The National Confidential Enquiry into Patient Outcome and Death highlighted the need to improve patient outcomes and safety when undergoing chemotherapy. The audit discussed in this article assessed proactive telephone follow up by staff on a chemotherapy helpline after a patient’s first cycle of chemotherapy. A list of patients eligible for proactive follow up was compiled from a database of those undergoing treatment. A subset of eligible patients consented to participate in a telephone satisfaction survey and 150 were eligible for proactive follow up. Of 131 calls made, most (90%) were successful and 61% reported a number of problems (range=0-5), the most common being gastrointestinal side effects and fatigue. Active management was required in 18% of patients. Patients reported high levels of satisfaction with proactive follow up. Of those surveyed (n=49), all reported that the call was useful. The majority (98%) were satisfied with telephone calls as a means of follow up. Proactive telephone follow up is shown to be an effective and acceptable method that enhances quality of care.