This article explores the evidence for service improvements in the provision of care to heart failure patients in the community. It looks at the different methods of service delivery, including nurse-led clinics and home visiting. As patients’ condition can vary considerably, both palliative care and rehabilitation are considered as care contexts. It is argued that distinction should be made between palliative and end of life care, which might otherwise limit the care agreed between the nurse and the patient. The need for nurses to gain appropriate knowledge and skills is emphasised to ensure the provision of effective care.