Trade-off between benefits and harms The committee agreed that the findings and sub-findings identified in the review resonated with their own experiences as healthcare professionals or patients within heart failure services in the NHS. The committee acknowledged that some of the sub-findings identified in the review reflect general issues around communication and information needs in health care and are addressed by recommendations in the patient experience guideline CG138. The committee identified several key recommendations in that guideline which, if implemented in heart failure services, would go some way towards addressing the issues identified in the review. Highly pertinent recommendations from CG138 include allow adequate time so that discussions do not feel rushed (1.3.4.), clarify with the patient at the first point of contact whether and how they would like their partner, family members and/or carers to be involved in key decisions (1.3.10), avoid the use of jargon and define unfamiliar words (1.5.6), provide both oral and written information (1.5.12), and to give the patient the opportunity to discuss their diagnosis, prognosis and treatment options (1.5.21). The committee agreed that there was no need to replicate these recommendations in this guideline and instead decided to cross refer to the patient experience guideline. The committee decided to focus on the issues raised that are specific to the communication of the diagnosis and prognosis of heart failure. In line with the review findings, the committee was unanimous that a single consultation was too short to explain the diagnosis to the patient and the amount of information that would have to be relayed could be overwhelming. This echoed the general recommendation in the patient experience guideline to allow adequate time so that discussions do not feel rushed (section 1.3). 