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For patients undergoing diagnostic procedures such as MRI, although separate written consent for anaesthesia is not mandatory in the UK, all discussions about sedation and anaesthesia should be documented. Discussion should include methods of induction, associated risks, side effects and potential benefits of the procedure. It is not the responsibility of the anaesthetist to explain the indications for the procedure.^55,56

If the patient is planned to be discharged on the same day after their procedure, relevant information should be provided on discharge, including contact details for the neurosurgical service. Other relevant recommendations for daycase anaesthesia outlined in Guidelines for the Provision of Anaesthesia Services for Day Surgery should be followed.⁵⁷

For procedures such as awake craniotomies, departments should consider giving patients information in different formats including audiovisual. Consideration should be given to offering patients who are anxious about their awake procedure a prior visit to various areas of operating theatres.

The possibility of a parent or carer being present at induction and/or during recovery from anaesthesia should be explored where this is considered to be in the best interests of the patient.

Departments of neuroanaesthesia should be encouraged to develop research interests, even if not part of an academic department. Research collaboration with other neuroscience disciplines is good practice. Taking part in national anaesthesia and critical care projects is to be encouraged.^41,52

Audit programmes should be developed locally but should include continuous audit of transfer of neuroscience patients, neurocritical care capacity and demand, rates of unplanned admission and readmission to the intensive care unit, and the caseload of anaesthetists in training, among others. In general, local practice should be audited against compliance rates with national and expert consensus guidelines.^5,41,53

Collaborative audit with the other neuroscience disciplines should be encouraged, as well as close liaison and joint transfer audits with referring hospitals.⁶

Regular morbidity and mortality meetings should be held jointly with neurosurgeons, interventional neuroradiologists and other relevant stakeholders.

All departments should maintain active links to national bodies and societies (e.g. NACCS Link Doctor Scheme) to facilitate national audit and dissemination of information.

Clinical research staff allocation to clinical activities (beyond those job planned) should be limited to situations of major strain in the resources, such as major departmental emergencies.⁵⁴