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This guideline covers routine preoperative tests for people aged over 16 who are having elective surgery. It aims to reduce unnecessary testing by advising which tests to offer people before minor, intermediate and major or complex surgery, taking into account specific comorbidities (cardiovascular, renal and respiratory conditions and diabetes and obesity). It does not cover pregnant women or people having cardiothoracic procedures or neurosurgery. When offering tests before surgery, give people information in line with recommendations on consent and capacity made in the NICE guideline on patient experience in adult NHS services. Take into account any medicines people are taking when considering whether to offer any preoperative test. Do not routinely offer testing for sickle cell disease or sickle cell trait before surgery. Do not routinely offer HbA1c testing before surgery to people without diagnosed diabetes. Offer HbA1c testing to people with diabetes having surgery if they have not been tested in the last 3 months. Do not routinely offer resting echocardiography before surgery.