The problem: While the need for integrating palliative care (PC) services into heart failure (HF) care has been well recognised, as of yet this integration has been slow to develop, especially when compared to cancer care. Currently, only 5-7% of patients with HF utilise PC services, due to a focus on optimising therapy and an unpredictable disease trajectory, with exacerbations hampering prognosis. As a result, many symptoms and concerns that are not directly related to HF management are not recognised and undertreated and patients are often referred to PC services only at the very end of their lives.

Our solution: The RAPHAEL consortium sets out to take the next big step in integrating PC into HF care by integrating the RAPHAEL palliative care approach in existing HF care pathways. This flexible and patient centred approach starts with the identification of multidimensional symptoms and concerns, prioritising needs with patient and informal carer and formulating a proactive care plan.