Pre-operative anaemia may significantly affect patient outcomes. Anaemic patients are at increased risk of transfusion, mortality and major morbidity, in proportion to the severity of anaemia. There are three distinct reasons to consider the identification and management of pre-operative anaemia as important:

• Anaemia detected during surgical work-up may be secondary to previously undiagnosed disease, e.g. malignancy.

• To reduce the likelihood of having to resort to transfusion, thus limiting demand on donors and conserving blood supplies for      those patients who need it most.

• To avoid unnecessarily exposing surgical patients to potential adverse effects of anaemia, transfusion or both.

Declaration of Interests

The BSH paid the expenses incurred during the writing of this guidance. None of the authors had conflicts of interest to declare. All authors have made a declaration of interests to the BSH and Task Force Chairs which may be viewed on request.