Palliative radiotherapy represents a substantial workload of a radiotherapy department. This paper provides an overview of a unique service designed to minimise the time between consent and delivery of radiotherapy for palliative patients. In common with other patient-focused care initiatives, this has been achieved by innovative and radically redesigned work practices. Through role development therapeutic radiographers can perform simple palliative treatments. Utilising dedicated equipment they cover all stages of the treatment process, from patient booking through to the end of treatment, providing seamless care for the patient and significant benefits for the department. Auditing the accuracy of simulator radiographs performed by radiographers alone tested the validity of providing simulation of palliative treatment without medical support. The results show 90% required no change with only 1% rejected due to radiographer misinterpretation. The remaining 9% required further information to be supplied by the medical staff. Evaluation of this service included patient and medical staff satisfaction surveys. The results of both were very positive with 100% of medical staff satisfied with the service and all patients rating the service from good to excellent. This project has more than achieved its targets.