Advanced heart failure patients have a poor quality of life and high symptom burden; often equivalent to patients with metastatic cancer. The expanding non-cancer remit of palliative care has provided an ideal opportunity to explore ways to address the holistic needs of this vulnerable group of patients. However, although there are some published service designs with improved outcomes, there is no consensus as to the best approach for addressing the needs of these patients or clear thinking on which models of care may be able to offer cost improvements, whilst concurrently providing a good patient experience.

In early 2016, a heart failure supportive care co-speciality pathway was initiated in Cardiff and Vale University Health Board which has shown significant value-based improvements by reducing hospital bed days in the last 1-2 years of life, whilst simultaneously demonstrating positive patient reported outcomes and experience.

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