However, the committee recognised that this was a significant issue. Contact/Access: The subfinding of difficulty accessing routine care was rated low confidence due mainly to methodological limitations. The subfinding of a primary contact person was rated as very low confidence, but was seen to overlap with other findings to a large extent. The subfinding regarding access to urgent care was rated low confidence due to concerns over methodology, relevance and adequacy. Role of specialist HF services: The committee felt that some of these subfindings were inevitable in an organisation like the NHS for a condition that crosses boundaries between services. The subfinding on the expectations on HF services was rated very low confidence due to methodological concerns and lack of depth. However the committee recognised the experience of a member who had been involved in creating a local HF pathway and experienced the same issue: that people involved in different aspects of HF care had different expectations of the service. They also recognised that GPs differ in their desire to have specialist input and facility to manage heart failure and its comorbidities. Chronic Heart Failure Referral and approach to care NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 The subfinding of focus for HF services was rated as low confidence due to concerns in methodology, relevance and adequacy. The committee debated these findings. Some felt that that it was impossible for cardiologists to have the expertise and capacity to provide care for all the healthcare needs of patients with heart failure whose co-morbid conditions are complex, and therefore supported a focussed approach. 