Examples of what has been done

Integrated care services built around an alliance of primary and secondary care and including community support services


Darlington Integrated Heart Failure Service is a dedicated heart failure service build around an alliance of primary care and secondary care staff, patients and carers, including palliative care, counselling services, and voluntary social care agencies.

What they did


The Integrated Heart Failure Service offers a weekly diagnostic clinic run by a GP specialist and a heart failure nurse to ensure an accurate and timely diagnosis of HF. Patients who have been referred by their doctors are assessed at the clinic with a range of HF diagnostic tools recommended by NICE (UK) clinical guidelines, including an echocardiogram, chest X-ray and electrocardiogram (ECG).


For patients with a confirmed diagnosis of HF a management plan is created, which includes information materials and education for patients and their carers, evidence based treatment options and, if necessary, a referral to tertiary care.


Other services for HF patients offered by the clinic include symptom management, treatment adjustments, advice for patients and their carers and palliative support.

What they achieved?

In the first year, a total of 217 patients were seen in the diagnostics clinics, of which 38% were diagnosed with HF and 37% were diagnosed with other cardiovascular diseases. A survey among patients found a very high satisfaction with the services offered (around 95%). 1

Links, references, and key reading


  1. Pearson M, Cowie M. Managing chronic heart failure: learning from best practice: Royal College of Phsysicians, 2005.