Background People with heart failure have a high symptom burden (Kavalieratos, Gelfman, Tycon, et al. J Am Coll Cardiol. 2017;70(15):1919–1930). Palliative care can improve the outcomes for this demographic, however, palliative care is often misunderstood leading to poor access for those who would benefit from its support (Jaarsma, Beattie, Ryder, et al. Eur J Heart Fail. 2009;11(5):433–43).

Aim To create and test an integrated model of community working to support those living with and dying from heart failure.

Method This 18-month, nurse-led project, finishes in September 2024. Through building new relationships across organisational boundaries, we have expanded our clinical caseload, changed referral processes, and through multi-disciplinary working promoted palliative care as a valid intervention for people living with heart failure. We have established a community of practice alongside multidisciplinary meetings and joint working to share learning across organisational boundaries. We have introduced a hospice-based day infusion service, allowing choice about care and treatment, and reducing burden of care for patients and hospital services. Listening to the lived experience of people with heart failure, their carers, and healthcare professionals, we are co-designing services and resources to meet unmet need.

Results We have supported 189 patients over the past year; 49% people living with left-sided heart failure, and 51% people with other aetiology, a population who historically rarely had access to palliative care. Referrers include heart failure teams, general practitioners and rapid response services. We are supporting people to remain in their preferred place of care with 73% having achieved death outside of the hospital setting and 76% achieving their preferred place of death. Our community of practice has reached 189 people from multiple organisations at local, national and global level.

Conclusion Whilst still in progress, this project has already enhanced and expanded our services, built new foundations for integrated working and shared learning, and enabled wider access to palliative care for those living with and dying from heart failure.