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This systematic study of the most common and most serious safety incidents in primary care has identified major contributory themes and made recommendations for future research and development.

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Andrew Carson-Stevens, Peter Hibbert, Huw Williams, Huw Prosser Evans, Alison Cooper, Philippa Rees, Anita Deakin, Emma Shiels, Russell Gibson, Amy Butlin, Ben Carter, Donna Luff, Gareth Parry, Meredith Makeham, Paul McEnhill, Hope Olivia Ward, Raymond Samuriwo, Anthony Avery, Antony Chuter, Liam Donaldson, Sharon Mayor, Sukhmeet Panesar, Aziz Sheikh, Fiona Wood & Adrian Edwards.

Andrew Carson-Stevens 1,2,3,*, Peter Hibbert 4, Huw Williams 1, Huw Prosser Evans 1, Alison Cooper 1, Philippa Rees 1, Anita Deakin 5, Emma Shiels 1, Russell Gibson 1, Amy Butlin 1, Ben Carter 6, Donna Luff 7, Gareth Parry 7,8, Meredith Makeham 4, Paul McEnhill 1, Hope Olivia Ward 1, Raymond Samuriwo 1,9, Anthony Avery 10, Antony Chuter 11, Liam Donaldson 12, Sharon Mayor 13, Sukhmeet Panesar 14, Aziz Sheikh 7,15, Fiona Wood 1, Adrian Edwards 1,2

1 Primary Care Patient Safety (PISA) Research Group, Division of Population Medicine, Cardiff University, Cardiff, UK
2 Wales Primary and Emergency Care (PRIME) Research Centre, Cardiff University, Cardiff, UK
3 Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
4 Australian Institute for Health Innovation (AIHI), Macquarie University, Sydney, NSW, Australia
5 Australian Patient Safety Foundation, University of South Australia, Adelaide, SA, Australia
6 Centre for Medical Education, Cardiff University, Cardiff, UK
7 Harvard Medical School, Harvard University, Boston, MA, USA
8 Institute for Healthcare Improvement (IHI), Cambridge, MA, USA
9 School of Healthcare Sciences, Cardiff University, Cardiff, UK
10 Division of Primary Care, University of Nottingham, Nottingham, UK
11 Independent patient, ,
12 Department of Surgery and Cancer, Imperial College London, London, UK
13 Division of Population Medicine, Cardiff University, Cardiff, UK
14 Department of Medicine, Baylor College of Medicine, Houston, TX, USA
15 Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
* Corresponding author Email:

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