The provision of high-quality palliative and end-of-life care can be a very rewarding and important part of general practice. In this article, we explore how to identify patients at risk of dying in the next year. To help with this, we will look at some of the illness trajectories of cancer, organ failure, multi-morbidity and frailty. Finally, we will share some strategies and phrases that may be helpful in conversations when giving support to patients and planning for the future.