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Background Although referrals to the Community Specialist Palliative Care Team (CSPCT) for patients with heart failure had increased significantly, it was considered likely that there remained a significant unmet need with patients referred to the service at a late stage. The CSPCT and Heart Failure Teams identified a need to enhance their skills for the benefit of patients in the Salford community.Aims A service improvement initiative was agreed with the aim of improving the care and management of patients with heart failure, particularly in the last year of life, through improved collaboration between services, facilitating earlier access to specialist palliative care, timely advance care planning, hospital admission avoidance and improved knowledge and skills across both teams.Methods Interventions included CSPCT attendance at the Heart Failure multidisciplinary team meeting, establishing a monthly joint clinic for an initial one-year pilot and education sessions for both the CSPCT and Heart Failure Teams. Activity measures at baseline and at the end of the project were collected. IPOS questionnaires were introduced in clinic. Staff confidence was evaluated across both services using baseline and post-project surveys.Results The pilot was extended to two years due to low clinic numbers in the first year. A total of twenty-nine patients were referred with an average of 1.6 attendances. Twenty-five had a recorded advance care planning discussion. Seven hospital admissions were recorded after first clinic attendance. Of fourteen deaths, six were in hospital. Eighteen patients accessed at least one hospice service. Staff confidence showed little change between pre and post-project surveys.Conclusion The joint clinic is considered a positive development with improved collaboration between services. Patient selection has improved. Further work is required to improve access to services, to better utilise IPOS to support care, and to improve staff confidence across the teams.