Cardiovascular disease is recognised as a silent killer, with 4.8 million people living in the UK undiagnosed. The condition is highly manageable with medication. Looking for a way to combat this lack of awareness, NHSEI wanted to test a new model of care. Community pharmacists would provide free blood pressure checks for those over 40. People with hypertension would then be referred to their GP for management.
SCW supported the pilot programme developing the model of hypertension case finding and delivery documentation and supporting the pharmacy teams with the pilot. Outcomes from the pilot, which started in early 2021, have led NHSE to announce that from October 2021 everyone over the age of 40 will be able to have their blood pressure checked at their local pharmacy for free.
Hypertension or cardiovascular disease (CVD) is seen as a silent killer. Often presenting no symptoms, people only realise there is a problem when they get their blood pressure measured by a health professional. With 4.8m people in the UK living with undiagnosed hypertension, NHS England estimated that 3,700 strokes and 2,500 heart attacks could be prevented within five years if more people received blood pressure tests.
With GP practices extremely busy, and restrictions due to COVID-19, NHSEI needed to find new and easier ways for people to get their blood pressure checked. Community pharmacists were an obvious choice to deliver this service with their professional experience.
NHSEI commissioned a programme to test a new model of care for risk identification and prevention of cardiovascular disease (CVD) using community pharmacies to deliver blood pressure checks. There are 35 pilot sites across Birmingham and the Black Country, the Darlington area, Derbyshire, and London. The outputs from the community pharmacy hypertension case finding pilot will be included in Community Pharmacy Contractual Framework (CPCF) and the Primary Care Network (PCN) contracts.
NHSEI needed a partner to manage the programme and came to SCW to develop the documentation to enable the testing of the community pharmacy service model.
The model needed to be able to identify people over the age of 40, or at the discretion of the pharmacy, people under the age of 40, with high blood pressure who had previously not had a confirmed diagnosis of hypertension or a related condition. It then needed to be able to refer them to general practice to confirm diagnosis and for appropriate management.
What we delivered together
SCW collaborated with the Pharmacy Integration Fund (PhIF) Clinical Reference Group (CRG) and the PhIF Decision Making Authority in developing the model of hypertension case finding and supporting documentation. To ensure clinical efficacy it was based on NICE guidance, the advice of the NHSE&I CVD Task & Finish Group, and evidence from previous pilots.
To give the best chance of success, SCW developed a toolkit for the pharmacy teams which included a user guide and a how-to video. We also worked collaboratively to develop an Excel-based data collection tool that was easy to use in pharmacies.
The final version of the specification for the pilot was launched in early 2021. Given the continuing pandemic conditions at the time it included an element of Covid-recovery support. This was where GP Practices in the area of the pilots were offered the opportunity to refer or direct patients in need of routine blood pressure monitoring for long-term conditions, or similar, to a pharmacy involved in the pilot to help to tackle any backlog.
We are currently supporting pharmacy teams within the pilot to understand any barriers to providing the service or reporting the outcomes.
Outcomes from the pilot, which has been extended to the end of September 2021, have been so positive that NHSE will launch the scheme nationally in October 2021. Everyone over the age of 40 will be able to have their blood pressure checked at their local pharmacy for free.
Cardiovascular disease claims 136,000 lives a year and is a major cause of health inequalities with about half of heart attacks and strokes are associated with high blood pressure. The detection and control of high blood pressure is one of the best things we can do to save lives and reduce health inequalities. Community pharmacists are ideally placed to deliver this life saving work and I am delighted they are now offering blood pressure checks. - Dr Shahed Ahmad, National Clinical Director for Cardiovascular Disease Prevention