Updated HCFS spec published
NHS England has today (6th August 2026), published an updated version of the Hypertension Case-Finding Service (HCFS) specification.
This revised version has been agreed by Community Pharmacy England and it contains a number of changes to the service requirements which were agreed as part of the 2025/26 CPCF negotiations. See below for further information on the rationale for the changes.
Download the revised service specification
The changes to the service, come into effect on Thursday 3rd September 2026, providing pharmacy owners with four weeks’ notice.
Summary of the key changes to the service
To better focus the service towards case-finding, the service specification clarifies that any patient who seeks a clinic check, but who is already being treated for hypertension, is not eligible to receive the service.
In line with NICE guidance, there is now a general exclusion of people who have had their blood pressure checked in the last five years.
Signposting from general practice for a clinic check is restricted to adults aged 40 years and over without a diagnosis of hypertension, who have not had a blood pressure check in the last five years.
Other healthcare professionals who have been commissioned to support case-finding (such as optometrists and dentists – not other community pharmacies) can request ambulatory blood pressure monitoring (ABPM) following clinic checks undertaken at their practices.
Expectations regarding patient consent, clinical judgement, escalation of abnormal findings and health promotion are further clarified.
ABPM requirements have been clarified, covering timing, minimum readings, follow‑up of non‑attenders and equipment availability.
Advice on record‑keeping, claiming, monitoring, post‑payment verification and service withdrawal have been aligned with the requirements in other Advanced service specifications.
Service delivery requirements have been clarified, including tighter rules on off‑site provision, for which ICB approval must continue to be sought. Previously, NHS England guidance for local commissioners said off-site provision should only be for occasional approval. This has now been clarified in the service specification, with a limit of 4 days off‑site provision allowed per financial year.
Guidance has also been added on the process to request off-site provision and to provide visibility on the ICB approval framework for off‑site service provision.
Find out more about the changes
Briefing 016/26: Changes to Hypertension Case-Finding Service specification (August 2026)
This Community Pharmacy England Briefing highlights the main changes to the service announced in August 2026. However, it is important that all pharmacy owners and Responsible Pharmacists (who will be providing clinical supervision for the service) do also read the revised service specification.
Community Pharmacy England Briefing for pharmacy teams on the service (August 2026)
Why have the changes to the service been made?
The key changes to the service requirements and patient eligibility criteria are being made to better reflect the service’s primary purpose of hypertension case‑finding.
During the 2025/26 CPCF negotiations, DHSC, NHS England and Community Pharmacy England reviewed data on the service which showed that some patients were using the service to obtain regular BP measurements.
This has never been the purpose of the service and where patients need regular BP measurements for medical reasons, their general practice should support them with that need.
Patients without a diagnosis of hypertension seeking regular BP measurements is not aligned with NICE guidance and represents a sub-optimal use of NHS funding.
Similarly, the data showed that some general practices were referring patients for clinic checks who already had diagnoses of hypertension. While this is allowed under the current service requirements, it reduces the potential health economic benefits of the service to the NHS and country, as these benefits are derived from case-finding people with undiagnosed hypertension.
The fees for the service come from the CPCF contract sum, so any money not spent on this service will instead be used to fund pharmacies to provide other elements of the contractual framework.
