At Osaka National Hospital, we established a hospital based palliative care team in July 2004. The team provided consultation to 355 patients (189 males and 166 females). Even though consultation was requested from every department, the department of surgery requested most with 100 cases, of which a request for lung (16%) and gastric (13%) cancer patients were asked fairly often. Some of the consultation requests were 177 in pain control, 221 in psychiatric and 91 in physical related symptoms, respectively. The department of surgery requested PCT intervention most frequently. Finally, a total of 115 patients had died, 81 were discharged and 36 were continually treated with cancer chemotherapy as an outpatient basis. OCNS have a major role in coordination with the PCT and primary team, and intervene directly in the CNS's specialty area. To provide more appropriate care services with the primary team, the OCNS should assume more responsibility for promoting a support relationship with the staff and to enhance staff skills.