Models to improve co-ordination suggested by health care professionals (HCPs) in the studies included a single care-coordinator, a shared-care protocol between primary and secondary care, and using HF nurses as a bridge between primary and secondary care. Communication: There was a finding of poor communication across service boundaries, especially between hospital-based and primary / community services, which can lead to extra burden on patients, and under-treatment. Some of the factors HCPs felt contributed to this were a fragmented IT system and lack of time available within appointments. Patients reported that there was a paucity of information about their condition after they had been discharged from HF services. Contact/Access: The evidence suggested that people with HF can struggle to access the services they require, and referral / re-referral to HF specific- services can be inconsistent. People with heart failure felt that things may be improved if they had a primary contact, with whom they had a relationship, and most would choose their GP. It was reported that HF clinics and HF nurses can provide easy access to urgent assessment and treatment where people are able to access them. Role of specialist HF services: Expectations of HF services, such as whether they will take over total care of the patient (that is, including all comorbidities), and at what point they will discharge patients to primary care, differed between professionals working within, compared with those working outside of HF-services. Some professionals found that managing issues beyond HF in the HF clinic may cause an unwanted loss of continuity in primary care and take time away from HF management. Professionals in HF services felt the decision about whether to keep a patient under follow-up in the HF clinic is complex and taken on an individual basis. 