{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T20:04:44Z","timestamp":1768593884615,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T00:00:00Z","timestamp":1608249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007567","name":"Association of Anaesthetists of Great Britain and Ireland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007567","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001297","name":"Royal College of Anaesthetists","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001297","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Postoperative critical care is a finite resource that is recommended for high\u2010risk patients. Despite national recommendations specifying that such patients should receive postoperative critical care, there is evidence that these recommendations are not universally followed. We performed a national survey aiming to better understand how patients are risk\u2010stratified in practice; elucidate clinicians\u2019 opinions about how patients should be selected for critical care; and determine factors which affect the actual provision of postoperative critical care. As part of the second Sprint National Anaesthesia Project, epidemiology of critical care after surgery study, we distributed a paper survey to anaesthetists, surgeons and intensivists providing peri\u2010operative care during a single week in March 2017. We collected data on respondent characteristics, and their opinions of postoperative critical care provision, potential benefits and real\u2010world challenges. We undertook both quantitative and qualitative analyses to interpret the responses. We received 10,383 survey responses from 237 hospitals across the UK. Consultants used a lower threshold for critical care admission than other career grades, indicating potentially more risk\u2010averse behaviour. The majority of respondents reported that critical care provision was inadequate, and cited the value of critical care as being predominantly due to higher nurse: patient ratios. Use of objective risk assessment tools was poor, and patients were commonly selected for critical care based on procedure\u2010specific pathways rather than individualised risk assessment. Challenges were highlighted in the delivery of peri\u2010operative critical care services, such as an overall lack of capacity, competition for beds with non\u2010surgical cases and poor flow through the hospital leading to bed \u2018blockages\u2019. Critical care is perceived to provide benefit to high\u2010risk surgical patients, but there is variation in practice about the definition and determination of risk, how patients are referred and how to deal with the lack of critical care resources. Future work should focus on evaluating \u2018enhanced care\u2019 units for postoperative patients, how to better implement individualised risk assessment in practice, and how to improve patient flow through hospitals.<\/jats:p>","DOI":"10.1111\/anae.15302","type":"journal-article","created":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T16:53:40Z","timestamp":1608310420000},"page":"336-345","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Perceptions of UK clinicians towards postoperative critical care"],"prefix":"10.1111","volume":"76","author":[{"given":"S.","family":"Hashim","sequence":"first","affiliation":[{"name":"University College London Medical School London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. J. N.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Guy\u2019s and St Thomas' NHS Foundation Trust London UK"},{"name":"Health Services Research Centre National Institute for Academic Anaesthesia Royal College of Anaesthetists London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Farmer","sequence":"additional","affiliation":[{"name":"Health Services Research Centre National Institute for Academic Anaesthesia Royal College of Anaesthetists London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. K.","family":"Harris","sequence":"additional","affiliation":[{"name":"University College London Hospitals NHS Foundation Trust London UK"},{"name":"Bloomsbury Institute of Intensive Care Medicine Department of Internal Medicine Division of Medicine University College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. R.","family":"Moonesinghe","sequence":"additional","affiliation":[{"name":"Surgical Outcomes Research Centre Centre for Peri\u2010operative Medicine Department for Targeted Intervention Division of Surgery and Interventional Science University College London London UK"},{"name":"Health Services Research Centre National Institute for Academic Anaesthesia Royal College of Anaesthetists London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,18]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"NHS England.Critical Care Bed Capacity and Urgent Operations Cancelled 2018\u201319 Data.https:\/\/www.england.nhs.uk\/statistics\/statistical\u2010work\u2010areas\/critical\u2010care\u2010capacity\/critical\u2010care\u2010bed\u2010capacity\u2010and\u2010urgent\u2010operations\u2010cancelled\u20102019\u201020\u2010data\/(accessed 25\/06\/2020)."