Widely regarded as champions of patient safety, it was anaesthetists who first pioneered incident reporting systems within hospital medicine. Signed in 2010, the Helsinki declaration for patient safety in anaesthesiology requires members to contribute to national reporting systems, and this podcast accompanies a paper surveying reporting systems within member countries. Professor Andy Smith from the Lancaster Patient Safety Research Unit talks to us about why incident reporting is such a vital component of patient safety, how we should be reporting anaesthesia incidents in the UK, and the future of incident reporting in the wake of the Mid-Staffordshire enquiry.