ISBN: Study design and sample size Findings Quality assessment No of studies contributing to the finding Design Criteria Rating Overall assessment of confidence Interviews with HCP Interviews with HCP in HF services Interviews with pt with severe CHF and their care network Expectations of HF services from primary care and pt can differ both from what HF services think primary care and pt want, and from what the service is capable of delivering. Methodology serious limitations VERY LOW Coherence minor concerns Relevance moderate concerns Adequacy serious concerns Interviews with HCP from HF services Interviews with severe CHF and their carer network Healthcare professionals felt that HF services should be focussed on heart failure rather than its comorbidities, as addressing people s primary care issues has other consequences. Methodology moderate limitations LOW Coherence no or very minor concerns Relevance moderate concerns Adequacy moderate concerns 5c Decision to keep patients on the caseload Interviews with pt and care network Healthcare professionals involved in HF specialist services vary widely on whether they take over patients, basing their decisions on the balance of a person s needs for HF care and resources, e.g. the perceived ability of their general practitioner. Methodology minor limitations LOW Coherence no or very minor concerns Relevance moderate concerns Adequacy moderate concerns Chronic Heart Failure Referral and approach to care NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 9.3.4 Economic evidence Published literature No relevant economic evaluations were identified. See also the economic article selection flow chart in Appendix D. 9.3.5 Evidence statements Qualitative See the narrative summaries of review findings in section 1.3.3.1. Economic No relevant economic evaluations were identified. 