The Griffith Palliative Care Service (GAPS) commenced in 2001 as a project to improve palliative care in the town of Griffith. At project completion, some elements of service delivery established by the project were sustained and have remained in place, albeit with changes, since that time. Formal evaluation was undertaken in 2003. This paper reports on a follow-up evaluation in 2006. A total of 137 people were referred to GAPS between March 2003 and March 2006, with the majority of patients in the stable phase on referral. There is evidence that the service has been able to extend its reach to people with non-malignant conditions but some elements of the service have not been maintained, including use of common clinical assessment tools as a ‘common language’. The most effective elements of the service are weekly case conferences and an on-call service for those enrolled in GAPS. Both have become part of day-to-day practice, achieving an excellent level of sustainability. There is also continued support and involvement of GPs. There has been a move away from a primary care model but a stable pattern of service delivery has been maintained.