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. One paper was rated serious limitations due to the lack of explanation of methods and lack of depth of data collection. One paper was rated as moderate limitations due to the participants not being well described. Two papers were rated as minor limitations. Coherence was rated minor concerns overall. Agreement between papers was good, showing that both patients and other health professionals value the continuity provided by GPs, and believe there is danger of that being disrupted. However, there is other data that challenges the primacy of continuity over other important factors in HF care, for instance the in-depth knowledge of the cardiologist, or the easy access to the HF nurse. Relevance was rated minor concerns overall. The relevance of the subfinding to the focus of the review was high. Both studies that included patients were from outside the UK. A third study (of HCP) Chronic Heart Failure Referral and approach to care NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 was from the Highlands of Scotland, which has rather specific challenges of geography that may affect the importance of primary care. The remaining study however, was conducted with HCP in three different trusts, offering results that seem to generalise well over settings. Adequacy was rated as no or very minor concerns. The subfinding was fairly general, was expected, and is supported by numbers of studies. The finding was descriptive and supported adequately by the richness of data. 