- This report presents the findings from a two-year research project comprising six case studies of how primary care groups and trusts (primary care organisations, PCOs) are carrying out their health improvement role. It analyses: the approach taken by the six sites to health improvement, and the development of relevant strategies and processes; and the context, national, local and internal in which PCOs are working. The authors report on their findings from the data collected. Most respondents had a complex understanding of the phrase 'health improvement'. Their health improvement objectives and reported activity are categorised and listed, as are the factors reported to have influenced progress towards health improvement objectives. The authors give the messages for PCOs that have come out of their research and put forward some suggestions of how PCOs can be supported in their health improvement work.