This presentation will detail the implementation of a new model of sedation in Central Queensland to address critical gaps in access to diagnostic endoscopy exacerbated by anaesthetic workforce shortages. This initiative, developed collaboratively with Cairns Endoscopy, the local nursing and surgical team, anaesthetists, executive leadership, and a surgical rural generalist, aimed to improve access for rural and regional patients. The presentation will cover the strategic implementation process, including site visits, training, guideline development, and a novel credentialing pathway. Audit data from both patients and staff will be presented, demonstrating the safety and high satisfaction rates achieved with Endoscopist Directed Nurse Administered Propofol Sedation, which has already enabled over 100 additional procedures in its early inception. Key learning points will include the role of surgical rural generalists in driving innovation and facilitating skills transfer between health services, lessons learnt from the implementation strategy, the benefits of multidisciplinary collaboration, and the importance of patient-centered solutions in overcoming healthcare access barriers in rural and regional settings. This presentation offers transferable insights for other regions facing similar challenges.