There are many challenges in providing safe palliative care out-of-hours A recent study published in the journal Palliative Care analysed incident reports, describing the nature of the issues as to what happened, the underlying causes, harm created, and severity of the incident. 1072 patient safety incident reports involving patients receiving sub-optimal palliative care via the out-of-hours primary-care services were assessed. Medications (n = 613) were the most commonly implicated issue, followed by access to timely care, information transfer (n = 102), and/or non-medication-related treatment such as pressure ulcer relief or catheter care (n = 102). Almost two-thirds of reports (n = 695) were associated with harm such as increased pain, and emotional, and psychological distress. Commonly identified contributory factors to these incidents were a failure to follow protocol (n = 282), lack of skills/confidence of staff (n = 156), and patients requiring medication delivered via a syringe driver (n = 80).