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Local protocols should determine the grade, experience and competency based training of non-anaesthetist healthcare professionals undertaking preoperative assessments.⁴⁶ In addition , all members of the team including administrative, managerial and clinical staff who interact with the patient preoperatively should have skills in motivational interviewing and preoperative optimisation.^47,48 Courses such as ‘Making Every Contact Count’ may be helpful.

The lead obstetric anaesthetist should be responsible for the overall delivery of the service, including:

• ensuring that evidence based guidelines and protocols are in use and are up to date
• monitoring staff training
• workforce planning
• service risk management
• ensuring that national specifications are met
• auditing the service against agreed standards, including anaesthetic complication rates, as set out in the RCoA ...

A difficult intubation trolley with a variety of laryngoscopes including video laryngoscopes, tracheal tubes (size 7 and smaller), second-generation supraglottic airway devices, equipment for emergency front of neck and other aids for difficult airway management should be available in theatre. Videolaryngoscope should always be available. The difficult intubation trolley should have a standard layout that is identical to trolleys in other parts of...

Anaesthetists should be familiar with the specific needs of patients with cancer, including the following:

• the adverse effects of high concentrations of oxygen in the presence of some antineoplastic agents, for example bleomycin, and should adjust their technique accordingly.[i]^,[ii] Recent evidence confirms the association between unnecessarily high intraoperative fraction of inspired oxygen and increased risk of...

Where ophthalmic surgery is performed as a daycase procedure, the facilities should conform to best practice guidance. Day surgery operating theatres should meet the same standards as inpatient operating theatres.^24,25,26 Room should be available for patients to be seen in private by the anaesthetist and surgeon on the day of surgery.²There should...

Preoperative assessment, optimisation and shared decision making in older patients with multiple comorbidities, frailty or cognitive impairment require a cross specialty approach involving anaesthetists, surgeons, geriatricians, pharmacists and allied health professionals. Liaison with a clinical pharmacist to support older patients with polypharmacy in the perioperative period will enable optimisation of medicines and improved management of the patients’ non-surgical comorbidities during...