What is the recommended referral and approach to care for Chronic Heart Failure according to NICE 2018 guidelines?
The NICE 2018 guidelines recommend referral to a specialist heart failure clinic for 6 months, with contact within 72 hours of discharge and monthly visits. The clinic should include a cardiologist, cardiac nurse, and multidisciplinary team (MDT), and may include a pharmacist, dietician, occupational therapist, and social worker. Pre-discharge education by an experienced cardiovascular nurse is recommended, and thereafter contact with the nurse to reinforce the message. Face-to-face meetings with a doctor and nurse three times in the next six months are also recommended. High-risk patients may require mid-length interventions, such as a nurse-led clinic in consultation with a cardiologist to make onward referrals to other professionals, or a nurse-run clinic in cooperation with doctors, with communication with primary care and social care. For high-risk patients requiring long interventions, a nurse case manager in liaison with the MDT should be considered for 6 months.