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Each unit should have a multidisciplinary operational group that oversees the day to day running of the unit, agrees policies and timetables, reviews operational problems and organises audit strategies.⁵⁵

Effective preoperative assessment and patient preparation, performed as early as possible in the planned patient pathway, is essential to the safety and success of day surgery.^9,11,12

Local preoperative assessment guidelines and protocols should be established. These should be in line with current national recommendations from the Preoperative Association. ^{24, 43}

Protocols should be available to maximise the opportunity for patients with significant co-morbidities (e.g. diabetes, morbid obesity, sleep apnoea) to be safely managed via a day case pathway.

Consultant anaesthetic advice should be available to comment on an individual patient’s suitability for day surgery and to assist with preoperative optimisation.

Clinical investigations rarely inform the suitability for day surgery or influence subsequent management or outcome.^3,44 Those that are appropriate should be ordered at preassessment, according to a locally agreed protocol. A mechanism for review and interpretation of the results of tests ordered before the day of surgery should be developed.

The patient should be provided with written information outlining the day surgery pathway, planned procedure and anaesthetic, and expectation of postoperative recovery.

Mixed inpatient and day surgery lists may increase flexibility, but this practice should be minimised, as conflicting priorities can compromise the care of both groups.²²

If it is occasionally necessary to undertake day case surgery on inpatient operating lists, the day cases should be prioritised at the beginning of the list to allow time for postoperative recovery and timely discharge.

The anaesthetist should have the skills to hold a competent interview, assess and communicate the chance of benefit and harm, and facilitate shared decision-making.