Other considerations The committee acknowledged The Second Conversation Project which was currently piloting an educational intervention, to enable junior doctors to build their skills and confidence in navigating end of life discussions which they agreed would provide insight into the benefit of this type of training and may be extrapolated to the heart failure population. 9.5.1 Multi-disciplinary teams 71.The core specialist heart failure multidisciplinary team (MDT) should work in collaboration with the primary care team, and should include: a lead physician with a subspecialty interest in heart failure (usually a consultant cardiologist) who is responsible for making the clinical diagnosis a specialist heart failure nurse a healthcare professional with expertise in specialist prescribing for heart failure. 72.The specialist heart failure MDT should directly involve, or refer people to, other services, including rehabilitation services, and tertiary and palliative care, as needed. [2018] 73.The specialist heart failure MDT should: diagnose heart failure give information to people newly diagnosed with heart failure (see section 9.4.6) manage newly diagnosed, recently decompensated or advanced heart failure (NYHA [New York Heart Association] class III to IV) heart failure optimise treatment start new medicines that need specialist supervision continue to manage care after an interventional procedure such as implantation of a cardioverter defibrillator or cardiac resynchronisation device manage heart failure that is not responding to treatment. [2018] Chronic Heart Failure Domiciliary oxygen therapy in people with advanced heart failure NICE 2018. All rights reserved. Subject to Notice of rights. 