Integrating cardiac palliative care into clinical practice—part one: the gap between evidence and practice

Healthcare providers in England have a legal responsibility to provide equitable palliative care services that meet the needs of the populations they serve, yet integrated palliative and heart failure care remains largely absent from routine clinical practice. This is the first in a series of three articles on cardiac palliative care. The authors explore the gap between evidence and practice, describing the barriers to the integration of palliative and heart failure care in routine clinical practice. These barriers include uncertainty, unpredictability, a poor understanding of what palliative care is and what it has to offer, time constraints and poor communication. This article argues that these factors prevent the realisation of the ethos of right care, right place, right time.