The acute hospital setting is increasingly regarded as an important area for the delivery of palliative care. A significant number of patients with advanced, life-limiting illness have a range of palliative care needs, some of which can be met by ward staff, but others may require additional, specialist input. Several factors have the potential to limit the palliative care patients in hospital receive, not least of these being disagreement about when and how the transition to palliative care should take place. In practice, however, palliative care can readily be delivered in conjunction with active disease management.