The Helsinki Declaration on Patient Safety in Anaesthesiology 2.0

An update to raise the standards of safer patient care in today’s anaesthesiology 

16 years ago, when Patient Safety was still an emerging field, the European Board of Anaesthesiology (EBA) of the European Union of Medical Specialists (UEMS) created a declaration highlighting a consensus on how anaesthesiology could take steps to improve the safety of patients on the perioperative pathway of care. 

The first draft was created in November 2009 at the EBA meeting in London. EBA, ESAIC (then known as the European Society of Anaesthesiology (ESA)) and delegates from all over Europe representing national societies contributed. It was officially launched at the Euroanaesthesia Congress in Helsinki in June 2010.  

The Helsinki Declaration on Patient Safety in Anaesthesiology was signed by the Presidents of the EBA, Jannicke Mellin-Olsen, the ESAIC, Paolo Pelosi, the National Anaesthesia Societies Committee (NASC), Hugo Van Aken and many other bodies including patient representatives and industry, all declaring its aims for improving Patient Safety at a European level. This timely declaration quickly caught the imagination of anaesthesiologists not only across Europe, but in Africa, South America, Asia and the Middle East who signed it and translated it, making an enormous impact on anaesthesiology globally. It highlighted key areas of risk and proposed safer standards of care, supporting patients and healthcare professionals all over the world.  

Now in 2025, an updated version will be launched. The EBA, along with delegates from the ESAIC Patient Safety and Quality Committee, have worked to update the declaration to include recommendations that reflect how anaesthesiology has evolved. The original document is still highly relevant, and this speaks volumes for the clarity and vision of the original authors. It represents a shared European opinion of what are agreed to be the current issues and makes practical suggestions to improve patient safety in anaesthesiology in 2025 and beyond. The declaration endorses the World Health Organization-World Federation of Societies of Anesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia, the WHO Global Patient Safety Action Plan 2021-2030 and the WHO Patient Safety Rights Charter. 

It also includes key recommendations that have a direct impact on the quality and safety of patient care and that are highly relevant to emerging developments in healthcare. 

Patient Involvement: Patients and families should be educated about their role in safe care and be encouraged to provide feedback. 

Transparency: If harm occurs, a compassionate explanation and steps to reduce injury should follow, along with independent investigations where appropriate. 

Staffing: Healthcare funders must ensure safe perioperative anaesthesia care through adequate staffing and resources. 

Education & Training: Ongoing patient safety education, including simulation training, must be supported with dedicated time and resources. 

Human Factors: Recognizing and addressing human factors is vital for safe care, requiring collaboration across clinical and non-clinical teams. 

Industry Partnerships: Strong relationships with industry are essential for safe medication and equipment supply. 

Technology & AI: New technologies must be thoroughly evaluated, with patient safety as the top priority. 

Research: High-standard academic research into patient safety is crucial. 

Independent Investigations: Every country should have bodies to investigate patient safety incidents independently and transparently, without assigning blame. 

Criminalisation of errors: Medical errors should not be criminalised; they are key opportunities for learning. 

Speaking Up: Staff should be supported to voice safety concerns, and leadership must respond constructively within a just culture. 

Fatigue Management: Hospitals must have and monitor policies to manage staff fatigue, as it impacts care quality. 

Staff Wellbeing: Promoting staff wellbeing is essential for a strong safety culture and workforce retention. 

Environmental Sustainability: Should be pursued, but never at the expense of patient safety. 

Legal/Ethical Safeguards: No regulation should compromise patient safety protections. 

Anaesthesiologists have been leaders in Patient Safety for decades. As the declaration states: “Anaesthesiology shares responsibility for quality and safety in Anaesthesia, Intensive Care, Critical Emergency Medicine and Pain Medicine, including the whole perioperative process, and also in many other situations inside and outside the hospital, where patients are at their most vulnerable.” This declaration represents the highest ethos of care and quality of practice and sets the tone for all other specialities to follow.  

The new updates will increase the relevance of this important declaration. ESAIC supports and promotes the Helsinki Declaration on Patient Safety in Anaesthesiology, and although the declaration’s words are important, the most critical thing for improving patient safety is their implementation both locally and nationally, with our colleagues and teams in clinical areas. It is an inclusive document, and everyone is encouraged to take action to help deliver its aims. You can find more information here. (https://esaic.org/patient-safety/helsinki-declaration-on-patient-safety-in-anaesthesiology/) Anyone can sign the declaration, either on behalf of an organisation or simply as an individual signee.  

The Helsinki Declaration on Patient Safety in Anaesthesiology 2.0 was signed at the opening ceremony of Euroanaesthesia 2025.