Nurse prescribing is a key government initiative which aims to enhance patient care. The aim of this study was to investigate the prescribing practice of specialist nurses working in cancer and palliative care and to explore the benefits of and barriers to uptake of nurse prescribing training. A national postal survey of 2252 Macmillan nurses was undertaken using a structured questionnaire with open-ended questions. Data were analyzed using thematic content analysis for 1575 respondents (70% response rate). Only 13% (203) had undergone prescribing training and of these 105 provided responses to the open questions concerning training and of the 87% (1372) who had not undergone the training, 423 provided details on barriers to nurse prescribing training. The data presented in this paper draw from this data. The findings indicate that those who prescribed gave the prospect of improving care as the main reason for undertaking nurse prescribing training. The main reasons why these specialist nurses did not undertake training were: resource issues particularly with respect to backfill while training, lack of medical support and mentorship, concerns about the relevance of prescribing as a nursing role and prioritizing other courses. If nurse prescribing is to be more widely available for cancer and palliative care patients it is important in both primary and secondary care to address the resource and support issues.