The ability to rescue a patient suffering complications after major abdominal surgery is influenced by what happens before, during and after surgery. Before: Some patients are fit enough for surgery but not for a complication. All patients undergoing major surgery should have a frailty and risk assessment. Comorbidities should be optimised and prehabilitation, if needed, provided. Goals of care incorporating patient preferences, values and expectations should be documented and be part of shared decision making. During: SipTilSend; Team briefing, preoperative review of results, careful dissection, willingness to obtain a second opinion when there are unexpected findings, having a second surgeon present for complex procedures, and clear postoperative instructions around anticoagulation. After: Provide the right level of early postoperative monitoring in ICU/HDU or ECU/ARRC. Recognise and respond to deterioration promptly. Don't delay URTT (HAC4) if indicated. Prompt recognition & management of complications will reduce failure to rescue rates. FTR rates are a better indication of quality than URTT. Reflect, (Peer) Review, Report on outcomes. Learn from complications that occur. Share your learning.