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ICARe-HF – Recognising excellence in heart failure care

An international accreditation programme for heart failure centres  

Does your centre apply best practices and strive for excellence in heart failure care? If so, it may be eligible for accreditation as an HFA Quality of Care Centre through ICARe-HF - the new gold standard for heart failure care in Europe and beyond. 

What is ICARe-HF?

ICARe-HF is about improving patient outcomes by raising standards in care facilities and recognising those that apply best practices.

ICARe-HF evaluates the performance of individual centres, institutions and clinics against recognised standards of care that have been developed according to the HF Specialist Curriculum, the ESC Guidelines and appropriate publications.

If a centre meets or exceeds the standards, it will be accredited as an HFA Quality of Care Centre (QCC).

Improving Care through Accreditation and Recognition in Heart Failure (ICARe-HF) has been developed by the Heart Failure Association of the ESC.

Why should centres seek accreditation?

The process of accreditation is about raising standards, meaning centres will continue to get feedback to identify gaps in education and research and will receive recommendations on how to bridge these.

Once accredited, HFA Quality of Care Centres will benefit from:

  • Recognition of their quality of care at a European level
  • Improved information for referral sources and patients on the categorisation of the centre
  • Access to a network of HFA Accredited Centres in Europe

“ICARe-HF is creating a ‘gold standard’ in heart failure services across the HFA’s network of National Heart Failure Societies and Working Groups in Europe. It will give centres status, attract new talent and may also act as a lever to access tools such as NTproBNP that may not currently be available. It could also persuade commissioners to invest where needed to improve patient care.” Dr. Lisa Anderson, St. George's, University of London and St George's University Hospitals NHS Foundation Trust, London.

Who can enrol in ICARe-HF to become an HFA Quality of Care Centre?

All hospitals, clinics and care centres treating patients with heart failure can apply for accreditation through ICARe-HF.

HFA Quality of Care Centres (QCC) categories: Essential features

HFA QCC Cat Visual revised.png Download the table (pdf) 

There are three categories of HFA Quality of Care Centres:

Community Quality of Care Centres

Community centres include primary care institutions, resident cardiologists, and local (community-based) hospitals and rehabilitation centres. Their role is to provide initial assessment and treatment of patients presenting with heart failure in the community setting and to ensure the optimisation of therapy in chronic heart failure. 

Specialised Quality of Care Centres

Specialised centres manage patients referred from Community Quality of Care Centres and include district hospitals with intensive care units and cardiac catheterisation facilities. The availability of electrophysiology and device implantation is strongly recommended but not mandatory. Specialised centres provide further etiological diagnostic assessment and treatment, as well as acute/decompensated HF patients of intermediate complexity.

Advanced Quality of Care Centres

Advanced centres include national reference centres that provide inpatient care for advanced/severely decompensated heart failure patients and for heart transplant/mechanical circulatory support candidates and recipients.

A distinction will be made between:

Advanced centres - Type A et Type B - webpage.png

Who is involved in the application?

Key opinion leaders within the centre will likely be involved in the decision to enrol in ICARe-HF. The institution’s heart failure lead will complete the application.

National Heart Failure Societies will support each individual centre's application through a letter of support.

Applications will be reviewed by the ICARe-HF committee, comprising members of the HFA Board, National Heart Failure Societies and Working Groups, and the GRASP-HF Snapshot Study Task Force.

How do centres enrol in ICARe-HF?

