surgical operations can be efficiently and effectively treated as day cases via a semi-elective pathway (see BADS Directory of Procedures).10 Patients suitable for treatment as day cases should be identified by the surgical team.^3,8,17

Pathways should be developed to facilitate access to day case surgery for urgent surgery which may prevent recurrent admissions while awaiting elective surgery. This includes robust preoperative assessment process to facilitate day case surgery.^3,27,53

It is essential to determine whether the patient is safe to be sent home with oral treatment and analgesia for up to 24 hours while awaiting urgent surgery on a daycase basis.²⁷

Day surgery can be an advantageous choice for the frail or older patient allowing better recovery in their own familiar environment at home and avoiding a hospital stay with risk of exposure to infections.⁵⁴

Patients who are frail or elderly with many comorbidities should be identified early at preoperative assessment and risk assessments made.^12,17,51

Perioperative plans should be made with carers or relatives involving access to day surgery pathways to increase the chance of success.12

Multidisciplinary involvement early to optimise frail or elderly comorbid patients may help decrease postoperative complications.^12,51,55

Planned early mobilisation and multimodal, opiate light analgesic regimens should be used to reduce postoperative delirium in high-risk frail or elderly patients.⁵¹