In this episode of The PJ Pod, we explore the main changes and implications for practice of the National Institute for Health and Care Excellence (NICE)’s chronic heart failure guidance update. On 3 September 2025, NICE released its updated guidance on ‘Chronic heart failure in adults: diagnosis and management’. The guidance mentions the role of pharmacy for the first time and has implications for an expanded role for primary care in managing heart failure. The guidance makes several recommendations, including on the use of combination treatment of the four main types of treatment: angiotensin-converting enzyme inhibitors (ACEIs), beta-blockers (BBs), mineralocorticoid receptor antagonists (MRAs) and sodium-glucose co-transporter-2s (SGLT2s) inhibitors — also known as the four pillars — in the early treatment of heart failure. In this episode of The PJ Pod, clinical editor Caitlin Killen talks to Paul Wright, consultant cardiovascular pharmacist at Barts Health NHS Trust, to learn more about the guidance and its implications for practice. This episode was produced by Geoff Marsh.