Heart Failure Nurse Specialists play a key role in facilitating the provision of palliative care for patients with advanced heart failure where supportive and palliative care needs are comparable to those with cancer. This article describes the attitudes of heart failure nurse specialists towards palliative care in the management of patients and their interface with specialist services in the context of changing policy drivers over this time period. Data is drawn from two national surveys, the first in 2005, and repeated in 2010 following national educational initiatives. This comparison provides encouraging results that over five years there has been a growing partnership between heart failure nurses and palliative care services and that heart failure nurses play a pivotal role in ensuring provision of both general and specialist palliative care for their patients. The importance of integrating cardiology and palliative care clinical services, and aspects of local, regional and national service provision in the setting of the Innovative Care for Chronic Conditions framework is highlighted.