This study aimed to explore the accident prevention activities of primary care organizations (PCOs) and the views of their board members regarding accident prevention. Qualitative study using semi-structured telephone interviews of 17 board members of PCOs (primary care groups and primary care trusts) in the National Health Service (NHS) Trent Region was undertaken. Accident prevention activity varied substantially between PCOs. The reduction of home hazards was a frequent focus of the PCOs’ accident prevention initiatives. Board members did not see accident prevention as their biggest priority in health improvement, although they had positive attitudes towards it. Local morbidity and NHS guidance were seen to be key determinants of PCOs’ priorities in health promotion. There was little reference to any strategic planning for accident prevention. Information to support accident prevention could be more timely and relevant to PCOs’ needs. The degree of involvement with outside agencies in accident prevention work varied substantially. Collaboration between agencies may be held back by mutual lack of knowledge and differences in culture and priorities. It was concluded that accident prevention appears to be receiving less attention in PCOs than other national health priorities. They may need more support for developing strategies for accident prevention and better provision of information so that they can identify local problems which can be addressed by preventative activities. The accident prevention plans contained in health improvement programmes should be monitored.