Chapter 9: Safety Management Systems (SMS)
This chapter provides additional details and guidance for service providers implementing Safety Management Systems (SMS) framework in accordance with Annex 19. It also provides guidance for States while overseeing their service providers’ SMS implementation. The purpose of an SMS is to provide service providers with a systematic approach to managing safety. It is designed to continuously improve service provider safety performance by enabling them to identifying hazards, collecting and analysing data and continuously assessing safety risks. The SMS seeks to proactively mitigate safety risks before they result in aviation accidents and incidents.
This chapter covers 9.1-9.6 of 4th edition of the SMM.
9.1 Introduction
This section provides details and guidance to service providers implementing Safety Management Systems and guidance for States while overseeing their service providers’ SMS implementation. This section explains how SMS should be tailored to an organization and its activities in its safety policy and objectives, its safety risk management, its safety assurance, and its safety promotion.
1. Ten Things you should know about SMS
This is a helpful example as safety promotion material as an overview of SMS. This tri-fold brochure briefly defines SMS, describes its focus and key processes, identifies key SMS roles and responsibilities, and articulates organizational qualities and benefits of an effective SMS. It also describes how SMS differs from a flight safety program.
Click to download:
Ten Things you should know about SMS.pdf
Source: Safety Management International Collaboration Group (SM ICG)
9.2 SMS framework
A19 specifies SMS framework for the implementation and maintenance of an SMS. Regardless of the service provider’s size and complexity, all elements of the SMS framework apply. The ICAO SMS framework is made up of the following four components and twelve elements:
COMPONENT | ELEMENT |
| 1.1 Management commitment |
| 1.2 Safety accountability and responsibilities | |
| 1.3 Appointment of key safety personnel | |
| 1.4 Coordination of emergency response planning | |
| 1.5 SMS documentation | |
| 2. Safety risk management | 2.1 Hazard identification |
| 2.2 Safety risk assessment and mitigation | |
| 3. Safety assurance | 3.1 Safety performance monitoring and measurement |
| 3.2 The management of change | |
| 3.3 Continuous improvement of the SMS | |
| 4. Safety promotion | 4.1 Training and education |
| 4.2 Safety communication |
1. Determining the Value of SMS
This document is for safety professionals who understand that the investment in safety interventions and Safety Management Programs are necessary to ensure safe operations. Safety professionals and their economic partners know the human and financial impact of a serious event or accident. Prevention of such loss is the return on the safety investment. However, return on investment is also impacted by operational savings like adherence to schedules, satisfied customers, healthier workplaces and employees, less engineering rework, and increased cooperation with authorities, to name a few examples. This document clarifies the steps needed for the safety professional to calculate return on investment. The math is simple; however, the complexity lies in balancing your costs with the value of events that did not happen—the intangible high value of safe operations. The document helps all parties better appreciate and calculate both the cost and the value of safety.
Click link to download:
Determining the Value of SMS.pdf
Source: Safety Management International Collaboration Group (SM ICG)
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2. US Part 5 - Safety Management System SMS for 121 Operators
US FAA Part 5 contains the regulatory requirement for Part 121 operators to have a Safety Management System.
Click link to download:
Source: US Federal Aviation Administration (FAA)
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3. Guidance on Safety Management Systems
This document provides guidance on some of the ways SMS can be implemented in large, complex organizations.
Source: Transport Canada Civil Aviation
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4. Implementing a SMS in Design, Manufacturing and Maintenance organisations
This document provides detailed guidance to implement SMS requirements and guidelines for interfaces management, including the sharing of safety-related information between organizations with SMS obligations, such as: design, manufacturing, maintenance but also continuing airworthiness management, relevant aviation authorities, training organizations and operators.
