Enhancing public safety in primary care

Improving the safety record of the NHS is a national priority. This is not surprising, as recent research shows that up to 850 000 adverse events occur in hospitals every year. 1 Up to 90 000 iatrogenic deaths may occur each year in hospitals in the United States, 2 and the picture is likely to be similar in the United Kingdom. The landmark report To Err is Human has led to substantial investment in the US Agency for Health Research and Quality's safety unit. 2 This was closely followed in the United Kingdom by the Department of Health reports An Organisation with a Memory and Building a Safer NHS, heralding the introduction of the National Patient Safety Agency. 3 4 Our understanding of the causes of iatrogenic adverse events in secondary care has increased substantially over the past decade, but the same cannot be claimed of primary care.