It was acknowledged that although many general practices may have access to the equipment it was not widely implemented due to a lack of infrastructure to support its use. The quantity of data that needs to be analysed as a result of TM has a significant effect on staff workload and associated changes to staff roles and responsibilities. This may impact their ability to perform important daily tasks and responsibilities potentially negatively impacting patient safety. The presence of publication bias within this area was acknowledged by the committee. They were aware of instances where small studies showing no effect had not been published and agreed that this also made it difficult to ascertain the potential clinical benefit of such an intervention. In addition to this the committee agreed that the intensification of more conventional methods of delivering care, such as more home visits or clinic visits could Chronic Heart Failure Monitoring NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 Recommendations No recommendation Research recommendation No research recommendation deliver results similar to those of home telemonitoring. The committee discussed groups of people who may not be able to access STS which included those from socioeconomically disadvantaged groups who do not have access to touch tone telephone. In addition, people whose first language is not English may also have difficulty accessing this form of support. 8.5 Recommendations for monitoring heart failure 8.5.1 Clinical review 66.All people with chronic heart failure need monitoring. 