Background Following a scoping exercise, the need for timely prescribing of symptom control medication was clearly identified. After extensive collaboration with the healthcare community, overcoming challenges such as engaging the GPs and setting up a cost centre, non-medical prescribing has now become an essential part of our community palliative care nurse specialist's role.

Purpose Our aim was to improve the patient's experience in terms of more effective symptom control through timely access to medication.

In addition, job satisfaction for prescribers has become enhanced through using expert knowledge, skills and providing a seamless service.

Approach A review of our community services for the locality and several audits indicated a need to better support GPs in providing a seamless service for palliative care patients and helped identify the training and skills required to deliver the service requirements.

Outcomes Patients have received more timely access to medications, resulting in improved symptom management without compromising safety, reducing out of hours crises and helping to alleviate patient and carer distress. Medication is now prescribed in the patient's home helping to enhance patients' quality of life.

Non-medical prescribing has made better use of clinical skills allowing us to practice autonomously, enhancing professional development and continuing to build effective working relationships with other health professionals. This has also resulted in more effective use of time for GPs and has improved relationships with district nurses.

Conclusion As a charity, trying to deliver an enhanced service from outside of the NHS community was not without its challenges. Governance issues and partnership working were the key areas that needed to be addressed.

Our experiences have emphasised the benefits of nurse prescribing in community palliative care, which far outweigh the challenges. Our case studies demonstrate that effective communication is paramount to patient-centred prescribing and improved quality of care.