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All cases of maternal death, significant permanent neurological deficit, failed intubation or awareness during general anaesthesia should undergo case review, with learning from this shared locally and/or nationally.²⁷

Hospitals should have clear operational policies regarding the care of young people aged 16-18 years of age and for preterm babies who have been discharged from neonatal units.¹³

Elective plastic surgery operating lists should be separated from those for plastic surgery trauma to allow efficient planning in advance for elective cases, to prevent cancellation of elective cases and to allow a flexible response to emergencies.⁶³

Information from the patient’s preoperative assessment should be readily available, ideally as part of an electronic patient record so that information is easy to transfer between locations and to enable data collection for later analysis.¹²

Mechanisms for the early recognition of patients requiring specialist postoperative input from geriatrician led services and/or critical care should be developed. These should include patients at risk of or presenting with delirium, multiple medical complications, functional decline or complex discharge planning.

Local preoperative assessment guidelines and protocols should be established. These should be in line with current national recommendations from the British Association of Day Surgery, Getting It Right First Time, the Centre for Perioperative Care, NHS England and the Preoperative Association.^{4,18,19,20,21}

A viable  alternative is for patients to be admitted to and discharged from a dedicated day surgery ward, with surgery undertaken in the main theatre suite. This arrangement may be more flexible for complex surgery and avoids duplicating theatre skills and equipment. Day surgery patients should be prioritised as first on the main theatre list to allow recovery time for...

It may be difficult to make the ECG gel electrodes adhere to damaged skin. ECG electrodes could be sited away from the chest,²⁹ or could be attached to crocodile clips, surgical staples or steel sutures placed in burned areas.^20,24,31

Capnography, pulse oximetry and non-invasive blood pressure monitoring should be available until the patient is fully recovered from general anaesthesia. An electrocardiograph, nerve stimulator, thermometer and glucometer should also be readily available.^{131,182,192,194}