Hypertension Case-Finding Service
Published on: 23rd August 2021 | Updated on: 5th July 2024
This page contains information about the Hypertension Case-Finding Service which was commissioned as an Advanced service from 1st October 2021.
In public-facing communications, the service is described as the NHS Blood Pressure Check Service.
From 1st December 2023, the service can be provided by suitably trained and competent pharmacy staff; previously, only pharmacists and pharmacy technicians could provide the service.
Where non-registered pharmacy staff provide the service, until clinical IT systems are updated to allow their names to be entered within the clinical record, the name and GPhC registration number of the responsible pharmacist should be included in the clinical record.
Click on a heading below for more information
The 5-year Community Pharmacy Contractual Framework (CPCF) agreement reached in July 2019 included a plan to pilot case-finding for undiagnosed cardiovascular disease.
In 2020, NHS England commenced a pilot involving pharmacies offering blood pressure checks to people 40 years and over. In some pharmacies within the pilot, where the patient’s initial blood pressure reading was elevated, they would be offered ambulatory blood pressure monitoring (ABPM), which is the gold-standard for diagnosis of hypertension.
Following the initial findings of the pilot, the Department of Health and Social Care (DHSC) and NHS England proposed the commissioning of a new Hypertension Case-Finding Service, as an Advanced service, in the Year 3 negotiations.
The policy background
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.
CVD is a key driver of health inequalities, accounting for around 25% of the life expectancy gap (27% in men and 24% in women) between rich and poor populations in England. Those in the most deprived 10% of the population are almost twice as likely to die as a result of CVD than those in the least deprived 10% of the population. Additionally, 60% of excess mortality for those living with severe mental illness can be attributed to preventable physical health conditions, such as heart disease.
Residents of the most deprived areas in England are 30% more likely to have high blood pressure (BP) compared to those in the least deprived areas. Community pharmacy BP monitoring has the potential to increase the detection of hypertension within local populations and is expected to positively impact health inequalities by targeting people who do not routinely see their GP or use other NHS services.
The NHS Long Term Plan commits the NHS to reducing morbidity and mortality due to CVD, tackling inequalities and a shift towards prevention strategies. It specifically states that community pharmacy, in collaboration with other providers, will provide opportunities for the public to check on their health through tests for high BP and other high-risk conditions.
In February 2019, as part of the Cardiovascular Disease Prevention System Leadership Forum, NHS England published new national ambitions for the detection and management of the high-risk conditions. The ambition for hypertension is that 80% of the expected number of people with high BP are detected by 2029, and that 80% of the population diagnosed with hypertension are treated to target. At the time of publication of the NHS Long Term Plan, NHS England and Public Health England estimated less than 60% of people with hypertension had been diagnosed.
The aims of the service
The service aims to:
- Identify people aged 40 years or older, or at the discretion of pharmacy staff, people under the age of 40, 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;
- At the request of a general practice, undertake ad hoc clinic and ambulatory blood pressure measurements. These requests can be in relation to people either with or without a diagnosis of hypertension; and
- Provide another opportunity to promote healthy behaviours to patients.
The service requirements are included in the service specification, which pharmacy owners must read before deciding whether to provide the service.
Download the service specification
Service specification Annex A – Blood pressure check process flowchart
Service specification Annex B – Guidance on clinic blood pressure check
Service specification Annex C – Clinic BP flowchart
Service specification Annex D – ABPM flowchart
Service Directions & Determination (published September 2021)
Briefing 035/23: Updated guidance on the Hypertension Case-Finding (22nd November 2023)
This Community Pharmacy England Briefing provides additional guidance for pharmacy owners and their teams on the service.
The service has two stages – the first is identifying people at risk of hypertension and offering them a blood pressure measurement (a ‘clinic check’).
The second stage, where clinically indicated, is offering ambulatory blood pressure monitoring (ABPM). The blood pressure test results will then be shared with the patient’s GP practice to inform a potential diagnosis of hypertension.
Pharmacy owners opting to provide the service must undertake both stages of it, where clinically required, i.e. it is not possible to just undertake clinic BP readings and not ABPM.
The service should be provided by suitably trained and competent pharmacy staff. The Responsible Pharmacist must ensure that delegated tasks are being undertaken safely by competent pharmacy staff.
