TY - JOUR T1 - The challenge of improving patient safety in primary care JF - British Journal of General Practice JO - Br J Gen Pract SP - 805 LP - 806 DO - 10.3399/bjgp09X472845 VL - 59 IS - 568 AU - Anneliese Dodds AU - Naomi Fulop Y1 - 2009/11/01 UR - http://bjgp.org/content/59/568/805.abstract N2 - Improving patient safety in primary care is critical for the NHS. The majority of clinical encounters occur in primary care,1,2 and the sector is becoming more exposed with earlier discharge from hospital, increasing prescriptions of potentially dangerous drugs by GPs, and an increasing fragmentation of services.3,4 Nonetheless, little research has been carried out into risk management in the primary care setting.5Although primary care may in some ways constitute a less safe environment than acute care, it has a relatively small and flat organisational structure, and a strong tradition of multidisciplinary teamwork; both of which are important factors in fostering a safer culture.4Nonetheless, some have maintained that there have historically been few effective levers for improving the quality and safety of primary care, partly due to GPs' status as self-employed contractors which has allegedly inhibited coordination and effective intervention.6 For some this was borne out by the relative lack of impact of the first Quality and Outcomes Framework (QOF) on the improvement of quality, … ER -