Primary care trusts (PCTs) are simply "paying lip service" to a government programme brought in to improve safety, MPs have warned.
The cross-party Public Accounts Committee attacked "a poor state of affairs" with "defective" communication between GPs, PCTs and other healthcare providers.
And it criticised GPs after finding only 4% of them regularly report incidents to the National Patient Safety Agency (NPSA).
Progress in implementing clinical governance is also not as well-established in primary as it is in secondary care, the report added.
This is down to the role of the 152 PCTs in both commissioning and providing care, and the independence of contractors delivering healthcare, particularly GPs, it said.
There is also confusion between PCTs and contractors over accountability, and greater scope for increased patient and public involvement, the study concluded.
The Conservative chairman of the committee, Edward Leigh, said: "Too many primary care organisations are paying lip service to the principles of the Department of Health's clinical governance agenda.
"The PCTs must get the message across that clinical governance systems and processes must be applied on a day-to-day basis to drive up standards of quality and safety.
"They are not just a set of principles on paper - something to be piously nodded through at management meetings and forgotten."
Public Accounts Committee
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