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Departments should consider providing all newly appointed consultants or autonomously practising anaesthetists, particularly those with limited experience, with a mentor to facilitate their development in thoracic anaesthesia.

Anaesthetic involvement in the leadership of thoracic units should be considered.

There should be a forum for discussion of matters relevant to both surgeons and anaesthetists, for example protocol development and critical incidents.

Clinical protocols should be developed from national guidelines and reviewed on a regular basis.

Anaesthetists should be part of the multidisciplinary team engaged in development and implementation of enhanced recovery programmes in thoracic surgery.^32,33,40

Hospitals should have systems in place to facilitate multidisciplinary meetings for thoracic services.

All handovers should contain representatives for the multidisciplinary teams from both theatre and the receiving area and should be documented and structured to ensure continuity of care.⁴¹

The theatre team should all engage in the use of the World Health Organization surgical safety process⁴² commencing with a team brief, and concluding the list with a team debrief. The debrief should highlight things done well and also identify areas requiring improvement. Teams should consider including the declaration of emergency call procedures specific to the location as...

Hospitals should review their local standards to ensure that they are harmonised with the relevant national safety standards, such as the National Safety Standards for Invasive Procedures in England (NatSSIPs) or the Scottish Patient Safety Programme in Scotland.^43,44

There should be sufficient numbers of clinical programmed activities in clinicians’ job plans to provide cover for all elective thoracic operating lists and to provide adequate emergency cover.⁴⁵