NHS Prescription Services

NHS Community Pharmacy Blood Pressure Check Service

The NHS Community Pharmacy Blood Pressure Check Service (also known as the NHS Community Pharmacy Hypertension Case-Finding Advanced Service) started on 1 October 2021.

Important Update for Contractors

The expanded NHS Community Pharmacy Blood Pressure Check Service launched on Friday 1 December 2023 which allows non-registered staff to take blood pressure readings.

NHS England received a few queries about this, and we wanted to clarify that blood pressure readings taken by non-registered staff should, for now, be recorded under the responsible pharmacist’s name and General Pharmaceutical Council (GPhC) number. This is because the pharmacist continues to be responsible for the delivery of the service.

NHS England is working with the NHSBSA and system suppliers to amend consultation record templates to allow non-registered staff member details to be recorded in due course.

Any further queries about the service changes should be emailed to the Pharmacy Integration Team at england.pharmacyintegration@nhs.net.

Thank you for all you do to support patients in England.

Aims of the service

The aims and objectives of this service are to:

identify people aged 40 years or older 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 (this can include people under 40 years, at the discretion of a pharmacist)
undertake clinic and ambulatory blood pressure checks when necessary, at the request of a general practice
promote healthy behaviours to service users

What the service will provide

The agreement is for a pharmacist to measure the blood pressure of adults.

At the end of a patient consultation, where readings indicate:

normal blood pressure - the pharmacist will promote healthy behaviours
high blood pressure - the pharmacist will offer Ambulatory Blood Pressure Monitoring (ABPM) from the pharmacy and will also promote healthy behaviours
very high blood pressure - the pharmacist will urgently refer the patient to see their GP within 24 hours
low blood pressure - the pharmacist will provide appropriate advice

Practices can refer patients to community pharmacies for either clinic readings or ambulatory measurements. This supports practices in their restoration and recovery work. Practices and pharmacies can work together locally to agree how the referrals are made. Two examples where this may be helpful to practices are:

the community pharmacy is asked to measure the blood pressure of patients diagnosed with hypertension where the practice has no recent blood pressure measurement recorded
the community pharmacy is asked to measure the ambulatory blood pressure of patients who have had a high clinic reading but have not yet been followed up with home or ambulatory monitoring

Service specification

The service specification can be found on the NHS England website.

Equipment

When purchasing the necessary equipment for this service, the pharmacy must use equipment that is validated by the British and Irish Hypertension Society (as recommended by NICE) with reference to:

validated BP monitors for home/clinic use validated BP monitors for specialist use

Contractors may also refer to the Medicines and Healthcare products Regulatory Agency guidance (PDF: 380KB) on the purchase, management and use of blood pressure measurement devices when selecting equipment for this service.

Devices using a mercury sphygmomanometer are no longer available for purchase in the UK. Consideration should be given to the selection of mercury free products.

Considerations for clinic use

Whether maintenance and training is included in purchase price.
Whether the supplier provides spare parts whilst it is being repaired, if broken.
Calibration vs. replacement cost and carbon footprint.
Frequency and cost of cuff replacement as well as other consumables.
Complexity and time taken to use.
The fact that it automatically takes 3 measurements.
Flags irregular pulse (optional).
Availability of bulk purchase savings where applicable.

Considerations for ambulatory use

Whether maintenance and training is included in purchase price.
Whether the supplier provides spare parts whilst it is being repaired, if broken.
Calibration vs. replacement cost and carbon footprint.
Frequency and cost of cuff replacement as well as other consumables.
Complexity, time taken to use and explanation on how to use.
Availability of bulk purchase savings where applicable.

Pharmacists using the equipment should be aware that:

ABPMs must be reset for each service user
validation, maintenance and recalibration of both clinic blood pressure monitors and ABPM devices should be carried out periodically according to manufacturers’ instructions
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

Training requirements

Pharmacists providing the service must:

be familiar with the Hypertension in adults: diagnosis and management NICE guideline
read the NHS Community Pharmacy Hypertension Case-Finding Advanced Service Specification (Word: 313KB) and understand the operational processes to provide the service

Pharmacists must complete training on how to use the blood pressure monitoring equipment, which should be provided by their equipment manufacturer. Training can be delivered either in e-learning format or face-to-face.