Nurse independent prescribing (NIP) is having a significant positive impact on patient care, yet little is written about NIP initiatives in the out-of-hours (OOH) period, which is a critical time for those with palliative care needs who wish to remain at home. This paper evaluates the impact of an NIP initiative in one weekend clinical nurse specialist (CNS) service in the UK. A 6-month audit of prescribing activity data is presented along with the results of a survey of local GPs. The paper concludes that NIP offers an effective way for the CNS working in the OOH period to offer timely and appropriate symptom control in a single, seamless consultation. Discussion surrounds the factors that affect the success of NIP initiatives and practical recommendations for other providers developing such a service.