Click link to download:
Implementing a SMS in Design, Manufacturing and Maintenance Organisations 2018.pdf
Implementing a SMS in Design, Manufacturing and Maintenance Organisations 2022.pdf
Source: Aerospace and Defense Industries Association of Europe (ASD), Aerospace Industries Association of America (AIA), Aerospace Industries Association of Brazil (AIA-B), Aerospace Industries Association of Canada (AIA-C) and the General Aviation Manufacturers Association (GAMA)
Please check example 5. Implementing a Safety Management System in Design, Manufacturing and Maintenance Organisations under section 8.4 Component 2: State safety risk management(opens in a new tab) (SMM 8.4)
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5. Safety Management Manual for Small Organizations
Example of a Safety Management Manual for Small Service Providers that has been in use since 2011.
Click link to download:
Safety Management Manual Example.pdf
Source: Dominican Institute of Civil Aviation
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6. Book 1 Safety Management System Basics
This is the 1st of 8 booklets making up a resource kit that contains advisory material for aviation operators and organisations. It provides guidance on, or best practice examples of, various safety management system (SMS) elements to consider when implementing or updating an SMS.
Click link to download:
SMS 1 Safety Management System Basics.pdf
Source: Civil Aviation Safety Authority (CASA), Australia
9.3 Component 1: Safety policy and objectives
This component focuses on how each service provider creates the right environment for an effective safety management. This includes the safety policy and objectives that sets out senior management’s commitment regarding safety, what it aims to achieve in relation to safety and the organisational structure to support that commitment.
Management commitment and safety leadership is key to the implementation of an effective SMS. Management commitment is declared through the safety policy and by establishing safety objectives and these will promote the desired safety culture.
Management decision-making and allocation of resources demonstrates the management commitment to safety. Management decisions and actions should always be consistent with the safety policy to cultivate a positive safety culture.
Senior management should develop and endorse the safety policy, which is signed by the accountable executive. In developing the safety policy, senior management should consult with the key safety personnel, and where appropriate, staff representative bodies (employee forums, trade unions, for example). Consultation will ensure that the safety policy and stated objectives are relevant to all staff. It will generate a sense of shared responsibility for the safety culture in the organization.
1. Safety Manager Job Description
The appointment of a competent person or persons fulfilling the role of safety manager is key to the effective implementation and functioning of the SMS. The safety manager may be identified by different titles, but for the purposes of this manual the generic term safety manager is used and is intended to refer to the function, not necessarily to an individual. From an accountability perspective, the person carrying out the safety manager function is responsible to the accountable executive for the performance of the SMS and for the delivery of safety services to the other departments in the organization.
This example provides guidance on the key roles, responsibilities, qualifications, nature and scope of safety managers.
Click to download:
Sample Job Description for a Safety Manager.docx
Source: SMM 3rd ed. 5-App 2-1.
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2. Development of an SMS manual
The SMS documentation should include a top-level “SMS manual”, which describes the organization’s SMS policies, processes and procedures. Such a document facilitates the organization’s internal administration, communication and maintenance of the SMS to help personnel understand how the SMS works and how the safety policy and objectives will be met. The documentation should include a system description that provides the boundaries of the SMS and helps to distinguish between policy, processes, procedures and requirements while defining how they are all linked to the safety policy and objectives.
This example provides guidance on the development of an SMS manual.
Click to download:
Guidance on the Development of an SMS Manual.docx
Source: SMM 3rd ed. 5-App4-1. Updated to reflect Annex 19, Amendment 1.
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3. Emergency Response Plan
SMS framework in the Annex 19 amendment 1 includes an element related to the coordination of emergency response plan, it applies only to those service providers required to establish and maintain an emergency response plan. Annex 19 does not establish a Standard and Recommended Practice (SARP) that specifies the creation or development of emergency response plan, this example is provided to assist those service providers in the development of an ERP. The purpose of an emergency response plan (ERP) is to provides a systematic approach to managing the service provider’s activities in the aftermath of a significant unplanned event or during an on-going emergency situation.
This example provides guidance on the purpose and content of an ERP as well as suggestions for checklists, training and exercises.
Click to download:
Source: SMM 3rd ed. 5-App 3-1. Updated to reflect Annex 19, Amendment 1.
