Two papers were rated serious limitations due to having limited discussion and reflection, and in one case a lack of richness of data in our area of interest. One paper was rated as moderate limitations as there is little description of the participants. Coherence was rated minor concerns overall. This was one of the least well-defined sub-findings in the review what was clear is that different groups had certain expectations on services, but the exact nature of the expectations differed between the studies, and few studies were able to look at the difference in expectations between different groups. The finding of conflict between interested groups due to differing expectations was clear in the two service evaluations included here (which, of the study types in the review, were the studies best able to look at this issue). Relevance was rated moderate concerns overall. The relevance of this sub-finding to the focus of the review was somewhat indirect. The issues identified may seem quite specific to the exact model of delivering HF care, but all studies were in the UK, at different time periods, so there may be a generalisable point. Adequacy was rated as serious concerns. The sub-finding was a complex issue, not explored in depth. The overall assessment of confidence was very low, having been downgraded by three increments for methodology, relevance and adequacy concerns. Review sub-finding 5b: Focus Healthcare professionals felt that HF services should be focussed on managing CHF rather than its comorbidities. HCP from HF services felt that they did not have the ability to assess and treat some comorbidities (an example condition was iron-deficiency anaemia). 