Understanding advanced heart failure: Information for patients and carers

What Does Advanced Heart Failure Mean?

Heart failure means that the heart isn't pumping blood around the body as well as it should and oxgyen levels may drop and not reach tissues such as lungs and muscles.

When the heart becomes very weak and medication is not controlling symptoms this is called advanced heart failure. At this stage medication should be reviewed regularly to keep symptoms as well controlled as possible.

Symptoms of advanced heart failure:

Please look at the links from the symptoms above for more detail on how to manage these.

Recommended Resources

Pumping marvellous - Heart failure guide

Published 1st April 2026

British Heart Foundation - Heart failure

Published 18th July 2025

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Community palliative care teams

Brent North Community Palliative Care Team - based at St Luke's
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Brent North Community Palliative Care Team - based at St Luke's

T. 020 8382 8013

North Brent Community Specialist Palliative Care Nurse team provides advice and visiting to palliative care patients in North Brent. The team is based at St Lukes Hospice.

Areas: Queensbury, Fryent, Welsh Harp, Barnhill, Kenton, Northwick Park, Preston, Sudbury, Wembley Central, Alperton, Tokyngton

The team can be contacted for referrals Monday to Sunday 8.30am to 4.30pm. 

After 4.30pm the Out of Hours Telephone Advice line 020 8382 8000 operates and calls will be taken by a nurse on St Lukes inpatient unit

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
Brent South Community Palliative Care Team - based at Pembridge Hospice
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Brent South Community Palliative Care Team - based at Pembridge Hospice

T. 020 8102 5000

South Brent Community Specialist Palliative Care Nurse Team provides advice and visiting to palliative care patients in South Brent. The team are based at Pembridge Hospice

Areas: Harlesden, Willesden, Kilburn, Neasden (south of north circular Brent, except the St Raphael's Estate) 

All referrals to be made via the CLCH Single Point of Access Service (SPA) email address and will be processed during working hours of Monday to Friday 9.00am to 4:30pm. Any referrals sent outside of this time period will be processed on the next working day.

For ALL urgent referrals, both in and out of working hours, please also call Pembridge (as per current process) on the 24 hour number above.

For any other email correspondence. clcht.pembridgeunit@nhs.net.

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
Community Palliative Care Team - based at Meadow House Hospice
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Community Palliative Care Team - based at Meadow House Hospice

T. 020 8967 5179

W. https://www.lnwh.nhs.uk/meadow-house-hospice/#community-palliative-care-team

The Community Specialist Palliative Care Nurse Team provides advice and visiting to palliative care patients in Ealing and Hounslow. The team are based at Meadow House Hospice.

The team will visit patients with progressive life limiting illness in their own homes. They provide specialist advice around pain and symptom control and support for patients, their families, and carers during the last stages of illness. They also support patients wishing to die at home through coordination with GPs and hospital teams.

The team is comprised of medical consultants, specialist nurses, physiotherapists, occupational therapists, social workers, a bereavement support officer and a patient and carer advocacy worker

The team can be contacted for referrals Monday to Friday 9.00am to 5.00pm.

Between Monday to Friday 5.00pm and 8.30am, the Out of Hours Telephone Advice line 020 8102 5000 takes calls. Weekends and Bank Holidays 5.00pm to 9.00am.

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
Community Palliative Care Team - based at St. John's Hospice
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Community Palliative Care Team - based at St. John's Hospice

T. 020 7806 4040

St. John's Hospice provides advice and visiting palliative care patients for some parts of Central London.

Referrals can be made Monday to Sunday 9.00am to 5.00pm.

Referral form for clinician use only.

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Community Palliative Care Team (South) - Royal Trinity
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Community Palliative Care Team (South) - Royal Trinity

T. 020 7787 1062

Royal Trinity Hospice (South) provides advice and visiting palliative care patients of Hammersmith and Fulham, Central London and West London.

They can be contacted 8am -8pm  7 days a week.

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
District Nurses Night Service Hounslow
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Referrals to the night service can be made Monday to Sunday 5.00pm to 7.00am.

Harrow Community Palliative Care
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Harrow Community Palliative Care

T. 020 8102 6163

Harrow Community Specialist Palliative Care Team (LNWHT) provides advice and visiting to palliative care patients in Harrow.

They can be contacted Monday to Friday 8.30am to 4.30pm.

They are based at Honeypot Lane Health Centre, 839 Honeypot Lane, HA7 1AT.

Out of Hours the Pall24 Helpline can be used 3000 200 224

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
Hillingdon Community Palliative Care Team
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Hillingdon Palliative Care Team (hosted by NHS CNWL) provides specialist advice and visiting to palliative care patients living in Hillingdon. Each GP practice has their own named Clinical Nurse Specialist ( CNS ). A Triage CNS manages calls and referrals each day and they have the option to escalate to consultants if needed.

They can be contacted Monday to Friday 8.00am to 4.30pm excluding bank holidays.

Out of hours phone Michael Sobell Hospice 24 hour Advice Line on 020 3824 1268

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
Pembridge Community Palliative Care Team (North)
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Pembridge Community Palliative Care Team (North)

T. 0208 102 5383 / 0208 102 5000 (out of hours)

Pembridge Community Palliative Nurse Team (North) provides advice and visiting palliative care patients of Hammersmith and Fulham, Central London and West London.

They can be contacted Monday to Friday 8.30am to 5.00pm.

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
St John's Hospice at Home
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St John's Hospice at Home

T. 020 7806 4027

St. John's Hospice provides palliative care services to the residents of Brent and Westminster.

Telephone response will be received within 2 hours.

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
St John's Hospice Inpatient unit
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St John's Hospice Inpatient unit

T. 020 7806 4040 / 07725 258767

W. https://www.stjohnshospice.org.uk/our-care/inpatient-care

St. John's Hospice provides inpatient palliative care services to the residents of Brent, Central London and West London.

This is an inpatient unit with 18 beds

Please contact for admissions for advice and Community Specialist Palliative Care.

The office hours are Monday to Friday 8.30am to 4.30pm. Referrals received in the morning are triaged the same afternoon, and those received in the afternoon are triaged the following working day.

If urgent, please follow up the referral by calling us on 020 7806 4040. Out of hours, urgent referrals will be discussed with the consultant on call.

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
St Luke's Hospice at Home
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St Luke's Hospice at Home

T. 0208 382 8020 / 8050

St. Lukes Hospice@Home provides palliative care services to the residents of North Brent and Harrow. Respite and bridging packages of care are available for end of life patients.

Please contact the team between Monday to Saturday 9.00am to 5.00pm.

The email can be used for fast track referrals.

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
St Luke's Hospice Inpatient Unit
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St Luke's Hospice provides inpatient palliative care services to the residents of Brent.

This is an inpatient unit with 12 beds. Please contact for admissions and advice.

Referrals can be made Monday to Sunday 9.00am to 4.00pm. 

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)

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