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Hospitals should have arrangements in place to provide language support, including interpretation and translation services (including sign language and Braille). This information should comply with the NHS England Accessible Information Standard.¹⁸⁷

Protocols and equipment should be available for the postoperative management of various symptoms, signs and conditions deemed locally appropriate. Such examples include the management of postoperative nausea and vomiting, pain relief of patients with chronic pain,²¹ hypothermia, blood transfusion, fluid therapy, diabetes,^22,23 acute coronary syndrome, the deteriorating and dying patient,²⁴ delirium, respiratory diseases, hypotension, hypertension and vulnerable adults and children.

If a patient has known visual or hearing impairment or wears dentures, then their corrective lenses/hearing aid/dentures should be readily accessible and available postoperatively.²⁵

When critically ill patients are held in the recovery area because of a lack of availability of appropriate facilities elsewhere, this should only occur if recovery staff are appropriately trained, and the recovery area is appropriately equipped to enable monitoring and treatment to the standard of a level 3 critical care unit. In some circumstances, such as a flu pandemic...

Excellent nursing care with prompt access to medical support will ensure that many key aspects of care are proactively managed to ensure good patient outcomes. Nurse-led, protocol driven care of frequently occurring problems for high risk surgical patients (such as pain, fluid imbalance, nutrition and mild cardiorespiratory compromise) can often be provided in a level 2 critical care unit or...

The risk of postoperative functional decline and complex discharge related issues should be considered.

Where the postoperative destination is a level 2 critical care unit, consideration should be given to initial care in a standard PACU until the patient has fully regained consciousness. This is of particular importance for critical care units that are not staffed with airway trained doctors.

All hospitals should have a clear policy describing the safe triage of surgical patients considered to need postoperative critical care, with guidance on which patients should be admitted immediately to critical care, and which can wait in a standard PACU for a short period while a critical care bed becomes available. Staff in critical care and PACUs should develop procedures...

Hospitals should have written policies on the management of patients whose surgery is sufficiently urgent that this proceeds when postoperative critical care is desirable but not available; this situation should be considered exceptional.

There should be easy and safe access to the delivery suite from the main hospital at all times.⁷⁷