Service case study: Cholesterol Point of Care Testing in community pharmacy

Overview

Community pharmacies across North East London took part in a pilot programme commissioned by Barts Health NHS Trust to deliver cholesterol point of care testing (POCT). The initiative formed part of a wider strategy to address declining cardiovascular disease (CVD) detection rates following the COVID-19 pandemic, during which routine monitoring significantly decreased. By offering cholesterol testing alongside existing NHS blood pressure checks, the programme aimed to redesign pathways, strengthen integration across sectors and deliver cardiovascular prevention closer to home to provide patients with a more comprehensive cardiovascular risk assessment in highly accessible community settings.

Service delivery

Participating pharmacies were equipped with lipid testing devices and trained to conduct non-fasting lipid testing and how to interpret the results. Blood pressure measurements, and height and weight assessments were also required as part of the consultation.

Pharmacists interpreted results during the same consultation, provided personalised lifestyle guidance, and referred patients with elevated risk to their GP for further evaluation and potential lipid lowering therapy.

This integrated pathway strengthened collaboration between community pharmacy and other primary care providers, aligning with national ambitions to increase CVD risk assessments in adults aged 40–74 and reduce health inequalities. The streamlined process enabled earlier intervention and improved access to preventive care—particularly for underserved groups.

Activity and reach

Between January and October 2025, the POCT service supported 556 patients across seven community pharmacies in North East London. Key insights from service activity include:

• Age profile: Most patients were in their 40s and 50s, demonstrating strong engagement among working age adults.
• Ethnic diversity: Over half of the participants identified as Asian, with representation also from White, Black, and other ethnic backgrounds.
• Deprivation profile: A large majority of patients lived in areas with high deprivation, indicating effective reach into communities traditionally facing barriers to preventive healthcare.

Outputs and outcomes

Around one in five patients (111 people) had a QRISK score of ≥10%, indicating elevated cardiovascular risk. Fourteen patients showed critically high cholesterol levels and 27 had raised triglycerides above 4.52 mmol/L, suggesting potential underlying metabolic conditions.

Twenty‑four patients were started on statins, while others chose to focus on healthy lifestyle changes. In all cases, the consultations created a valuable opportunity to increase awareness, support behaviour change, and initiate timely treatment, where appropriate.

Pharmacy team feedback

Pharmacists reported high levels of satisfaction with both the initial training and ongoing support provided by Barts Health NHS Trust. They described test procedures and patient interactions as generally smooth and well received.

However, several challenges were identified:

• Resource intensive setup: The initial implementation phase was time-consuming and may limit future expansion without additional support.
• Time Constraints: Consultations for some patients were significantly prolonged due to factors such as language barriers and challenges with health literacy.
• Statin hesitancy: Some patients were reluctant to begin statin therapy despite clear discussions about test results and associated risks.

Overall, pharmacy teams viewed the service as highly valuable, helping residents better understand and act on their cardiovascular health, although long-term clinical outcomes are yet to be measured.

Patient feedback

Patients reported overwhelmingly positive experiences with the POCT service. They valued:

• The convenience and speed of cholesterol testing in a local pharmacy;
• Clear, personalised explanations supporting their understanding of CVD risk; and
• The ability to access testing without needing a GP appointment, with some noting they would not otherwise have sought support.

Conclusion

This pilot demonstrates the significant potential of community pharmacies to strengthen early detection and prevention of cardiovascular disease. By providing high quality diagnostic services closer to where people live, community pharmacy can:

• Reduce health inequalities;
• Increase access to preventive care;
• Alleviate pressure on general practice; and
• Contribute to national efforts to prevent heart attacks, strokes, and other serious cardiovascular events.

The evidence and feedback suggests the programme is effective at reaching individuals who may face challenges accessing traditional healthcare routes. Many residents expressed support for making pharmacy-based cholesterol testing routinely available and recommended expanding similar services to other conditions, such as diabetes.

Speaking about the service, Shilpa Shah, Chief Officer of Community Pharmacy North East London, said:

“This was a great service to roll out to 7 pharmacies (six of which were independent prescriber pathfinder sites).

“It’s not new to community pharmacy, as POCT has been around for many years. However, this evaluation clearly shows the benefits of POCT.

“Community Pharmacy is so accessible and we often reach those that don’t need to see their GP.

“Opportunistic POCT is brilliant for this cohort. Services like this absolutely meet the NHS 10-year plan ambition of prevention and we need more of these services in community pharmacy. I’d like to see this service available from all Community Pharmacies.”

More information on the Cholesterol Point of Care Testing pilot can be found on the Community Pharmacy England Services Database and in the published Cholesterol Point of Care Testing Evaluation.

LPC members can watch the on-demand webinar on the Cholesterol Point of Care pilot.