What the service will provide
A community pharmacy will opportunistically measure the blood pressure of consenting adults who come into the pharmacy needing this service.
For the service to be a success, potential patients who meet the opportunistic inclusion criteria should be proactively identified.
The inclusion criteria for opportunistic blood pressure checks are as follows:
• Adults who are 40 years old or over, who do not have a current diagnosis of hypertension.
• Patients, by exception, under the age of 40 who request the service because they have a recognised family history of hypertension may be provided the service at the discretion of pharmacy staff.
• Patients between 35 and 39 years old who are approached about or request the service may be tested at the discretion of the pharmacy staff. The inclusion criteria for patients referred from the GP are as follows:
• Adults, of any age, with or without a prior diagnosis of hypertension, specified by a general practice for the measurement of blood pressure (clinic and ambulatory blood pressure checks).
This process should be agreed locally with general practices
The NHS Community Pharmacy Blood Pressure Check 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.
- undertake ad hoc clinic and ambulatory blood pressure measurements at the request of general practice.
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.
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.