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NHS Community Pharmacy Hypertension Case-Finding Advanced Service

The NHS Community Pharmacy Hypertension Case-Finding Advanced Service was announced on 24 August 2021 as part of the Year 3 Community Pharmacy Contractual Framework and is due to start on 1st October 2021.

The pilot for this service (only from the 35 community pharmacies in specified PCN localities) has now ended.

Aims of the service

The aims and objectives of this service are to:

  • identify people aged 40 years or older with high blood pressure, who have previously not had a confirmed diagnosis of hypertension, and to refer them to general practice to confirm diagnosis and for appropriate management (this can include people under 40 years, at the discretion of a pharmacist)
  • undertake clinic and ambulatory blood pressure checks when necessary, at the request of a general practice
  • promote healthy behaviours to service users

What the service will provide

The agreement is for a pharmacist to measure the blood pressure of adults. 

At the end of a patient 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
  • low blood pressure - the pharmacist will provide appropriate advice

Service specification

The NHS Community Pharmacy Hypertension Case-Finding Advanced Service Specification (Word: 313KB) is to be used from 1 October 2021. (Currently progressing through the NHS England and Improvement publishing process).

Equipment

When purchasing the necessary equipment for this service, the pharmacy must use equipment that is validated by the British and Irish Hypertension Society (as recommended by NICE) with reference to:

validated BP monitors for home/clinic usevalidated BP monitors for specialist use

Contractors may also refer to the Medicines and Healthcare products Regulatory Agency guidance (PDF: 380KB) on the purchase, management and use of blood pressure measurement devices when selecting equipment for this service.

Devices using a mercury sphygmomanometer are no longer available for purchase in the UK. Consideration should be given to the selection of mercury free products.

Considerations for clinic use

  • Whether maintenance and training is included in purchase price.
  • Whether the supplier provides spare parts whilst it is being repaired, if broken.
  • Calibration vs. replacement cost and carbon footprint.
  • Frequency and cost of cuff replacement as well as other consumables.
  • Complexity and time taken to use.
  • The fact that it automatically takes 3 measurements.
  • Flags irregular pulse (optional).
  • Availability of bulk purchase savings where applicable.

Considerations for ambulatory use

  • Whether maintenance and training is included in purchase price.
  • Whether the supplier provides spare parts whilst it is being repaired, if broken.
  • Calibration vs. replacement cost and carbon footprint.
  • Frequency and cost of cuff replacement as well as other consumables.
  • Complexity, time taken to use and explanation on how to use.
  • Availability of bulk purchase savings where applicable.

Pharmacists using the equipment should be aware that:

  • ABPMs must be reset for each service user
  • validation, maintenance and recalibration of both clinic blood pressure monitors and ABPM devices should be carried out periodically according to manufacturers’ instructions
  • infection control measures and cleaning must be carried out, as per the instructions of the manufacturer or supplier, and in line with current infection control guidance

Pharmacists providing the service must:

Pharmacists must complete training on how to use the blood pressure monitoring equipment, which should be provided by their equipment manufacturer. Training can be delivered either in e-learning format or face-to-face.