Accreditation comprises two phases:

  1. Pre-accreditation: validation of the centre’s category according to structural criteria (type of patients, setting, accessibility, portfolio, equipment and staffing). There is no particular period for pre-accreditation, this is a continuous process that can be started at any time. 
  2. Validation of performance and application of the ESC Guidelines through data collected in the ESC snapshot registry - GRASP-HF.
Phase 1 – Pre-accreditation

Centres must complete the relevant pre-accreditation form for their centre, providing detailed information about the centre’s structure, including:

  • Service portfolio, facilities, and equipment
  • Human resources
  • Process measures
  • Performance measures

In addition, the centre must attach the following support documents to the pre-accreditation form:

  • Motivation letter – outlining why the centre is a good candidate for accreditation and any relevant details for the attention of the accreditation committee
  • Letter of support – written by the National Heart Failure Society or Working Group
  • Curricula vitae of medical personnel involved in heart failure care
  • An official document confirming that the QCC adheres to HFA/ESC accreditation requirements and that all information provided in the pre-accreditation form is accurate. This document must be signed by the QCC coordinator (the local HF expert within the centre/institution) and the QCC Director of the centre/institution. A template to be included on your hospital's letterhead is proposed.

Important: Before you begin your application

Ensure that you have all the relevant information to hand before starting your application. Once you have started the process, you will not be able to save your information and return to it at a later date. We recommend printing a copy of the form to collect relevant data before completing it online.

Once you have submitted your application, you will no longer be able to edit it.

Please find below the accreditation forms in pdf format: 

Community QCC   Specialised QCC   Advanced QCC

Please allow up to 1.5 hours to complete your form. There are multiple fields, but these are primarily yes/no options.

Apply for community QCC pre-accreditation Apply for specialised QCC pre-accreditation

Apply for advanced QCC pre-accreditation

Once you have completed the pre-accreditation step, the ICARe-HF Committee will review the application. You may be contacted for additional information as part of the review process, which will take up to two months.

Successful centres will then need to complete phase two by enrolling in GRASP-HF.

Centres that do not meet the criteria for pre-accreditation will receive feedback highlighting the gaps and recommendations to close these. Centres can reapply once this feedback has been implemented.

Phase 2 – Enrol in GRASP-HF

The ESC’s Global Registries And Surveys Programme (GRASP) Heart Failure Snapshot measures adherence to ESC Guidelines. Centres applying to ICARe-HF must enrol in GRASP-HF.

Through this study, the ICARe-HF accreditation committee will be able to ascertain the individual performance of each centre. Centres demonstrating adherence to guidelines will be eligible for HFA Quality of Care Accreditation.

GRASP-HF enrolment will open in 2024. More information on GRASP-HF. 

If your centre is already enrolled in GRASP-HF, you must still complete the pre-accreditation form and submit the required paperwork. Completing both ICARe-HF pre-accreditation and enrolling in GRASP-HF are required in order to be considered for HFA Quality of Care status.

Receiving accreditation

Centres will be informed of their accreditation status in writing by the ICARe-HF Committee.

Accredited centres will be officially announced and receive their plaque at the following annual congress of the Heart Failure Association.

An annual appraisal will be conducted by the HFA for centres to maintain their accreditation. 

Please contact the ICARe-HF team if you have any questions.

Who is involved in ICARe-HF?

ICARe-HF has been developed by the Heart Failure Association of the European Society of Cardiology in collaboration with National Heart Failure Societies and Working Groups.

National Heart Failure Societies and Working Groups are actively involved in the implementation of ICARe-HF. They are the first point of contact to help institutions in their country understand the role and value of ICARe-HF and how they can become accredited. They must also provide a letter of support for any centre in their country enrolling on ICARe-HF.

Meet the ICARe-HF Committee
Ovidiu Chioncel-Co-chair
Maurizio Volterrani-Co-chair
Marco Metra
Barnabas Gellen



Mariya Tokmakova
Antonio Bayes Genis
Offer Amir



Loreena Hill
Stefan Stoerk
Gianluigi Savarese


Application forms will be evaluated by an anonymous panel within the ICARe-HF Accreditation Committee on a rotating basis. If you have questions, please contact the team who will direct your question to the relevant member of the committee. 

ICARe-HF Quality of Care Centres

HFA is pleased to share the list of pre-accredited ICARe-HF Quality of Care Centres

For National Heart Failure Societies and Working Groups

If you are presenting ICARe-HF at your national and regional heart failure meetings and online forums, please feel free to use the elements of the following communication toolkit: