1 Introduction
1.1 Scope Health care systems are complex and include multiple stakeholders and providers. People using health care services have an essential role as co-producers of their health and indeed they represent the only consistent factor throughout the care pathway. They also hold key information vital for process, systems and policy improvement. Tapping into such a rich resource could contribute significantly to improving safety in primary care. This monograph examines why it is important to involve people using services in improving safety and how this might best be done. The term “patient engagement” is used throughout this document and refers to the process of building the capacity of patients, families, carers, as well as health care providers, to facilitate and support the active involvement of patients in their own care, in order to enhance safety, quality and people-centredness of health care service delivery. There are many definitions of patient engagement, but all share an underlying theme: the facilitation and strengthening of the role of those using services as coproducers of health, and health care policy and practice (1). 1.2 Approach To compile information for this monograph, the team searched for systematic reviews in PubMed, the Cochrane Library and specific websites and databases. Feedback from experts was obtained and further references were identified through the peer review process. Information was drawn from 39 reviews about patient engagement in safety, although most were not specific to primary care settings. The original studies included in each of these reviews were read to ensure a focus on primary care. For brevity, not all citations are listed. International experts in delivering safe primary care provided feedback, shared examples of strategies that have worked well around the world, and gave practical suggestions about potential priorities for the World Health Organization (WHO) Member States to improve the safety of primary care services.