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4. Airport Safety Policy
This example is a signed copy of the Safety Policy currently in used at Incheon Airport. This safety Policy is clear and easy to understand for airport staff.
Click to download:
Incheon Airport Safety Policy.pdf
Source: Republic of South Korea
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5. The Senior Manager's Role in SMS
This is a helpful example of safety promotion material targeted at senior managers offering an overview of SMS. This document provides practical guidance to help senior managers understand leadership, accountabilities, and legal responsibilities with respect to SMS.
Click to download:
The Senior Manager's Role in SMS.pdf
Source: Safety Management International Collaboration Group (SM ICG)
Aligned with Annex 19, edition 1
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6. Safety policy for ATS provider in EU Member State
The document describes the Maltese ATS safety policy with associated safety objectives.
Click link to download:
MATS Integrated Management System Policy Safety Sub-Document.pdf
Source: EUROCONTROL and Malta ATS
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7. Operator Safety Policy and promotion poster
This is an example of how a safety policy can be promoted by focusing on some of the key principles of the safety policy rather than the full details of the policy that might not get read. The full safety policy is also included and is signed by both the accountable manager and the CEO.
Click to download:
Flybe Group plc Safety Policy.pdf
Flybe Group Safety principles.docx
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8. Safety Policy of Air Navigation Service Provider
This is an example of Air Navigation Service Provider Safety Policy that is commonly used by ANSP in Brazil and reflect the commitment of the accountable executive with the Safety.
Click link to download:
Source: INFRAERO
Please check example 19. SMS for Aviation-A Practical Guide: Book 2 - Safety Policy and Objectives under section 8.3 Component 1: State safety policy, objectives and resources(opens in a new tab) (SMM 8.3.8)
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9. Ground Handling Regulation
This regulation establishes the minimum safety standards that must be met by any legal entity that intends to provide or currently provides Ground Handling Services operated on the apron of a national airport, as implemented by the Dominican Republic.
Click link to download:
Source: Instituto Dominicano de Aviación Civil (IDAC)
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10. Aviation Safety Management System Digital Website
The team at 3 Mile has created a complete Safety Management System Manual in an online format compliant to ICAO Annex 19 2nd edition. It is published as a FREE access website at https://sms.3mile.co.uk. SMS Manuals (commonly seen in a single document) are generally not very accessible to employees. This online resource demonstrates effective practices in how to communicate to your organisation on SMS matters – it is really simple. Using extensive experience in SMS implementation, the site shares best practice SMS material that you can use in your own organisation. This includes the foundation elements of Safety Policy, Just Culture Policy, detailed Safety Objectives and the Organisational Safety Arrangements including safety accountabilities. You can also access process maps and supporting templates and examples for all SMS processes. Detailed Role descriptions and Terms of Reference for safety committees are presented as well for further reference, with additional material about industry most effective practices.
Clink link to access:
Source: 3 Mile
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11. Copenhagen Airport Safety Accountability Document
Safety Accountability Document
Click link to download:
Copenhagen Airport, Safety Accountability Document.docx
Source: Airport Council International - ACI World
9.4 Component 2: Safety risk management
Service providers should ensure that they are managing their safety risks. This process is known as safety risk management (SRM). SRM includes hazard identification, safety risk assessment and safety risk mitigation.
The SRM process systematically identifies hazards that exist within the context of the delivery of its products or services. Hazards may be the result of systems that are deficient in their design, technical function, human interface or interactions with other processes and systems. They may also result from a failure of existing processes or systems to adapt to changes in the service provider’s operating environment. Careful analysis of these factors can often identify potential hazards at any point in the operation or activity lifecycle.
1. Risk Matrix Example
This is an example of a safety risk matrix used by Incheon airport that includes severity expressed in terms of human loss(casualties), Hardware loss (cost in $) and operational loss (airport closure for example). Stakeholders visualize better when they can see what it will cost them. Using the cost approach has improved the safety culture, ground handlers for example are more careful on the airside. This example also applies to 2.5.
