Abstract: A very remote Hospital Pharmacy Department undertook a six month trial of an additional full time clinical pharmacist. The Pharmacy Department, historically staffed by a sole pharmacist and pharmacy technician, provides clinical pharmacy, stock distribution, and medication management services to a 32 bed hospital and 23 community health care providers. This trial aimed to demonstrate improvements aligned with the strategic and business priorities of the health service, and National Safety and Quality Health Service Standards. Clinical pharmacy interventions were recorded for a 4 week period and graded using a national risk classification tool. Antimicrobial Stewardship (AMS) interventions were recorded for 3 months and assessed against National Guidelines. The percentage of patients for whom a pharmacist generated a discharge medication information summary was recorded over a 4 week period, and retrospectively calculated for the same 4 week period in the previous year for comparison. The expanded Pharmacy team contributed to safety and quality initiatives including: providing education for medical and nursing staff, reviewing all reported medication incidents, participating in an organisation wide review of adverse drug reaction and allergy recording, redesigning freight arrangements, and driving a comprehensive review of medications on Emergency Response trolleys. A total of 83 clinical pharmacy interventions were recorded, including 9 rated as extreme. There were 93 recorded AMS interventions and antibiotic usage in the hospital was decreased. Communication at transitions of care improved, with 52% of discharged patients having a pharmacist-generated discharge medication information summary sent to their community health care provider during the trial compared to 13% in the sole pharmacist period. Financial sustainability was demonstrated by decreased freight costs, improved stock management, and decreased reliance on locums for leave cover and associated costs. Feedback from staff and management about the increase in Pharmacy services across the hospital and region was positive. The clinical pharmacist quickly became an integral part of the very remote hospital multidisciplinary team. Increased contributions by the expanded Pharmacy team were noticed across the health service, in areas including inpatient clinical care, governance, quality improvement, AMS, medication safety, and collaboration with community health care providers. The results of the trial were presented to senior management and the position has been made permanent. The isolation of the sole hospital pharmacist in this very remote part of Australia has ended, and the possibilities for collaborative health care have grown.