Agreement between papers was good and appeared to fit well with related findings in other studies. The only findings that tend the other way are regarding the positive influence of GPs in continuity, and this is not inconsistent. Relevance was rated minor concerns overall. The relevance of the sub-finding to the focus of the review was high. Concerns stemmed from two papers being from outside the UK and in a sub-set of CHF, and the data collection in a UK paper dating back to 2010. However, the finding was found in various settings, and likely to generalise well. Adequacy was rated as no or very minor concerns. The sub-finding was general, and although explicitly supported by a limited number of studies, other studies found similar findings. The sub- finding was descriptive and the richness of data was sufficient for this. The overall assessment of confidence was moderate, having been downgraded by one increment due to the combination of concerns in methodology and relevance. Review sub-finding 1b: Primary care People with heart failure and professionals working in heart failure care both recognised that primary care, and general practitioners in particular, could provide individualised care with continuity. It was acknowledged that such continuity is important to patients, and there was concern that where HF services take over a patient, this could cause patients to lose touch with primary care, with a consequent loss of continuity. In one study GPs spoke of how they wished for a consultant model where specialists answered questions and made recommendations, but did not take over care of the patient. In an assessment of a new heart failure service, it was emphasised by GPs that new services should integrate into the existing primary care/community multidisciplinary team, partly for this reason Methodological limitations were rated minor overall. 