The original Handbook of Perioperative Medicines was published in 2016. It was developed and project managed by Sophie Blow, a specialist in surgery and theatres clinical pharmacy, and written collaboratively by numerous contributors.

The Handbook contains information on how medicines are to be managed in the perioperative period, a time when a patient often experiences interruption of medication regimens that are important for the treatment of other non-surgical comorbidities. It contains information pertaining to the risks and benefits of omitting, changing and continuing therapy during this period, and where possible how those risks can be managed.

The Handbook of Perioperative Medicines provides national guidance to all healthcare professionals involved in or interested in perioperative medicine, including Pharmacists, Anaesthetists, Pre-operative Assessment Nurses and ward-based Surgical Teams. It aims to ensure unified practice for the management of patients’ regular medicines in the perioperative period.

Since its launch in 2016 it has become a recognised and much-needed resource for many health professionals working with patients undergoing surgery.

This 3rd edition involves a comprehensive review and revision of the original content, an improved layout, and the addition of over 60 new monographs covering multiple new areas of medicines. The free-to-access online format ensures that the guidance can be adopted nationally and referred to by any health professional at the point of contact with patients undergoing surgery. Revisions and additions will be made continually, reassuring health professionals that they are accessing the most up-to-date information.

The Handbook aims to reduce the need for individual NHS Trusts to devise their own local guidelines, which leads to variations in practice across the NHS, introducing elements of risk, confusion and ambiguity across a multitude of treatment centres. The variation in practice is something recognised in the Carter review which identified that reduction of such variations would improve patient care and safety through compliance to national guidance.

The production of the Handbook supports patient safety initiatives in relation to medication which are aligned with the WHO Global Patient Safety Challenge: Medication Without Harm. The Handbook is particularly relevant to the following areas of focus:

  • ‘Medication Safety in Transitions of Care’ – in particular the importance of medication reconciliation between care settings, appropriate prescribing and risk assessment of medication, and medication review.
  • ‘Medication Safety in High-risk Situations’ – in particular the use of high-risk medicines (e.g. anticoagulants, insulin, opioids) and reduction of potential medication errors through healthcare providers having access to high-quality prescribing advice.

New and revised content has been written by Sarah Tinsley, Advanced Clinical Lead Pharmacist Surgical Division at University Hospitals of North Midlands, and Claire Frank, Lead Pre-operative Assessment Pharmacist at Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board. Specialist Pharmacists and reviewers have ensured that the content is evidence-based and provides practical advice.

Sarah Tinsley, Advanced Clinical Lead Pharmacist Surgical Division at University Hospitals of North Midlands and lead author says “My vision is that this will be the reference source for all perioperative medicines advice, ensuring that patients receive the same high standard of care wherever they are undergoing surgery”.

Claire Frank, Lead Pre-operative Assessment Pharmacist at  Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board and lead author says “The complexity of patient's comorbidities and medication regimes has increased over the past 10 years that I’ve been working in pre-operative assessment clinics making it imperative that patients receive appropriate perioperative medication advice to allow surgery to proceed safely and minimise post-operative complications”.

If you have any suggestions for improvements to the Handbook, please contact us at

If you are a UKCPA member and would like to be involved in updating the Handbook, please contact us at