Chronic heart failure (partial update) - draft guideline consultation

A clinical practice guideline on Chronic heart failure is being developed for use in the NHS in England, Wales and Northern Ireland. Registered stakeholders for this guideline are invited to comment on the provisional recommendations via this website. 

New updated recommendations have been added on signs and symptoms, echocardiography, specialist assessment and the measurement of serum natriuretic peptides in  the diagnosis of heart failure, as well as pharmacological treatment with ACE inhibitors, beta-blockers, aldosterone antagonists, isosorbide/hydralazine and angiotensin II receptor antagonists,and disease monitoring with serum natriuretic peptides, and rehabilitation.

The consultation draft of the full guideline includes the new updated recommendations and the original unchanged recommendations. However, the evidence reviews are presented only for the new updated recommendations. The evidence reviews for the original unchanged recommendations are in the 2003 full guideline which can be accessed here: /guidance/cg5/evidence

You are invited to comment on the new and updated recommendations in this guideline only. These are clearly marked in both the NICE guideline and the Full guideline versions.

Appendix E at the back of the NICE guideline contains recommendations from the 2003 guideline that NICE proposes deleting in the 2010 update. This is because the evidence has been reviewed and the recommendation has been updated or because NICE has updated the relevant guidance and has replaced the original recommendations. Where there are replacement recommendations based on a review of the evidence, this information is provided. Where there is no replacement recommendation, an explanation for the proposed deletion is given. You are invited to comment on the deleted recommendations as part of the consultation on the 2010 update.

Individuals and organisations not registered as stakeholders are not able to comment, we recommend that you register as a stakeholder or you contact the registered stakeholder organisation that most closely represents your interests and pass your comments to them.

Note that the provisional recommendations presented here do not constitute the Institute's formal guidance on this topic. The recommendations are provisional and may change after consultation.

Consultation dates: 14 January – 10 March 2010

Consultation documents:

The full version describes the evidence and views that have been considered, and sets out the provisional recommendations that have been developed.

The (NICE) short version presents the provisional recommendations only with some brief supporting information.

Points to consider in the consultation:

Full version

  • Points or areas that are not covered, but which appear to fall within the scope of the guideline
  • Potential inconsistencies or any disagreement with the Guideline Development Groups interpretation of the evidence
  • The practical value of the provisional recommendations.

Short version

  • Issues of style and format; for example, stakeholders may feel that the information could be made more readable and easy to follow.


  • Do you think this guidance could be changed to better promote equality of opportunity relating to age, disability, gender, gender identity, ethnicity, religion and belief, sexual orientation or socio-economic status?

In answering this question, please include details of:

  • Which particular parts of the guidance you think affect equality of opportunity.
  • Why and how you think equality of opportunity is affected.

How to submit your comments:

Please use the comments proforma and return by email to

The Institute is unable to accept:

  • Comments from non-registered organisations – if you wish your comments to be considered please register via the NICE website
  • Comments from individuals – please contact the registered stakeholder organisation that most closely represents your interests and pass your comments to them [insert link to SH list].
  • Comments received after the consultation deadline (5pm)
  • Comments that are not on the correct proforma
  • More than one response per stakeholder organisation
  • Confidential information or other material that you would not wish to be made public
  • Personal medical information about yourself or another person from which your or the person’s identity could be ascertained.

What will happen to your comments:

  • All eligible comments  will be sent to the developers at the end of the consultation
  • Comments from registered stakeholders and nominated expert reviewers ONLY will be formally responded to by the developers and posted on the NICE website at the time of the pre-publication check.
  • No action will be taken upon receipt of personal, individual comments, comments from non-registered organisations  and late comments.
  • PLEASE NOTE: The Institute reserves the right to summarise and edit comments received during consultations, or not to publish them at all, where in the reasonable opinion of the Institute, the comments are voluminous, publication would be unlawful or publication would be otherwise inappropriate.

Acknowledgement of comments:

You should receive an automated acknowledgement from the email box when you email your comments.  If you do not receive this acknowledgement, please contact the relevant Guidelines Coordinator to ensure your comments have been safely received.

Comments received in the course or consultations carried out by the Institute are published in the interests of openness and transparency, and to promote understanding of how recommendations are developed. The comments are published as a record of the submissions that the Institute has received, and are not endorsed by the Institute, its officers or advisory committees.

Anticipated publication date: August 2010

Further information

This page was last updated: 30 March 2010