Background: Patient / carer access to medicines at end-of-life (EoL) is critical for control of symptoms, including pain and distress and recent evidence confirms end-of-life medicines optimisation is a research priority for patients and carers (1, 2). Anecdotal data from our recent studies (3, 4) suggests the prescription, dispensing, supply and associated information given about medicines (medicines access) is experienced by patients as often difficult, complex, demanding, lacking coordination and involves a multiplicity of professionals and services. Some of these problems were associated with GPs', who are main providers of EoL care delivery. Nurses often also take a lead role in providing community-based EoL care, but evidence suggests that here too there might be problems: prescribing by palliative care nurses has not been exploited to its full potential (5) and nurses find it difficult to access GPs for EoL prescriptions (6). Moreover, community pharmacists' expertise in palliative care medicines optimisation remains underdeveloped (7, 8). Furthermore, whilst there are promising innovations in EoL service delivery, little is known about the impact of these on patient access to medicines, and their cost effectiveness remains largely unevaluated. We will investigate these issues and draw together findings to provide a comprehensive, critical evaluation of current practice, highlighting best practice, challenges and generating expertinformed solutions.