The pharmacy owner must ensure all pharmacy staff providing the service are appropriately trained and that clinical supervision for the service is being provided by the pharmacist.
BP meters to be used in the service
As part of preparations to provide the service, pharmacy owners will need to purchase or rent equipment for each of the two stages of the service – Clinic blood pressure check and ABPM – unless they already have equipment which meets the required standards.
Equipment that is to be used in the service must be validated by the British and Irish Hypertension Society (BIHS), so pharmacy owners must use a ‘normal’ BP meter and an ABPM which are included on one of the two following BIHS lists:
Validated BP Monitors for Home Use
Validated BP Monitors for Specialist Use
Points to note:
- ABPMs must be reset for each service user;
- To meet the service specification requirements, validation, maintenance and recalibration of both clinic blood pressure monitors and ABPM devices should be carried out periodically according to manufacturers’ instructions; and
- 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.
Considerations before purchasing/renting equipment
Pharmacy owners may find it useful to refer to the Medicines and Healthcare products Regulatory Agency guidance on the purchase, management and use of blood pressure measurement devices and the Point of care testing in community pharmacies guide when selecting equipment for this service.
Before a decision is made about the purchase or rental of equipment, there are several considerations pharmacy owners may need to think through to ensure they have weighed up the additional requirements, implications and costs associated with provision of the service when using their selected equipment.
A non-exhaustive list of some of the considerations can be found below:
- Is maintenance and training included in the purchase price?
- If equipment is broken or being calibrated, does the supplier provide a spare whilst it is being repaired/calibrated?
- Calibration versus replacement cost and the carbon footprint of both activities;
- Frequency/cost of cuff replacement and other consumables;
- Complexity of use – time taken to use (and explain use, in the case of ABPM);
- For clinic meters, do they automatically take 3 measurements and flag irregular pulse (this feature is very beneficial, but optional)?
- For ABPM, the usability of any inclusive software to support set up for the patient and interpretation of readings. Additionally, software and hardware compatibility with existing pharmacy IT systems needs to be considered, e.g. can you plug the meter into a USB port on a PC in the pharmacy; and
- Insurance to cover accidental damage to either type of meter and to cover the theft or failure of a patient to return ABPM.
Training requirements
To provide the service, pharmacy staff must:
- Be familiar with parts of NICE guideline Hypertension in adults: diagnosis and management [NG136] relevant to the role they are undertaking within the service;
- Have read and understood the operational processes to provide the service as described in the service specification; and
- Have completed the recommended training on how to use the blood pressure monitoring equipment which should be provided by the equipment manufacturer/supplier.
A checklist to provide suggested actions that pharmacy staff can undertake to prepare to provide the service is available.
Download the Hypertension Case-Finding Service staff training checklist (April 2024)
Additional optional training
Pharmacy staff wanting to undertake further training on hypertension, understanding vascular risk and behaviour change interventions can do so on an optional basis to support their own continuing professional development (CPD).
Support with additional CPD can be found on the:
- CPPE hypertension case-finding service page
- Pharmacy courses page of the Health Academy website.
Pharmacy team training
The whole pharmacy team can proactively promote this service and support with the recruitment of patients. Teams should be briefed on the service and coached on how to best approach people about the service. A pharmacy team briefing and a guide on how to recruit patients is available to assist pharmacy owners to engage and coach their team members.
Download the Community Pharmacy England Briefing for pharmacy teams on the service (22nd November 2023)
Consultation room
Pharmacies must have a consultation room that will be used for the provision of the service which meets the requirements in the Terms of Service. The consultation room should also comply with the following requirements:
- When measuring blood pressure, the patient must be able to rest their arm on a table/bench at a suitable height; and
- It must have IT equipment accessible within the consultation room to allow contemporaneous records of the consultations provided as part of this service to be made.
Provision other than in the pharmacy consultation room
In agreement with the local NHS contract management team, potential patients may be targeted and the service could be provided in other settings outside the pharmacy such as areas not designated part of the pharmacy within supermarkets or large stores or in community locations such as community centres, sports grounds and places of worship.
Provision other than in the pharmacy, can be considered for occasional approval, and should not be sought for the same site being used frequently for delivery of the service in a manner that may undermine the National Health Service (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 (PLPS) by setting up locations where pharmaceutical services are offered that are not pharmacies.
