Introduction Nurse independent prescribing (NIP) is a development of the nursing role that has been long awaited by both the Royal College of Nursing and the Nursing and Midwifery Council and is now widely celebrated. However, it has been met with varied responses among cancer and palliative care CNSs. In fact, while the Department of Health's End of Life Care Strategy encourages nurses to pioneer new ways of working in order to provide rapid access to specialist palliative care advice and assessment, the literature reveals a reluctance within CNS teams to embrace this development of the role, to undertake prescribing training and, once qualified, to practice as prescribers.

Aims This study evaluates the impact of nurse independent prescribing within a weekend CNS service at one hospice.

Methods A 6 month audit of prescribing activity data is presented in this study. In addition to this, specific case studies are used to highlight the benefits of CNS nurse prescribing in the out of hours (OOH) period.

Results This study demonstrates that the skills of nurse prescribing offer an effective way for the CNS to be more responsive to the changing and unpredictable needs of palliative patients, especially in the OOH period, enabling timely and appropriate symptom control in a single, seamless consultation.

Discussion Discussion surrounds the challenges of OOH access to drugs, off-label prescribing, CPD, mentorship, professional support and communication.

Conclusion This paper celebrates role expansion and innovations in practice, demonstrates the value of NIP in the OOH period, challenges and encourages other CNS teams to consider OOH NIP initiatives, and offers specific guidance and recommendations for developing and sustaining such a service.