},{"key":"e_1_2_6_3_1","unstructured":"NHS England.Cancelled elective operations.https:\/\/www.england.nhs.uk\/statistics\/statistical\u2010work\u2010areas\/cancelled\u2010elective\u2010operations\/cancelled\u2010ops\u2010data\/(accessed 25\/06\/2020)."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.07.002"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(15)70087-2"},{"key":"e_1_2_6_6_1","unstructured":"FindlayGP GoodwinAPL ProtopapaK SmithNCE MasonM.National Confidential Enquiry into Patient Outcome and Death (NCEPOD). Knowing the risk: a review of the peri\u2010operative care of surgical patients.2011.http:\/\/www.ncepod.org.uk\/2011report2\/downloads\/POC_fullreport.pdf(accessed 01\/06\/2019)."},{"key":"e_1_2_6_7_1","unstructured":"Royal College of Surgeons of England.The Royal College of Surgeons of England Working Group on the Perioperative Care of the High\u2010risk General Surgical Patient.2018.https:\/\/www.rcseng.ac.uk\/\u2010\/media\/files\/rcs\/standards\u2010and\u2010research\/standards\u2010and\u2010policy\/service\u2010standards\/rcs\u2010report\u2010the\u2010highrisk\u2010general\u2010surgical\u2010patient\u2013raising\u2010the\u2010standard\u2013december\u20102018.pdf(accessed 22\/01\/2020)."},{"key":"e_1_2_6_8_1","unstructured":"Faculty of Intensive Care Medicine and the Intensive Care Society.Guidelines for the Provision of Intensive Care Services.2017.https:\/\/www.ficm.ac.uk\/standards\u2010and\u2010guidelines\/gpics(accessed 01\/06\/2019)."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc4928"},{"key":"e_1_2_6_10_1","article-title":"SNAP\u20102 EPICCS: the second Sprint National Anaesthesia Project\u2014EPIdemiology of Critical Care after Surgery: protocol for an international observational cohort study","volume":"7","author":"Moonesinghe SR","year":"2017","journal-title":"British Medical Journal Open."},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3182a4e94d"},{"key":"e_1_2_6_12_1","unstructured":"National Institute for Health and Care Excellence.Acute and Critical Care.2017.https:\/\/www.nice.org.uk\/guidance\/service\u2010delivery\u2010\u2010organisation\u2010and\u2010staffing\/acute\u2010and\u2010critical\u2010care(accessed 06\/09\/17)."},{"key":"e_1_2_6_13_1","first-page":"77","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun V","year":"2006","journal-title":"Psychology"},{"key":"e_1_2_6_14_1","unstructured":"Faculty of Intensive Care Medicine and Centre for Peri\u2010operative Care.Guidelines on establishing and delivering enhanced perioperative care services.https:\/\/www.cpoc.org.uk\/sites\/cpoc\/files\/documents\/2020\u201010\/Enhanced%20Perioperative%20Care%20Guidance%20v1.0.pdf(accessed 09\/11\/2020)."},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14843"},{"key":"e_1_2_6_16_1","unstructured":"Montgomery v Lanarkshire Health Board (Respondent) (Scotland) [2015]UKSC 104."},{"key":"e_1_2_6_17_1","unstructured":"General Medical Council. Consent:\u00a0patients and doctors making decisions together.2008.https:\/\/www.gmc\u2010uk.org\/ethical\u2010guidance\/ethical\u2010guidance\u2010for\u2010doctors\/consent(accessed 29\/12\/2019)."},{"key":"e_1_2_6_18_1","unstructured":"Royal College of Surgeons. Consent: Supported Decision\u2010Making.2018.https:\/\/www.rcseng.ac.uk\/standards\u2010and\u2010research\/standards\u2010and\u2010guidance\/good\u2010practice\u2010guides\/consent(accessed 29\/12\/2019)."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.12.026"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/5341394"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.15302","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/anae.15302","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.15302","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T17:30:34Z","timestamp":1761672634000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.15302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,18]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1111\/anae.15302"],"URL":"https:\/\/doi.org\/10.1111\/anae.15302","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,18]]},"assertion":[{"value":"2020-09-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}