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Face-to-face and/or telemedicine preadmission clinics for elective neurosurgery should be available, with early input from the department of neuroanaesthesia, particularly for high-risk patients and those where additional time and discussion are required, such as awake craniotomy.³³ All centres should be able to demonstrate that discussion of perioperative risk is routine and that specific risks related to, for example...

Thoracic anaesthesia is a ‘key unit of training’ in both the 2010 intermediate level training in anaesthesia³⁴ and in the newer 2021 Curriculum Stage 2.³⁵of training. Trainee anaesthetists should be of appropriate seniority to be able to benefit from this area of training. Stage 3 training of the 2021 Curriculum also requires trainees to be proficient...

Consultation skills for shared decision making should be used to prepare patients for anaesthesia, surgery and analgesia. Patients should also be informed of the increasing number of decision aids available from NHS Direct to help them with their choices.^66,102,103 The use of shared decision making tools such as ‘Benefits, Risks, Alternatives, Nothing’ and ‘Ask 3 questions’ should be considered.^104,105

Adequate provision within job plans should be made for a member of the anaesthetic team to visit the following groups of patients within 24 hours following their operation:

• those graded as American Society of Anesthesiologists (ASA) physical status 3, 4 or 5
• those receiving epidural analgesia on a general ward 
• those discharged from the recovery unit with cardiovascular invasive monitoring...

Leaflets should explain pain management after discharge, including a step-down analgesic plan and how further supplies of medicine can be obtained. Patient information should emphasise the need to avoid harm from long-term opioid use and should give clear advice on the impact of analgesics on driving, acknowledging the current Driver and Vehicle Licensing Agency guidance.^{38,81,82,83,84}