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The transfer of trauma patients to a MTC will normally be facilitated by the referring hospital. The referring hospital should have robust arrangements in place to enable this to occur safely without compromising clinical activity at their base hospital.¹²

Information should be provided in a range of formats, including written leaflets or electronic material.¹⁰⁰ Details of websites that provide reliable, impartial and evidence based information should be made available to patients when appropriate. Where possible this should include large print, Braille and audio formats. Information should conform to the ‘accessible information’ standard set by the Department of...

Some patients may require additional monitoring equipment. The following should be considered based on case mix and workload:¹²³

• invasive cardiovascular pressure monitoring
• Point of Care coagulation testing.¹³⁹
• cardiac output monitors
• depth of anaesthesia monitoring.¹⁴⁰

Departments of anaesthesia should ensure that a named supervisory consultant or other autonomously practising anaesthetist is available to all non-autonomously practising anaesthetists based on the training and experience of the individual doctor and the range and scope of their clinical practice.²⁷⁸ Where an anaesthetist is supervised by a consultant or other autonomously practising anaesthetist, they should be aware of their...

Local protocols should determine the grade, experience and competency based training of non-anaesthetist healthcare professionals undertaking preoperative assessments.⁴⁹ 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.^50,51 

Where the postoperative destination is not a main ICU (e.g. a level 2 HDU or specifically developed PACU), the patient should remain in PACU until they are stable and are no longer likely to require immediate support from an anaesthetist. This is of particular importance when transferring patients from recovery to level 2 critical care units that are not staffed...

IPS should consider integrating clinical psychologists into their MDT. Areas which could benefit from clinical psychology involvement includes inpatients with complex pain. Certain patients may benefit from preoperative psychological interventions and within the framework of post-discharge transitional pain clinics.⁹