ABSTRACT
Extension of specialist palliative care services to heart failure patients is in its infancy, but as the examples illustrate, it can be accomplished successfully. The fears of professionals and patients can be overcome if the specialist nurses and doctors involved take an active role in setting up a collaborative service. However, at the present time an optimum service model is not known. Until recently, there has been little engagement of or by the voluntary sector (the majority of hospices) in strategic planning of health services. SPC services have therefore grown up in a haphazard way, often at the instigation of local benefactors rather than in response to a systematic needs assessment. In the palliative care of oncology, this has changed due to the advent of cancer networks, which have embraced the need for equitable SPC services. Such an approach needs to be mirrored for patients with non-malignant disease (see Chapter 1), and services currently running should evaluate the acceptability and outcomes of their service.