Off-site provision could therefore, support pharmacy owners with occasional provision, as part of approaches to support external provision of health promotion in communities in line with Health Living Pharmacy requirements.
Details for the principles that the local NHS contract management team decision-makers may consider, are outlined in guidance, which can be accessed via the below link. The guidance also provides a template that pharmacy owners will need to use to make a request for offsite provision to their local NHS contract management team.
Key Documents – NHS England Pharmacy Integration Programme – FutureNHS Collaboration Platform (Log-in required)
Requests for off-site provision should be submitted to your local NHS contract management team. Contact details for your local NHS contract management team can be found here.
Where the service is provided from premises other than the registered pharmacy premises, pharmacy owners must ensure the location is appropriate for service provision (i.e. meets standards required by the General Pharmaceutical Council and that patient confidentiality can be maintained). It is recommended that a risk assessment is also undertaken to identify and minimise risks to patient safety and impact on wider pharmacy services.
Provision from premises other than the registered pharmacy premises must be under the supervision of a pharmacist who is available to provide clinical advice where required.
Sign up to provide the service
Pharmacy owners must notify NHS England that they intend to provide the service by completion of an electronic registration through the NHS Business Services Authority’s (NHSBSA) Manage Your Service (MYS) application.
Standard Operating Procedure
Pharmacy owners must have a Standard Operating Procedure (SOP) for the service, which all staff participating in provision of the service must be familiar with and follow. SOPs must include the process for maintenance and validation of the equipment used.
Various pharmacy support organisations provide template SOPs which their members can personalise for use in their pharmacy.
Following changes to the service specification, pharmacy owners are advised to review any existing SOPs for the service, to ensure any relevant changes to these SOPs have been made. When developing or updating the SOP, pharmacy owners will need to decide the role of different staff types within the provision of the service, including how the pharmacist will be involved, including providing clinical supervision of the service.
Select an IT system
Pharmacy owners must use an NHS-assured clinical IT system to make their clinical records and payment claims for the service.
These IT systems allow pharmacy staff to make a clinical record for the service and the data in the record will then be used by the IT system to populate a claim for payment within the NHSBSA’s MYS platform.
The transfer of data via the API will happen throughout the month, as data is entered into the IT systems. The service provisions will then be available to view in MYS from the 1st of the following month. For example, service provisions in December will be available to view in MYS on 1st January. Pharmacy owners will then need to log into the MYS platform to check that the data matches the details in their IT system, and they will then need to submit their claim for payment.
The full dataset for the Hypertension Case-Finding Advanced service can be found in Annex F of the service specification.
The NHS approved clinical IT system will also send messages containing the patient’s results to their general practice.
The following four IT suppliers have developed their systems to include functionality to support the service, but over time, it is hoped other suppliers will add the service to their systems:
| System and supplier |
| HxConsult (Positive Solutions) |
| Pharmacy Manager (Cegedim) |
| PharmOutcomes (Pinnacle Health) |
| Sonar health (Sonar informatics) |
Pharmacy owners providing the service will need to consider which system they want to use and will then need to enter into a contract with that supplier.
Read more about the IT requirements for all CPCF clinical services
Engagement with local GP practices and/or PCN colleagues
Prior to provision of the service, pharmacy owners must engage with local general practices and/or PCN colleagues to make them aware the pharmacy is participating in this service.
Practices may want to refer patients to the pharmacy for blood pressure checks (clinic blood pressure checks or ABPM). Where practices wish to use this facility, pharmacy owners should agree a local process with the practice by which this will work. There are no specific requirements set for this process and it could involve the practice agreeing that a specific list of patients can access the service or a cohort of patients could be specified.
A letter / email template to support pharmacy owners to notify GP practices that the pharmacy will be providing the service is available.
Download the GP letter/email service notification template (Microsoft Word) (22nd November 2023)
A briefing to provide information for general practice teams on the Hypertension Case-Finding Service is available to assist pharmacy owners to engage their local general practice colleagues.
Download the Community Pharmacy England Briefing for general practice teams (22nd November 2023)
Pharmacy owner checklist
Once a pharmacy owner has decided they wish to provide the service, our implementation checklist will guide them through the steps they need to take to prepare to provide the service.
Download the pharmacy owner implementation checklist (22nd November 2023)
Following the publication of the latest service specification, pharmacy owners who are already providing the service can use our existing provider checklist to guide them through the steps they need to take to continue to provide the service.
