Limitations Moderate concerns about methodological limitations MODERATE Coherence Minor concerns about Referral and approach to care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: Study design and sample size Finding Quality assessment Number of studies contributing to the finding Design Criteria Rating Overall assessment of confidence HCPs Individual interviews with pt + carer and interviews or FG with HCPs Open-ended narrative interviews with pt Open semi-structured interviews with pt Ethnographic study involving pt and HCPs Semi-structured interviews and one FG with carers of pt and the person they cared for coherence Relevance No or very minor concerns about relevance Adequacy No or very minor concerns about adequacy Improving communication/ information flow 4a. Education and joint working Individual interviews with pt + carers and focus groups with HCPs Semi-structured interviews with pt, their carers and HCPs Staff identified training needs regarding diagnosing and prognosticating heart failure and mutual education for staff of different specialities that would improve the communication with the patient and family. Limitations Serious concerns about methodological limitations MODERATE Coherence No or very minor concerns about coherence Relevance No or very minor concerns about relevance Adequacy No or very minor concerns about adequacy Referral and approach to care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: Study design and sample size Finding Quality assessment Number of studies contributing to the finding Design Criteria Rating Overall assessment of confidence Improving communication/ information flow 4b. Ongoing relationship Individual interviews with pt + carers and focus groups with HCPs Ethnographic study involving pt and HCPs Staff suggested for information and education to be delivered within an ongoing relationship with the patient in an appropriate setting. 