OBJECTIVES Unplanned patient admissions to hospital with heart failure (HF) are on the increase due to an ageing population and increasing survival post coronary disease. Pre-discharge mortality is high, predictable and often occurs after many days stay for many patients and often without palliative care involvement, not aligned with guidance. METHODS We audited palliative care input to HF patients admitted to our hospital as the predominant condition and subsequently passing away, both before and after an awareness campaign, publishing barriers to end of life dialogues between patient and clinicians, demonstrating the early use of a Get With The Guidelines (GWTG) risk assessment tool to predict mortality and introduction of a daily HF nursing team service. RESULTS In 2009, amongst 57 HF patients the average time to death was 17.8 days, only 7% received any palliative input before death.  The time to death in these patients correlated positively with the (GWTG) predictive score indicating that these deaths could have been anticipated and appropriate palliative involvement triggered. Data from 2010 to 2013 following these interventions (n=99) showed a marked improvement with 44% of patients having palliative input before death. The average time to death in this group was comparable at 17.22 days. CONCLUSIONS The care of HF patients and their families can be greatly improved with early mortality prediction, sensitive dialogues, routine involvement of HF teams both to enhance survival for patients who will benefit from aggressive therapies such as complex devices or ultrafiltration, as well as enabling an enriched end of life experience for those beyond such therapies. Enabling end stage patients to die in their location of choice would also release considerable resources at the same time.