Download the pharmacy owner checklist (existing providers) (22nd November 2023)
Withdrawal from the service
If the pharmacy owner wishes to stop providing the Hypertension Case-Finding Service, they must notify NHS England that they are no longer going to provide the service via the MYS platform, giving at least one months’ notice prior to the cessation of the service. The pharmacy owner may be asked for their reason for withdrawal from the service.
Patient eligibility to receive the service
The service specification lists the following inclusion and exclusion criteria for the service:
Inclusion criteria
- 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 pharmacy staff’s discretion;
- Patients between 35 and 39 years old who are approached about or request the service may be tested at the pharmacy staff’s discretion; and
- Adults, 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.
Exclusion criteria
- People under the age of 40 years old, unless at the discretion of the pharmacy staff or unless they have been specified by a general practice for the measurement of blood pressure; and
- People who have their blood pressure regularly monitored by a healthcare professional, unless the general practice requests the service is provided for the patient. Requests should be sent via a process which is agreed locally with general practices;
- People who require daily blood pressure monitoring for any period of time e.g. 7 day clinic checks as an alternative to ABPM; and
- People with a diagnosis of atrial fibrillation or history of irregular heartbeat.
General practice referrals
If practices want to refer patients who have already been diagnosed with hypertension for blood pressure checks, then pharmacy owners should work with their practices to agree a local process by which this will work; there are no specific requirements set for this process and it could involve the practice agreeing that a specific list of patients can access the service or a cohort of patients could be specified.
General practices will also be able to refer patients requiring ABPM; in this scenario it is recommended that this referral is made electronically to the pharmacy.
Download a GP practice referral template (Microsoft Word) (22nd November 2023)
Download a GP practice referral template (22nd November 2023)
Pharmacy blood pressure service finder tool
The service finder on the NHS website lets patients and healthcare professionals search for a pharmacy that provides blood pressure checks as part of the Hypertension Case-Finding Service. The tool also provides information on who is eligible for the service.
The blood pressure service finder
Promoting the service
Pharmacy owners who will be providing the service can use a poster and, where facilities exist, digital marketing resources to advertise the availability of the service in the pharmacy.
Download poster 1 (May 2024)
Download poster 2 (May 2024)
Download poster 3 (May 2024)
Download poster 4 (May 2024)
Download poster 5 (May 2024)
Download poster 6 (May 2024)
Download poster 7 (May 2024)
Download the digital marketing resources
Download social media card 1 (May 2024)
Download social media card 2 (May 2024)
Download social media card 3 (May 2024)
Download social media card 4 (May 2024)
Download social media card 5 (May 2024)
Download social media card 6 (May 2024)
Download social media card 7 (May 2024)
Download tweet templates (May 2024)
Small flyers to use on prescription bags etc. (Microsoft Word) (22nd November 2023)
Template patient leaflet to promote the service (Microsoft Word) (22nd November 2023)
Patient leaflet to promote the service (22nd November 2023)
A checklist providing suggested actions that pharmacy owners can review to maximise promotion of the service is available.
Promoting the service checklist May 2024 (May 2024)
A patient recruitment guide containing tips on how to successfully recruit patients using some of the insights from pilot sites is available as part of the briefing for pharmacy teams on the service.
Download the Community Pharmacy England Briefing for pharmacy teams on the service (22nd November 2023)
DHSC publicity campaign
DHSC launched a campaign to promote the Hypertension Case-Finding Service in March 2024.
A TV, social media, public relations and billboard campaign encourages those aged 40 years and over, to get a free blood pressure check at the nearest participating pharmacy. The public are being encouraged to search for participating pharmacies via the NHS Check your blood pressure tool.
Pharmacy owners providing the service, can order a free pharmacy campaign pack from the Campaign Resource Centre to promote and support the campaign. The campaign resource centre also has other resources available to support hypertension awareness as part of ‘help us help you’.
Read our news story for further information
Patient advice
To further promote the service and support the provision of healthy lifestyle advice, pharmacy owners may consider the use of the Department of Health and Social Care (DHSC) and other patient support or charity organisations such as the British Heart Foundation to source educational materials to promote healthy behaviours, signpost to other services, and improve understanding about blood pressure.
To download or order resources including leaflets, posters, guides and resource packs for campaigns from the DHSC campaigns web pages the pharmacy will need to register on the DHSC Campaign Resource Centre website.
Below are links to some examples resources which may be appropriate to the healthy lifestyle advice offered as part of this service:
Consent
Prior to provision of the service, verbal consent must be sought from the patient by the pharmacy staff and recorded in the pharmacy’s clinical record for the service. Pharmacy owners also need to ensure that the patient is made aware that the following sharing of information will take place:
- The sharing of information between the pharmacy and the patient’s general practice to allow the recording of the blood pressure reading in their GP practice record;
- The sharing of information about the service with NHS England as part of service monitoring and evaluation; and
- The sharing of information about the service with NHSBSA and NHS England as part of post-payment verification.
The General Pharmaceutical Council’s Guidance on Consent provides information on consent for pharmacy staff.
Clinic blood pressure check
The first stage of the service is the provision of a normal blood pressure check (clinic check) in line with NICE guidelines.
A visual guide that can be used to support pharmacy staff providing this stage of the service is available below.
Download the clinic blood pressure guide (PDF)
A high systolic and normal diastolic reading OR a high diastolic and normal systolic reading should be recorded as a high blood pressure reading. Appropriate action should be taken if either the systolic or the diastolic measurement or both fall outside the normal range.
Where pharmacy staff, other than the pharmacist, have provided the service, the Responsible Pharmacist should be made aware of any patients exhibiting physical symptoms before the patient leaves the pharmacy.
ABPM provision
Where a patient is identified as having high blood pressure (140/90mmHg or higher, but lower than 180/120mmHg) prompt provision of ABPM will be dependent on the availability of an ABPM device. Should the patient decline ABPM through the pharmacy, they should be referred to their general practice or another appropriate local pathway.
A leaflet that can be used to provide patients, relatives or carers with information about ABPM and what is involved is available.
ABPM patient leaflet template (Microsoft Word) (22nd November 2023)
ABPM patient leaflet template (22nd November 2023)
When providing ABPM, pharmacy owners may wish to ask the patient to complete an equipment loan agreement.
Download a template ABPM loan agreement form (Microsoft Word) (22nd November 2023)
During a consultation to fit an ABPM device and in line with the device’s instructions and the training provided:
- Reset the ABPM;
- Fit the ABPM to the patient;
- Explain the functioning of the ABPM device to the patient;
- Confirm that the patient understands that they need to stop any activity and rest when the cuff starts to inflate, and that the ABPM is set to take measurements every 30 minutes during waking hours (for example between 8am and 10pm) A minimum of 14 readings are needed during the person’s usual waking hours to provide an accurate average reading;
- Explain they must not get the ABPM wet therefore, baths and showers should be avoided during the monitoring period; and
- Arrange a follow up appointment to discuss the readings and return the equipment.
The use of 14 readings means the latest time for an appointment to see a patient and fit an ABPM would be 2pm if monitoring is stopping at 10pm.
Should a patient fail to attend a scheduled pharmacy appointment to be fitted with an ABPM device, the pharmacy team should make at least two attempts, on separate occasions, to contact the patient to rearrange the appointment. In the event of a failure to attend, the patient’s GP practice should be provided with the initial clinic blood pressure measurement and notified that the patient failed to attend to be fitted with the ABPM device.
Return of ABPM devices
When the patient attends the ABPM follow up appointment:
- Retrieve the patient’s consultation data from the ABPM device in accordance with the manufacturer’s instructions;
- Record the average daytime blood pressure readings in the consultation record; and
- Based on the average daytime reading, the pharmacy staff should follow the relevant guidance in the service specification on the next steps for the patient. All readings (systolic and diastolic for daytime) and the full ABPM report should be shared with the patient’s general practice.
Where pharmacy staff, other than the pharmacist, have provided the service, the Responsible Pharmacist should be made aware of any patients exhibiting physical symptoms before the patient leaves the pharmacy.
Failure to attend after ABPM for discussion of readings and equipment return
Where a patient fails to attend a scheduled follow up appointment, the pharmacy team should make attempts to contact the patient to rearrange the appointment and return the equipment. If despite the pharmacy team making several attempts on separate occasions to contact the patient, the patient does not return to receive their ABPM results within five working days, the pharmacy staff should:
- contact the patient’s registered general practice, to provide the initial clinic blood pressure result and notify the practice of the service user’s failure to attend following ABPM; and
- Suspend provision of the Hypertension Case-Finding Service until the ABPM meter is retrieved or a replacement device is available.
