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Anaesthetists should participate in departmental audit and quality improvement projects, using specific, measurable, attainable, relevant and time-bound (SMART) methodology (see Glossary) and consideration of full audit cycles (e.g. plan, do, study, act). This participation should adhere to the standards and principles outlined in the College’s Raising the Standards: RCoA Quality Improvement Compendium.⁵

The patient’s GP should be informed of the patient’s procedure as soon as practical, and provided with a written discharge summary, which will usually be completed by the surgeon.

Patients with morbid obesity who require emergency surgery should have experienced anaesthetists and surgeons available (typically, but not exclusively, at consultant level) to minimise operative time.¹⁷³ A surgical team familiar with emergency surgery in patients with morbid obesity and the complications associated with laparoscopic surgery should be available.

All patients over the age of 65 undergoing emergency laparotomy should have a formal assessment of frailty. Surgeons, anaesthetists and intensivists should ensure frailty has been taken into account when assessing the mortality risk as the NELA risk score does not take frailty into account.¹²⁹