The committee agreed that ensuring a care plan was in place and shared with the patient and necessary healthcare professionals was important to improve current barriers in co-ordination and communication for people with heart failure. The committee noted that there may be some small costs associated with the time spent on the administrative tasks such as the writing and dissemination of the care plan. However, the committee felt that providing a care plan was already standard practice in many cases, and could be achieved by changes to current paperwork rather than additional time and resource. The committee agreed that ensuring care plans are regularly updated and shared would likely improve patient treatment by reducing cases of under or over treatment and any resultant adverse events. The committee believed that the reduced treatment burden would improve patient quality of life and reduce patients anxiety about their condition and treatment. Therefore, overall the committee considered that any additional administrative tasks and care plans are likely to be a cost-effective use of resources. Other considerations The current experience of HF care across the country was felt to be variable due to a number of factors These included the degree to which GPs were engaged with national programmes such as QOF and NICE Quality Standards programme; the degree to which GPs are involved in regionally agreed long- term conditions frameworks or other benchmarking; locally agreed protocols; and the involvement of the third sector, such as patient advocate groups, in facilitating access to care. The committee felt that clarifying the roles of primary care and the rest of the multidisciplinary specialist HF team would enable commissioners and others to reduce variation by defining the structures for high quality HF care, including effective co-ordination and communication. Chronic Heart Failure Referral and approach to care NICE 2018. 