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Bariatric patients requiring emergency surgery should have experienced surgeons and anaesthetists available (typically, but not exclusively, at a consultant level), in order to minimise operative time.^85,127

A multidisciplinary team approach is highly recommended, typically involving anaesthetists, obstetricians, surgeons, paediatricians and midwives.^{137,138,139,140}

Preoperative assessment, optimisation, manipulation of patients’ normal drugs and shared decision-making in patients with diabetes requires a cross specialty approach involving anaesthetists, surgeons, diabetologists and diabetes inpatient specialist nurses. The development of such teams requires time and resources. This should be recognised and provided.³⁸

In a true emergency situation involving a child requiring urgent neurosurgery for a deteriorating condition admitted to an ‘adult only’ neurosurgical service, the most appropriate surgeon, anaesthetist and intensivist available would be expected to provide life saving care, including emergency resuscitation and surgery.³⁰

Appropriate staffing levels and skill mix should be provided in all units: multispecialty general hospitals, isolated units and large single-specialty centres delivering ophthalmic anaesthesia. For most operating sessions this should include surgeon, anaesthetist, two theatre-trained scrub practitioners, one trained nurse or operating department practitioner to assist with local anaesthesia/patient monitoring and one theatre support worker/runner.^2,3 

Where postoperative care is delivered outside of a main ICU (e.g. a level 2 high dependency unit (HDU) or specifically developed PACU), 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 ensure good patient outcomes.²⁵⁰ Protocols and policies should be agreed between nursing staff...