For example: People with heart failure value the time the HF nurse has to spend with them, and the psychosocial support they provide; GPs however said they wanted HF nurses to be a resource for primary care, for advice and a point of contact with cardiology; but HF nurses felt a pressure from GPs to fill a gap in service provision. As one HF nurse states: GPs will try to pass the buck because heart failure patients are a problem because they re not stabilised So they get a patient they even suspect has got heart failure, they ll move heaven and earth to get them Chronic Heart Failure Referral and approach to care NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 through your clinic because they know you ll sort them out, give them everything they need, sort all their echoes , all their blood tests, all go back as a lovely little package. p301294 Healthcare professionals involved in HF services perceived GPs as wanting patients to be taken on (or not discharged) by the HF clinic. In one of the studies, those same GPs were also heard, and on the contrary expressed willingness to manage the CHF for most of their CHF patients, suggesting that the HF clinic could concentrate on the most complex cases. One GP stated: Now that we have open access echo available [to primary care), I am much more comfortable about being the person who makes the decision, the diagnosis, and who initiates and monitors . Methodological limitations were rated serious overall. Two papers were rated serious limitations due to having limited discussion and reflection, and in one case a lack of richness of data in our area of interest. 