Click to download:
Source: Airports Council International
Aligned with Annex 19, edition 1.
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2. Aviation Safety Risk Assessment
This is an example of a template that can be used for the management of change. All changes must be risk assessed at CPH through the process described in the document.
Click to download:
Aviation Safety Risk Assessment.pdf
Source: Copenhagen Airport
Aligned with Annex 19, edition 1.
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3. Safety Risk Matrix - Aerodrome Example
Risk assessment matrix used by CPH.
Click link to download:
Source: Airport Council International (ACI)
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4. Hazard Library - Aerodrome Example
Hazard Library – Provides a clear picture to the Management on the identified Hazards and actions initiated.
Click link to download:
BIA Hazard Library.pdf
Source: Airport Council International (ACI)
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5. Common Safety Method on Risk Evaluation and Assessment for ANSPs
This guidance sets out the CANSO Standard for a common safety method on risk evaluation and assessment for ANSPs. It applies to all ATM/ANSP ground based functional changes1, whether people, procedures or equipment and includes changes to the interactions between these elements.
Click link to download:
Source: Airport Council International (ACI)
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6. Lithium Batteries in Cargo Aircraft Bowtie Analysis
The bow tie was developed for the carriage of lithium batteries onboard cargo aircraft (e.g. freighters). The model effectively depicts risk providing an opportunity to identify and assess the key safety barriers either in place or lacking between a safety event and an unsafe outcome. The left side of the model shows the preventative measures which should eliminate the threat entirely or prevent it from causing the top event recovery. The right side shows measures to reduce the likelihood of the consequence owing to the top event being "live" or mitigate the severity of the consequence. The model seeks to be comprehensive, so the elements on either side may not be presented within a specific operation. Further, the operator needs to evaluate the strength of each element based on their own knowledge and experience of their operation and the external factors affecting it.
Note: This example complements the Guidance for Safe Operations Involving Aeroplane Cargo Compartments (Doc 10102)
Click to download:
Bowtie Analysis - Lithium Batteries in Cargo Aircraft.png
Source: UK Civil Aviation Authority
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7. Dynamic Risk Assessment Tool
Safety Risk assessment with extensive operational domains in the Airline has been a challenging issue. The proposed model, as a decision-making aid, gives a tool to top-level as well as expert level management to monitor safety statues more precisely.
This model develops a Dynamic Safety Risk Assessment Modeling - three dimensional exponential (nonlinear formula) for calculation of risk index instead of the two dimensional linear formula which enables the definition of the safety indicators at the low, medium and top-levels management of a grand organizations. By this model, they are able to monitor safety level within their departments or organization, set quantitative safety goals and provide feedback for improvement.
In the proposed model two-dimensional classic risk formula was replaced with three-dimensional (nonlinear formula) exponential ones, considering “the impact on the business” as a source of safety risk and hazard. “The impact on business” covers all of the consequences that have originated from safety reports, but have no direct loss, damage, injury or fatality and instead latent or hidden impacts on the reputation of the company.
This method employs a Fuzzy ANP (Analytical Network Process) to help quantify judgments, make qualitative judgments, and weigh the priority of elements contributing to safety risk from the management viewpoint.
Safety risk indexes assessment results are demonstrated as figures in guidance (as attachment No.01) by numerical example usage as sample numbers. Also, Computational formulas are modeled (as the attachment No.02).
Naimeh Borjalilu
Ph.D candidate of industrial engineering (Tehran university)
IranAir Co. Senior Manager, Flightsafety
Click link to download:
Dynamic Risk Assessment Modelling paper.pdf
Source: Iran Delegation
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Please check example 8. TCCA - Civil Aviation Daily Occurrence Reporting System (CADORS) Manual under section 5.2 Safety data and safety information collection as an example of Hazard identification (SMM 9.4.4).
