RT Journal Article SR Electronic T1 How safe is primary care? A systematic review JF BMJ Quality & Safety JO BMJ Qual Saf FD BMJ Publishing Group Ltd SP 544 OP 553 DO 10.1136/bmjqs-2015-004178 VO 25 IS 7 A1 Panesar, Sukhmeet Singh A1 deSilva, Debra A1 Carson-Stevens, Andrew A1 Cresswell, Kathrin M A1 Salvilla, Sarah Angostora A1 Slight, Sarah Patricia A1 Javad, Sundas A1 Netuveli, Gopalakrishnan A1 Larizgoitia, Itziar A1 Donaldson, Liam J A1 Bates, David W A1 Sheikh, Aziz YR 2016 UL http://qualitysafety.bmj.com/content/25/7/544.abstract AB Importance Improving patient safety is at the forefront of policy and practice. While considerable progress has been made in understanding the frequency, causes and consequences of error in hospitals, less is known about the safety of primary care.Objective We investigated how often patient safety incidents occur in primary care and how often these were associated with patient harm.Evidence review We searched 18 databases and contacted international experts to identify published and unpublished studies available between 1 January 1980 and 31 July 2014. Patient safety incidents of any type were eligible. Eligible studies were critically appraised using validated instruments and data were descriptively and narratively synthesised.Findings Nine systematic reviews and 100 primary studies were included. Studies reported between <1 and 24 patient safety incidents per 100 consultations. The median from population-based record review studies was 2–3 incidents for every 100 consultations/records reviewed. It was estimated that around 4% of these incidents may be associated with severe harm, defined as significantly impacting on a patient's well-being, including long-term physical or psychological issues or death (range <1% to 44% of incidents). Incidents relating to diagnosis and prescribing were most likely to result in severe harm.Conclusions and relevance Millions of people throughout the world use primary care services on any given day. This review suggests that safety incidents are relatively common, but most do not result in serious harm that reaches the patient. Diagnostic and prescribing incidents are the most likely to result in avoidable harm.Systematic review registration This systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42012002304).