The National Audit carried out research into accidents in hospitals in 1997. They reviewed accidents and safety procedures in 30 National Health Service (NHS) Trusts and found that 75% of accidents involved visitors or patients and most were caused by slips or falls. For staff, needlestick injuries and manual handling were the main culprits. They calculated that as many as 1 million people a year are injured in accidents in hospital at the total cost of £154 million. Their main recommendation was that hospital management needs to do more to reduce accidents, introducing hospital-wide strategies that are led from the top to ensure safety is given a high priority.