What cost considerations are associated with extended first consultations for patients with chronic heart failure?
An extended first consultation for patients with chronic heart failure will incur an additional cost due to the required extra time from the clinician to fully explain the person's diagnosis and prognosis. The committee considered that a standard consultation appointment is unlikely to be long enough to allow sufficient time to explain the diagnosis and prognosis as recommended in the patient experience guideline, and it is necessary for good clinical practice. Furthermore, this type of recommendation is endorsed by the patient experience guideline which specifies that when discussing patient views and preferences that adequate time should be allowed so that discussion does not seem rushed. In many centres, extended consultations are likely to already be occurring. The committee also acknowledged that further communication training would incur a cost. The committee were aware of training for other chronic conditions that could also be extended to heart failure specialists. Furthermore, such training is likely be undertaken in a group setting to minimise cost, or alternatively could be provided through e-learning, or at medical school in future.