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In all centres admitting children, one or more anaesthetist should be appointed as clinical lead (see Glossary) for paediatric anaesthesia. Typically, they should undertake at least one paediatric list each week and will be responsible for co-ordinating and overseeing anaesthetic services for children, with particular reference to teaching and training, audit, equipment, guidelines, pain management and resuscitation. There should...

Children and young people undergoing surgery should be placed on designated children’s operating lists in a separate children’s theatre area. When this is not possible, children and young people should be given priority by placing them at the beginning of a mixed list of elective or emergency cases.

A WHO checklist should be completed before and during all procedures and investigations under anaesthesia and sedation, if provided by the anaesthetic department. A pre-procedure team safety brief should be undertaken as per the national safety standards for invasive procedures.⁶⁸

Hospitals should review their local standards to ensure that they are harmonised with the relevant national safety standards (e.g. National Safety Standards for Invasive Procedures in England and Wales, the Scottish Patient Safety Programme in Scotland and Safety and quality standards in Northern Ireland).^69,70,71 Organisational leaders are ultimately responsible for implementing local safety standards as necessary.

A family-centred approach to the perioperative care pathway should be adopted, with physical separation between adult patients and children in the operating department, recovery area, day units and in the emergency department whenever possible.^15,72

All children and young people should be assessed before their operation by an anaesthetist. Parents and carers, as well as the child, should be given the opportunity to ask questions and to be involved in the physical and psychological preparation for surgery.

Parents and carers should be involved throughout the care process. With the agreement of the anaesthetist in charge of the case on the day, they should be able to accompany children to the anaesthetic room, remain present for induction of anaesthesia and be able to gain easy access to the recovery area. In special circumstances, such as with some small...

Hospitals should engage with networks to develop agreed standard patient care pathways based on age, comorbidity and complexity of procedure, as well as clinical urgency. There should be multidirectional flow of patients within the care pathways as part of the ODN determined by patient needs to local service provision, staffing and geography.

The ODN and the hospitals within the network should work in partnership in providing a framework for CPD education and training, audit and standards for clinical care to meet the needs of individual clinicians within the network and the local service provision.

Sharing of resources amongst hospitals within the network should be encouraged and facilitated.