This update highlights and further expands on the roles of the MDT and collaboration between the MDT and the primary care team. The Department of Health and Social Care's policy paper on improving cardiovascular disease outcomes: strategy also noted that the proportion of people with heart failure who have cardiac rehabilitation was around 4%, and that increasing this proportion would reduce mortality and hospitalisation. This update recommends that all people with heart failure are offered an easily accessible, exercise-based cardiac rehabilitation programme, if this is suitable for them. 28 of Recommendations for research The guideline committee has made the following key recommendations for research. The committee's full set of research recommendations is detailed in the full guideline. 1 Diuretic therapy for managing fluid overload in people with advanced heart failure in the community In people with advanced heart failure and significant peripheral fluid overload, what is the clinical and cost effectiveness of oral, subcutaneous and intravenous diuretic therapy in the community? Why this is important This research is critical to inform practice of how best to manage people with advanced heart failure in the community if they develop significant peripheral fluid overload. These people are more likely to have multiple admissions that, together with fluid overload, have a negative impact on their quality of life. Management in the community can minimise disruption for the person and reduce costs from hospital admissions. Knowledge of the most clinically and cost-effective routes of administration for diuretic therapy will dictate the level of resource needed to provide the service. Intravenous and subcutaneous diuretics usually need to be administered by nursing or healthcare staff. although a pump for self-administration of subcutaneous diuretics has recently been developed. Oral formulations can be self-administered. 