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Hospitals should have systems in place to facilitate multidisciplinary meetings for neuroscience services.

A World Health Organization (WHO) checklist adapted for neuroscience procedures should be in use.³⁸

The theatre team should all engage in the use of the WHO surgical safety process, commencing with a team brief and concluding the list with a team debrief.³⁸ Debrief should highlight things done well and should also identify areas requiring improvement. Teams should consider including the declaration of emergency call procedures specific to the location as part of the...

For standalone neuroscience centres, local arrangements should be in place for specialist opinion and review of patients by other disciplines. A named consultant neuroanaesthetist should be identified to facilitate such liaison.

Hospitals should review their local standards to ensure that they are harmonised with the relevant national safety standards (e.g. National Safety Standards for Invasive Procedures in England or the Scottish Patient Safety Programme in Scotland).^39,40

Local guidance should be developed for the intrahospital transfer of neuroscience patients, based on guidance from the Neuroanaesthesia and Neurocritical Care Society (NACCS), the Association of Anaesthetists and the Intensive Care Society.^41,42,43

Each department should appoint a designated liaison consultant responsible for identifying the strategic pathways and logistical pitfalls of the intrahospital transfer of neurosurgical patients. The appointment should ensure that any identified problems are either removed or mitigated.

Communication with critical care should occur at the earliest possible time (preoperative clinic letter) to enhance the appropriate allocation of beds.

Patients should be provided written information (in a format of their choice) specific to the neurosurgical procedure they are planned to undergo, which explains the procedure, any preoperative preparation required, the risks, benefits and relevant advice in an easy to understand language.

All patients (and relatives where appropriate and relevant) should be fully informed about the planned procedure and should be encouraged to be active participants in decisions about their care, including the option of doing nothing.⁸