Information for patients and referrals
Blood pressure readings
Blood pressure readings should be discussed with the patient and the appropriate next steps as detailed in the service specification (Annex G) should be completed. Results should be provided to the patient in a format that best suits the patient. The patient may prefer to have their readings written on a printed leaflet, it may be completed electronically by the pharmacy staff and emailed to the patient or the patient may prefer to take a photo of their readings using their phone.
Download a patient leaflet to support provision of readings (Microsoft Word)
Download a patient leaflet to support provision of readings (PDF)
Healthy lifestyle advice
In line with the principle of Making Every Contact Count, pharmacy staff should encourage the patient to discuss their lifestyle/behaviours and appropriate lifestyle advice should be provided where applicable. Local initiative and services that may assist the patient should be signposted.
Example resources which may be appropriate to support the patient or raise awareness are detailed in the above patient advice section.
Pharmacy owners should record any advice provided and any signposting in the clinical record. Where a patient is not registered with a GP practice, information should be provided to assist the patient to do this.
Communicating with GP practices
Pharmacy owners must ensure that a notification of the provision of the service is sent to the patient’s general practice on the day of provision or on the following working day. Where possible, this should be sent as a structured message in real-time via the NHS assured IT system. In the absence of an automated digital solution or if there is a temporary problem with the system, this should be sent via NHSmail or hard copy.
Details of when to make a referral based on the blood pressure monitoring outcome are detailed in the service specification.
Details of the required information to be sent to the patient’s general practice based on the blood pressure reading are outlined in Annex E of the service specification.
Record keeping and data management
Pharmacy owners must use an NHS approved clinical IT system to make their clinical records and payment claims for the service and to send messages containing the patient’s results to their general practice. The transfer of data to the MYS platform is via an API (Application Programming Interface) to automate payment claims and reporting of the data to the NHSBSA.
The transfer of data via the API will happen throughout the month, as data is entered into the IT systems. The service provisions will then be available to view in MYS from the 1st of the following month. For example, service provisions in December will be available to view in MYS on 1st January.
The information to be submitted via the API can be found in an Annex of the service specification. When submitted to the NHSBSA, this data will be used for post-payment verification and it will also be shared with NHS England to support evaluation of the service.
Clinical records of service provisions should be retained for an appropriate period, but for the purposes of post-payment verification, reimbursement records must be kept for a period of three years after the service takes place to demonstrate service delivery in accordance with the service specification. As pharmacy owners are the data controller, it is for each pharmacy owner to determine what the appropriate length of time is, beyond three years that the clinical records are kept for. Decisions on this matter should be documented in the SOP and should be in line with Records Management Code of Practice for Health and Social Care.
Working with Primary Care Networks
The Advanced service supports the work that general practices and wider Primary Care Network (PCN) teams are undertaking on CVD prevention and management, under the PCN Directed Enhanced Service which commenced on 1st October 2021.
From that date, PCNs must improve diagnosis of patients with hypertension, in line with NICE guideline NG136, by ensuring appropriate follow-up activity is undertaken to confirm or exclude a hypertension diagnosis where a blood pressure of ≥140/90mmHg in a GP practice, or ≥135/85mmHg in a community setting, is recorded.
As part of this, PCNs must work pro-actively with community pharmacies to improve access to blood pressure checks, via the hypertension case finding service.
Best practice guidance for 2023/24 on the Network Contract Directed Enhanced Service for CVD prevention and diagnosis can be found on the NHS England website.
Service Data available on the SHAPE website
Data on community pharmacies providing the service is available on the SHAPE Place Atlas tool.
Strategic Health Asset Planning and Evaluation (SHAPE) is a web enabled, evidence-based application that informs and supports the strategic planning of services and assets across a whole health economy.
The service data on SHAPE, which is aligned to the Index of Multiple Deprivation profiles, includes the number of patients seen monthly, the monthly change and the cumulative number of patients seen since the launch of the Advanced service in October 2021.
Local Pharmaceutical Committees, commissioners, pharmacy owners, general practice and public health professionals and their teams can use the data to work together to target the populations most at risk of CVD morbidity and mortality, to design and implement services to help identify more people with undiagnosed hypertension and reduce health inequalities.
Access to the SHAPE Place Atlas tool is free to NHS professionals and Local Authority professionals with a role in Public Health or Social Care. Access to the application is by formal registration and licence agreement. Pharmacy owners will need to use their personal NHSmail address to register to use the tool.
Where a non-public sector email address is used to register for access, then a senior public sector manager will be required as a sponsor in order to gain access to SHAPE.
Complete the user registration form
Signposting patients
The blood pressure service finder on the NHS website lets patients and healthcare professionals search for a pharmacy that provides blood pressure checks as part of the Hypertension Case-Finding Service.
The blood pressure service finder
Business continuity – service provision during IT issues
Should a pharmacy owner’s chosen NHS approved clinical IT system fail the following forms may be used to maintain provision of the service. Where the clinical IT system is unavailable due to exceptional circumstances beyond the control of the pharmacy owner, then the record of service provision must be added to the clinical IT system as soon as possible after the clinical IT system becomes available again.
Download a template clinical record form(Microsoft Word) (22nd November 2023)
Download a template clinical record form (PDF) (22nd November 2023)
Download a weekly summary template (Microsoft Excel)
Download a weekly summary template (OpenDocument)
Download an urgent, same day referral letter/email template(Microsoft Word) (22nd November 2023)
Download an urgent, same day referral letter/email template (PDF) (22nd November 2023)
Download an appointment within seven days referral letter/email template (Microsoft Word) (22nd November 2023)
Download an appointment within seven days referral letter/email template (PDF) (22nd November 2023)
Download an appointment within three weeks referral letter/email template (Microsoft Word) (22nd November 2023)
Download an appointment within three weeks referral letter/email template (PDF) (22nd November 2023)
The following fees have been agreed for the service:
- A set-up fee of £440;
- A fee for each clinic check of £15; and
- A fee for each ambulatory monitoring of £45.
In Years 3, 4 and 5 of the CPCF 5-year agreement incentive fees was also available. The incentive fees were to help pharmacy owners to fund the capital cost of purchasing a suitable clinic BP meter and an ABPM. A fee of £1,000 was payable in the first year of reaching a specified ABPM threshold for the service, followed by a payment of £400 in each of the subsequent years if the pharmacy reached the specified thresholds for those years. The additional incentive fee period has now ended.
If clinic blood pressure measurements or ABPM are provided at the request of a general practice, the service fees set out above will be paid to the pharmacy owner.
If a pharmacy owner de-registers from the service within 30 days of registration, they will not qualify for the £440 set-up fee. In this event, if the £440 set-up fee has already been paid to the pharmacy owner, this money will be claimed back.
Claiming payment
Data from the NHS assured IT system will be submitted to the MYS portal via an application programming interface and will be used by the NHSBSA to populate a payment claim within the MYS portal.
The pharmacy owner needs to review this payment claim and then submit it. Claims for payment for this service should be made monthly, via the MYS portal and no later than three months from the claim period for the chargeable activity provided. Claims which relate to work completed more than three months after the claim period in question, will not be paid.
If the pharmacy owner is commissioned to deliver any related services, e.g. the Pharmacy Contraception Service (incorporating BP clinic measurement), the pharmacy owner may not claim twice for the same activity.
Data will only be submitted by the NHS assured IT system for completed service provisions. For example, where a clinic check has been undertaken and an ABPM is required, which will be undertaken in the following month, the data for the complete service provision will be reported once both elements of the service (clinic check and ABPM) have been completed.
The full dataset for the Hypertension Case-Finding Service can be found in Annex F of the service specification.
Visit the Hypertension Case-Finding Service Frequently Asked Questions page for FAQs on the service requirements.
Pharmacy owners and their teams can watch an on-demand recording of Community Pharmacy England’s January 2024 webinar on the re-launch of the Hypertension Case-Finding Service.
The webinar looked at how to make greater use of the whole pharmacy team and ways to maximise the number of eligible patients taking up ambulatory blood pressure monitoring (ABPM).
During the session, the presenters gave a brief review of the service requirements and the changes to the service from 1st December 2023. Attendees also received practical advice and tips from Nadya Jethwa, owner of Bosworth Pharmacy, and Ruksana Khandoker, pharmacist at Day Lewis Harold Hill Health Centre.
