This is an analysis of patterns and trends in referrals and deaths in a palliative nursing service Comparisons are made over a 10-year period and with national and district statistics. Results show numerical increases in patients referred, a trend towards medical referrals, small numbers of referrals from other professional groups and from hospitals, and death trends which are not significantly different from national statistics Possible reasons for these patterns and trends are explored in the context of the developing Macmillan Nurse role