Background Health promoting palliative care began in Victoria, Australia and has been included in Victorian palliative care policy for over a decade.

Aim To review the way Victorian palliative care services have responded to government policies and strategic directions that are based upon health promoting palliative care.

Method Thematic analysis of the annual reports of regional palliative care consortia over the past two four-year policy cycles. The eight regional consortia represent all palliative care services in the state of Victoria, and report their activities against the government’s strategic directions.

Results Most palliative care services report some level of community engagement, but health promoting approaches are seldom seen as core business. Community engagement tends to be episodic or event-driven rather than sustained and sustainable. Most services express a desire to increase community engagement, but report that they struggle to do so in the face of the increasing demand for clinical service provision.

Conclusion The understandings of health promotion and community development that inform the current community engagement activities of palliative care services need to be expanded. We suggest that this is more likely to happen if community groups become active in engaging the health services, including palliative care services, rather than by continuing to focus solely on building the services’ community engagement capacities. Some strategic opportunities for accomplishing this reorientation will be identified and illustrated as part of the presentation.