One of the challenges with producing a document such as GPICS can be the lack of a hard evidence base for some of the standards and recommendations that may be, by necessity, based on professional opinion and established practice. It is therefore essential that standards and recommendations are subject to regular review and revision, as new evidence becomes available and practice changes. In undertaking this significant review and revision to GPICS, the FICM and ICS consulted widely, both with the key stakeholder organisations and through an open public survey. One of the criticisms of the first edition was the underrepresentation of authors from smaller units and the devolved nations; we have addressed this in the second edition, recognising that the majority of critical care is not delivered in large tertiary centres.