Chief medical officer Sir Liam Donaldson is pushing primary care trusts to put his crusade on patient safety at the centre of their work (for more details, click here).

The acute sector is used to being the focus of attention from the government, the Healthcare Commission and occasionally the media; now, a year on from Sir Liam's report Safety First, the spotlight is beginning to swing towards PCTs.

Both sectors are still under-reporting safety breaches, but there is anecdotal evidence that primary care is the worse offender.

Although incidents are generally less serious than in hospitals, the responsibility for reporting is the same.

Key to improving reporting rates is promulgating the message to frontline staff that, apart from extreme cases, the service is operating a blame-free culture.

And, as always, the government is looking to boards and senior managers to champion the change - the group that failed so catastrophically to take the lead at Maidstone and Tunbridge Wells trust.