quality improvement programmes should be applied to primary care and community care services more extensively and consistently consolidation of some content from the multiple data platforms that currently exist would facilitate transparency and public understanding of the quality of care the lack of a national system for reportingcounting adverse events is another weakness despite other innovations in promoting patient safety consideration should also be given to the creation of a more independent mechanism for assessing health system performance since this function currently sits too closely to the agencies responsible for the task of quality improvement itself