Please check example 10. Voluntary Safety Report - Brussels Airport under section 5.2 Safety data and safety information collection as an example of Hazard identification (SMM 9.4.4).
Please check example 12. Voluntary Disclosure Reporting Program (VDRP) under section 5.2 Safety data and safety information collection (SMM 9.4.4).
Please check example 13. FAA Hotline under section 5.2 Safety data and safety information collection(opens in a new tab) (SMM 9.4.4).
Please check example 14. Service Difficulty Reporting System (SDRS) under section 5.2 Safety data and safety information collection (SMM 9.4.4).
Please check example 15. The Mandatory Occurrence Reporting Scheme – Information and Guidance under section 5.2 Safety data and safety information collection (SMM 9.4.4).
Please check example 16. Aviation Safety Reporting under section 5.2 Safety data and safety information collection.
Please check example 17. DGAC Online Safety Reporting Portal under section 5.2 Safety data and safety information collection.
9.5 Component 3: Safety assurance
Safety assurance consists of processes and activities to determine whether the SMS is operating according to expectations and requirements, which involves continuously monitoring its processes as well as its operating environment to detect changes or deviations that may introduce safety risks or the degradation of existing safety risk controls.
1. Safety Performance Measurement and Monitoring - Aerodrome Example
Clearly define the Safety Performance Metrics of each Airside operational function.
Click link to download:
Safety Performance Measurement & Monitoring.pdf
Source: Airport Council International (ACI)
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2. Safety Benchmark Group - Terms of Reference Aerodrome Example
The example is actual ToR for the arrangement between a group of Europeans airports which briefly describes how they organize themselves to share data and what SPIs they benchmark. All SPIs are tracked per 10,000 operations.
Click link to download:
ToR Safety Benchmark Group.docx
Source: Airport Council International
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3. Safety objectives, indicators and targets - Example Brazilian air operator
This presentation was inspired by the translation of strategic objectives in goals and performance indicators of the Brazilian airline Passaredo Transportes Aéreos, but the data was modified to preserve the privacy of the company.
Click link to download:
Safety objectives and indicators.pdf
Source: National Civil Aviation Agency - Brazil (ANAC)
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4. Measuring Safety Performance - Guidelines for Service Providers
The objective of this paper is to provide guidelines for the definition and implementation of a set of safety performance indicators as part of your safety management system.
This document proposes an approach to safety performance measurement aiming at increasing your company’s potential for effective safety management that considers systemic and operational issues. Effective safety performance measurement will be decisive in driving your safety management system towards excellence.
Click link to download:
Guidelines for Service Providers.pdf
Source: Safety Management International Collaboration Group (SM ICG)
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5. Solenta Aviation Safety Newsletter
Example of an air operator Safety Promotion Newsletter, including COVID measures.
Click link to download:
Safe Attitude Safety Newsletter.pdf
Source: South Africa CAA on behalf of Solenta Aviation
9.6 Component 4: Safety promotion
Safety promotion encourages a positive safety culture and helps the service provider to achieve its safety objectives through a combination of technical competence, education and training, effective communications and information sharing, as well as ensuring safety management promotes safety culture throughout the organization.
1. Five to Focus
This poster is a safety promotion example with a focus on Occupational Health, Safety & Environment (OHSE) and provides safety messages and information signs at airside entrances. The visibility and reminder factor makes it a strong awareness product. There are no challenges nor limitations to implement and get reference for operators of certified aerodromes.
Click to download:
Source: Belgian CAA
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2. Governance principles of multiple management systems
Rationale and needs for governance principles of management systems for ANSP. It begins with a discussion of governance and the issues identified with the implementation of multiple management systems. It then continues to discuss the objectives of the governance principles.
Click link to download:
Rationale for Governance Principles.pdf
Source: EUROCONTROL
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3. SMS Guidance Manual
Very well put together example of what operators should consider when implementing an organizational SMS.
Click to download:
IBAC Montreal - SMS Guidance Manual.pdf
Source: IBAC Montreal
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4. SMS Tools Booklet 2015
A very good document illustrating the concepts of SMS and providing tools to use in implementing the SMS.
