Service case study: Optical referral for Hypertension Case-Finding Service pilot

Community pharmacies and optical practices in Humber and North Yorkshire are working together to identify patients suitable for the Hypertension Case-Finding Service in a pilot which has recently been commissioned for another year (until 31st March 2025).

Across the two areas, so far, 126 community pharmacies and 36 optical practices have participated in the pilot, where opticians can refer patients that have been identified with raised blood pressure to a community pharmacy for the Hypertension Case-Finding Service.

The service launched in July 2022 and was supposed to run until March 2023. However, it was initially extended to 31st March 2024 and has now been further extended to 31st March 2025.

How does the service work?

When a patient attends at an optical practice for their eye examination, the optical practitioner will offer to take a blood pressure reading, if appropriate and if certain criteria is met.

Depending on the outcome of these readings, the optical practitioner will:

• Provide advice and guidance on health and lifestyle;
• Offer a referral to a community pharmacy for follow-up through the Hypertension Case-Finding service; or
• Escalate for those in hypertensive crisis by referring the patient to A&E, NHS 111 or 999.

Referrals are made from optical practices via a bespoke IT platform which supports timely and secure referrals to a participating community pharmacy of the patient’s choice.

Once a referral has been received, the community pharmacy will take further blood pressure readings and may offer ambulatory blood pressure monitoring (ABPM) if appropriate as per the Hypertension Case-Finding Service specification.

What are the outcomes and potential impact?

The Humber and North Yorkshire Health and Care Partnership yearly report for the Optical Practice and Community Pharmacy Hypertension pilot shows that between September 2022 and September 2023, 278 interventions at the optical practices were carried out with 134 (48.2%) of these cases being referred onwards to community pharmacies.

The data indicates that patients are being identified and directed to the relevant service. This also helps to reduce the possibility of patients ending up in urgent/emergency services, with only 6% of all cases being urgently directed onwards to general practices or emergency services.

Analysis of the data has shown that the majority of these interventions, have been screened and resolved outside of general practice and emergency services, thus reducing potential additional pressures on the already engaged systems.

Speaking about the service, Paul McGorry, Chief Officer of Community Pharmacy Humber, said:

“This pilot, though relatively small in scale, demonstrates the synergistic benefits for patients, and the professions, from working together and joining up our service pathways to deliver on the ‘I’ in Integrated Care Systems and genuinely Make Every Contact Count.

This shows that community pharmacy can be the glue that binds the disparate primary care professions together to deliver real benefits to patients and the entire integrated care system”.

Speaking about the service, Caroline Hayward, Professional Development Pharmacist at Community Pharmacy Humber, said:

“The service has demonstrated the positive value of collaboration between optical and pharmacy owners to improve patient outcomes by increasing awareness of the possible risks of cardiovascular disease and facilitating access to blood pressure checks.”

More information on the Optical referral to the Hypertension Case-Finding Service pilot can be found under the Cardiovascular section on the Community Pharmacy England Services Database.