NHS community pharmacy hypertension case-finding advanced service

The NHS Community Pharmacy Hypertension Case-Finding Advanced Service supports risk identification and prevention of cardiovascular disease (CVD).

This service will:

  • identify people over the age of 40 who have previously not been diagnosed with hypertension (high blood pressure), and to refer those with suspected hypertension for appropriate management.
  • promote healthy behaviours to service users.
  • refer people identified as likely to have high blood pressure to general practice, for ongoing care to manage their blood pressure.

CVD and why it is important

Cardiovascular disease (CVD) is the second most common cause of premature death in England, after cancer, affecting seven million people. One in four premature deaths are caused by CVD, and 1.6 million disability adjusted life years can be attributed to it.

High blood pressure significantly increases the risk of having a heart attack or stroke, but early detection and treatment can help people live longer, healthier lives. The NHS Long Term Plan focuses on tackling health inequalities and the prevention of ill health and aims to prevent 150,000 strokes and heart attacks as a result of CVD, over the next ten years.

High blood pressure and CVD

The NHS service is based on published research, previous pilots and the NICE guidance for high blood pressure, which includes using ambulatory measurement to confirm a diagnosis of hypertension. It suggests that people aged over 40 years should be considered for treatment of hypertension if they have a confirmed high blood pressure reading following ambulatory monitoring and taking certain risk factors into account.

What the service will provide

A community pharmacist will opportunistically measure the blood pressure of consenting adults who come into the pharmacy, by offering anyone a free blood pressure check who:

  • appears to be over the age of 40;
  • has not previously been identified as having hypertension or a related condition; and
  • has not had their blood pressure measured by a health professional within the previous six months.

At the end of a consultation, where readings indicate:

  • normal blood pressure, the pharmacist will promote healthy behaviours.
  • high blood pressure, the pharmacist will offer Ambulatory Blood Pressure Monitoring (ABPM) from the pharmacy and will also promote healthy behaviours.
  • very high blood pressure, the pharmacist will urgently refer the patient to see their GP within 24 hours and the pharmacist will inform the patient’s GP practice by NHS mail or via another locally agreed platform.
  • low blood pressure, the pharmacist will provide appropriate advice and may also refer the patient to their GP if there are any concerns.

All blood pressure readings are sent to the general practice from the community pharmacy so records can be updated and appropriate action taken.

The service is accessible, appropriate and sensitive to the needs of all service users.

In addition

  • General practices can refer patients to a participating community pharmacy for a clinic blood pressure reading or for 24 hour ambulatory blood pressure monitoring.
  • There are no specific requirements set for referrals from general practice to allow contractors to work with general practices to agree a local process which will work for both parties. Different practices may require differ levels of support, so an open approach allows flexibility for contractors to support each practice as needed at a local level.

The service specification can be found here: Advanced service specification: NHS community pharmacy hypertension case-finding advanced service