Summary This thesis is about improving care for people at the end of their lives who reside in the primary care setting. Palliative care is care for people with a life-threatening illness, focused on symptom alleviation and quality of life rather than on cure or life prolongation. The aim of this thesis is to investigate areas of improvement in primary palliative care and the role that the PaTz method can play in these improvements. PaTz is an initiative to improve palliative care in the primary care setting. The first part of this thesis addresses the potential areas of improvement, and the potential role of PaTz in the improvements is described in Part 2. In the general discussion, after summarizing the findings of the previous chapters and discussing some of the strengths and weakness of the studies, some overarching themes are described. These themes are: (i) the cooperation between healthcare providers in primary palliative care; (ii) the importance of timely identification of patients with palliative care needs; (iii) whether the development of PaTz-groups should focus on quality or quantity; (iv) the role of PaTz in Dutch policy on palliative care; and (v) the evidence for the value of PaTz. Finally, some recommendations for practice, policy and research are discussed.