Hypertension case-finding

Currently in England, most community pharmacies have signed up to the Hypertension Case-Finding advanced service. Initially, this had to be delivered by a pharmacist, but from December 2023, the scope was expanded to allow delivery by suitably trained and competent pharmacy staff in order to utilise the skills of the wider team.

Under the terms of the service, opportunistic blood pressure checks may be offered to identify people with high blood pressure. It targets those aged 40 years or older at risk of hypertension, who have previously not had a confirmed diagnosis (and at the discretion of pharmacy staff, people under the age of 40). The next step depends on the clinic readings:

• Normal blood pressure (90/60mmHg – 139/89mmHg): promote healthy behaviours
• High blood pressure (140/90mmHg – 179-119mmHg): offer ambulatory blood pressure monitoring (ABPM) from the pharmacy and promote healthy behaviours
• Very high blood pressure (greater than 180/120mmHg): refer for same day appointment with GP (or other locally agreed urgent care). Refer to A&E if acute symptoms
• Low blood pressure (less than 90/60mmHg): provide appropriate advice.

Additionally, patients may be referred to the pharmacy for a blood pressure check by their GP practice. All results should be reported to the GP practice to be recorded in the patient medical record. The GP practice is responsible for further evaluation of people referred for same day and urgent referral as well as anyone diagnosed with hypertension.

Scotland, Wales and Northern Ireland have previously run pilot projects looking at blood pressure monitoring in community pharmacy, but currently there are no nationally commissioned services.