Developments in information technology and in the use of telephone-based and direct telemonitoring technologies have the potential to further improve delivery of care (chapter 8) 241 . Heart failure is a progressive condition but access to palliative care services remains patchy, with unclear referral criteria (chapter 10), unclear policies on deactivation of implanted devices (chapter 10) and on the use of ancillary therapies such as diuretic regimes (chapter 10) or domiciliary oxygen (chapter 10). The guideline update is intended for use by the following people or organisations: All healthcare professionals People with chronic heart failure and their carers Patient support groups Commissioning organisations Service providers Chronic Heart Failure Development of the guideline NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 3 Development of the guideline 3.1 What is a NICE guideline? NICE guidelines are recommendations for the care of individuals in specific clinical conditions or circumstances within the NHS from prevention and self-care through primary and secondary care to more specialised services. These may also include elements of social care or public health measures. We base our guidelines on the best available research evidence, with the aim of improving the quality of healthcare. We use predetermined and systematic methods to identify and evaluate the evidence relating to specific review questions. NICE guidelines can: provide recommendations for the treatment and care of people by health professionals be used to develop standards to assess the clinical practice of individual health professionals be used in the education and training of health professionals help patients to make informed decisions improve communication between patient and health professional. While guidelines assist the practice of healthcare professionals, they do not replace their knowledge and skills. We produce our guidelines using the following steps: A guideline topic is referred to NICE from NHS England. 