Click link to download:
SMS Tools for Business Aircraft Operators.pdf
Source: IBAC Montreal
Please check example 6. SMS for Aviation-A Practical= Guide: Book 5 - Safety Promotion under section 6 Component 4: State safety promotion.
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5. SMS Factsheet
SMS Factsheet for Design, Manufacturing, and Production Organizations compiled by the SMICG.
Click link to download:
Source: Safety Management, International Collaboration Group (SM ICG)
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6. Copenhagen Airport - Internal Safety Promotion Initiatives
Relatable examples of practical safety management implementation.
Click link to download:
Copenhagen Airport example of internal Safety Promotion Initiative.pdf
Source: Airport Council International - ACI World
9.7 Implementation planning
SMS implementation planning begins with a comprehensive system description to define the scope of the SMS as well as the internal and external interfaces of the organization. The service provider should carry out an analysis of its activities to determine the right level of resources to manage the SMS. This should include the determination of the organisational structure needed to manage the SMS. This would include considerations of who will be responsible for managing and maintaining the SMS, what safety committees are needed, if any, and the need for specific safety specialists.
The service provider should carry out an analysis of its activities to determine the right level of resources to manage the SMS. This should include the determination of the organisational structure needed to manage the SMS. This would include considerations of who will be responsible for managing and maintaining the SMS, what safety committees are needed, if any, and the need for specific safety specialists. Service providers may want to consider whether it is beneficial to integrate the SMS with an existing management system.
1. SMS for Small Organizations
Supporting the implementation of Safety Management Systems (SMS) in accordance with size and complexity is of high importance to small organizations, some small organizations may feel that SMS are too complex or too costly to implement. This material provides guidance and tools for implementing and evaluating SMS in smaller organizations which operate or provide services in civil aviation. The guidance material aims to show that implementing an SMS is probably much simpler one might think. Many small organizations already have several elements of an SMS in place.
Click to download:
SMS for Small Organizations.pdf
Source: Safety Management International Collaboration Group (SM ICG)
Aligned with Annex 19, edition 1.
Please check example 2. SMS for Small Organizations Organisations under section 1.3 Implementing safety management (SMM 1.3)
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2. SMS Gap analysis and implementation plan
In order to develop an SMS implementation plan, the service provider should first carry out a gap analysis. This compares the service provider’s existing safety management processes and procedures with the SMS requirements as determined by the State. The gap analysis identifies the gaps that should be addressed through an SMS implementation plan that defines the actions needed to implement an effective SMS.
The SMS implementation plan should provide a clear picture of the resources, tasks and processes required to implement the SMS. The timing and sequencing of the implementation plan may depend on a variety of factors that will be specific to each organization. This example relates to SMS Gap analysis and implementation plan.
Click to download:
SMS Gap analysis and implementation plan.docx
SMS Implementation Project.pdf
Source: SMM 3rd ed. 5-App7-1. Updated to reflect Amendment 1 to Annex 19.
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3. How to implement an SMS
The video explains how to plan, apply and implant a safety management system in aviation.
Click to view
Source: UK Civil Aviation Authority
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4. Safety Management Manual Example - Small Organizations
Example of safety management manual for service providers.
Click to download:
Safety Management Manual Example.pdf
Source: Dominican Civil Aviation Institute (IDAC)
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5. Integral Safety Management System (ISMS) at Schiphol Airport
This document provides an overview of the reasons to start with ISMS, experiences from before adopting an Integral SMS and after implementing an ISMS. It also describes future activities and the governance of ISMS, highlighting the coordination of interfaces between different organizations.
Click link to download:
Source: Royal Schiphol Group
Management of Change
Our aviation industry is often faced with rapid and continuous changes in air traffic. This video visualizes the process and activities for the Management of Change. It also explains its relationships to the Global Aviation Safety Plan and the Global Air Navigation Plan.
