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

This service will:

• identify people aged 40 years and over who have not previously been diagnosed with hypertension (high blood pressure), and refer those with suspected hypertension for appropriate management
• promote healthy behaviours among service users
• undertake clinic blood pressure measurements at the request of general practice for people aged 40 years and over who do not have a prior diagnosis of hypertension and have not had their blood pressure checked in the last 5 years
• undertake ambulatory blood pressure measurements for adults aged 40 years and over at the request of general practice and other healthcare professionals, such as optometrists and dentists.

CVD and why it is important

Cardiovascular disease (CVD) is one of the leading causes of premature death in England and accounts for 1.6 million disability-adjusted life years. Hypertension is the biggest risk factor for CVD and is one of the top five risk factors for all premature death and disability in England. An estimated 5.5 million people have undiagnosed hypertension across the country.

Cardiovascular disease prevention remains a high priority, with a renewed commitment to focus on community-led methods to tackle variation in the uptake of high-impact cardiovascular disease interventions in the 10 Year Health Plan for England.

High blood pressure and CVD

The NHS service is based on published research, previous pilots and the National Institute for Health and Care Excellence (NICE) guideline NG136 on high blood pressure, which includes the use of ambulatory blood pressure monitoring (ABPM) to confirm a diagnosis of hypertension. It suggests that people aged 40 years and over should be considered for treatment of hypertension if they have a confirmed high blood pressure reading following ambulatory monitoring and after certain risk factors have been taken 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 a free blood pressure check to anyone who:

• is aged 40 years and over
• does not have a current diagnosis of hypertension
• has not had their blood pressure measured by a health professional in the last 5 years.

By exception, some people aged under 40 years who have a family history of hypertension, or who are at increased risk of developing hypertension (for example, people from South Asian and African-Caribbean communities), may be eligible for this service.

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 ABPM and will also promote healthy behaviours
• very high blood pressure, the pharmacist will urgently refer the person to see their GP within 24 hours and will inform the patient’s GP practice via NHSmail or another locally agreed platform
• low blood pressure, the pharmacist will provide appropriate advice and may also refer the person to their GP if there are any concerns.

All blood pressure readings are sent from the community pharmacy to the patient’s GP practice so that records can be updated and appropriate action taken.

In addition:

• general practices can refer patients to a participating community pharmacy for a clinic blood pressure reading if they have not had a check in the last 5 years, or for 24-hour ambulatory blood pressure monitoring
• there are no specific requirements for how referrals are made from general practice, but arrangements should be agreed locally to enable patients to choose their preferred pharmacy.

The pharmacy service specification can be found here: NHS Community Pharmacy Hypertension Case-Finding Advanced Service.

Watch this video to find out more about the service:

Further information

To find a pharmacy service see the NHS.uk website: Find a pharmacy that offers free blood pressure checks – NHS