During the webinar, attendees heard directly from the Community Pharmacy England Services Team, Dr Yeyenta Osasu, National Pharmacy Integration Lead at NHS England, and Paula Higginson, Head of Learning Development at the Centre for Pharmacy Postgraduate Education (CPPE).
Briefing 035/23: Updated guidance on the Hypertension Case-Finding (22nd November 2023)
Briefing 036/23: Briefing for pharmacy teams – the Hypertension Case-Finding Service (22nd November 2023)
Briefing 037/23: The Community Pharmacy Hypertension Case-Finding-Service – A briefing for general practice teams (22nd November 2023)
Pharmacy owner implementation checklist (new providers) (22nd November 2023)
Pharmacy owner checklist (existing providers) (22nd November 2023)
Service specification Annex A – Blood pressure check process flowchart
Service specification Annex B – Guidance on clinic blood pressure check
Service specification Annex C – Clinic BP flowchart
Service specification Annex D – ABPM flowchart
Staff training checklist (April 2024)
GP letter/email service notification template (Microsoft Word) (22nd November 2023)
GP practice referral template (Microsoft Word) (22nd November 2023)
GP practice referral template (PDF) (22nd November 2023)
Promoting the service checklist May 2024 (May 2024)
Poster 1 (May 2024)
Poster 2 (May 2024)
Poster 3 (May 2024)
Poster 4 (May 2024)
Poster 5 (May 2024)
Poster 6 (May 2024)
Poster 7 (May 2024)
Service digital marketing resources
Social media card 1 (May 2024)
Social media card 2 (May 2024)
Social media card 3 (May 2024)
Social media card 4 (May 2024)
Social media card 5 (May 2024)
Social media card 6 (May 2024)
Social media card 7 (May 2024)
Tweet templates (May 2024)
Small flyers to use on prescription bags etc. (Microsoft Word) (22nd November 2023)
Patient leaflet to promote the service (Microsoft Word) (22nd November 2023)
Patient leaflet to promote the service (PDF) (22nd November 2023)
ABPM patient leaflet template (Microsoft Word) (22nd November 2023)
ABPM patient leaflet template (PDF) (22nd November 2023)
ABPM loan agreement form (Microsoft Word) (22nd November 2023)
Patient leaflet to support provision of readings (Microsoft Word)
Patient leaflet to support provision of readings (PDF)
To support business continuity provisions in the event of IT issues only
Template clinical record form (Microsoft Word) (22nd November 2023)
Template clinical record form (PDF) (22nd November 2023)
Weekly summary template (Microsoft Excel)
Weekly summary template (OpenDocument)
Urgent, same day referral letter/email template(Microsoft Word) (22nd November 2023)
Urgent, same day referral letter/email template (PDF) (22nd November 2023)
Appointment within seven days referral letter/email template (Microsoft Word) (22nd November 2023)
Appointment within seven days referral letter/email template (PDF) (22nd November 2023)
Appointment within three weeks referral letter/email template (Microsoft Word) (22nd November 2023)
Appointment within three weeks referral letter/email template (PDF) (22nd November 2023)
The following links provide further information on Hypertension and related topics.
- Blood Pressure UK
- British and Irish Hypertension Society
- British Heart Foundation
- NHS website
- NICE guideline [NG136] – Hypertension in adults: diagnosis and management
- NICE Clinical Knowledge Summaries
NHSE case study: Rohpharm Pharmacy
As part of NHS England’s activity to support the International Society for Hypertension’s May Measurement Month campaign, which raises awareness of the risks of high blood pressure, they have published a case study on Rohpharm Pharmacy in Newham, East London who are providing the Hypertension case-finding service.
Community Pharmacy England clinical service statistics dashboard
The dashboard presents data on the Hypertension case-finding service (as well as other Advanced services) at three levels (national, LPC and individual pharmacy) for each quarter. The dashboards are based on the NHS Business Services Authority’s (NHSBSA) Dispensing Contractors’ data.
NHSBSA Dispensing Contractors’ data
Data on the Hypertension Case-Finding Service (as well as other Advanced services) can be found by clicking on the ‘Pharmacy and appliance contractor dispensing data’ dropdown tab.
If having read the service specification and the information on this webpage pharmacy owners have outstanding questions regarding the service, they can email them to services.team@cpe.org.uk.
For more information on this topic please email services.team@cpe.org.uk
