Palliative care is a complex environment in which teams of healthcare professionals are constantly challenged to match the configuration of care delivery to suit the dynamics of the patient's bio-medical, social and spiritual situations as they change during the end-of-life process. In such an environment these teams need to engage in ongoing interaction between different professional disciplines, incremental improvement in care delivery, learning and radical innovation. This is aimed at combining operational effectiveness, strategic flexibility, exploitation and exploration, in a way that ensures the best possible care for the patient. This paper examines previous research on the management competences and the organisational capabilities necessary for continuous innovation, and analyses evidence emerging from a study of palliative care. Work on the relationships between innovation capacities, organisational capabilities and team-based competence is drawn together. Evidence is presented from research into the management of innovation in palliative care.