- High blood pressure is a risk factor for cardiovascular disease (CVD). In the UK, an estimated 1 in 4 adults have high blood pressure and almost 6 million are undiagnosed. Early detection is vital given that CVD is a leading cause of premature death.
- In the first year of the NHS Community Pharmacy Blood Pressure Check Service, pharmacies conducted nearly 600,000 blood pressure checks, preventing 600 future heart attacks and strokes1.
- Of these checks, 44% were delivered in the 30% most deprived areas in England.
- By 2026, we calculate 15 million blood pressure screenings will have taken place, preventing up to 15,000 heart attacks and strokes.
- Community pharmacy offers a new route to access vital cardiovascular care – and we call on the NHS to be ambitious in their commissioning to improve patient care and access, whilst reducing pressure on GPs.
Since October 2021, community pharmacies in England have been commissioned to screen people for high blood pressure – a key risk factor for heart attacks and strokes.
After the first year of the service, community pharmacies delivered nearly 600,000 blood pressure checks identifying over 25,000 people with high blood pressure. 44% of these checks were in the 30% most deprived communities. Using modelling from UCL1, we calculate this has prevented over 600 heart attacks and strokes already.
By 2026, approximately 15 million blood pressure screenings will be delivered, identifying over 650,000 patients with high blood pressure. This will prevent 15,000 people from suffering heart attacks or strokes.
There is an opportunity to use the expertise of community pharmacy to go further and provide the care these newly identified patients’ need. Currently, newly diagnosed patients need to attend overwhelmed GP surgeries for treatment.
We call on the Government to take up our offer and commission pharmacies as the first port of call for cardiovascular care. Thousands of lives can be saved with ambitious commissioning and the investment to match.
To do this there is a need for:
- Funding – Communitypharmacy is under great financial pressure, suffering a real term funding cut of over 30% over 8 years2. With funding, the sector can transform to deliver this critical need for patients.
- Workforce – Whilst there are plans to train Independent Prescribers (IPs), there are no clear roles for them to use these skills. There is a need to accelerate training plans to allow pharmacists to deliver the service described here and play their part in CVD management.
Malcolm Harrison, Chief Executive of the Company Chemists’ Association said:
“Pharmacies will deliver 15 million blood pressure checks by 2026. The sector can, and should, play a huge role in the nations fight against cardiovascular disease.
Whilst the funding model for community pharmacy is broken, it is not beyond repair. Investing in community pharmacy to become the first point of contact for cardiovascular disease is a sure-fire way of freeing up GP capacity, reversing health inequalities and ultimately saving lives.
On average pharmacies are underfunded by more than £67,000 every year5. It’s now time that the Government and NHS invest in the tremendous potential of community pharmacy”.
John Maingay, Director of Policy and Influencing at the British Heart Foundation, said:
“By delivering blood pressure checks to more people more easily, high street pharmacies are helping to save lives every day. Local pharmacies are well placed to detect high blood pressure and help people receive appropriate care, while also relieving some of the immense pressure on GPs.
“High blood pressure often doesn’t present any symptoms but if left untreated, it can lead to a life-threatening heart attack or stroke. That’s why it’s important to get your blood pressure checked at a local pharmacy, GP surgery or during a free NHS health check in England, especially if you have a family history of heart and circulatory diseases. A quick and simple five-minute test could prevent a future heart attack or stroke, and even save your life.”
NOTES TO EDITORS
- High blood pressure (hypertension) is a risk factor of cardiovascular disease with devastating consequences. An estimated 13.7m UK adults have high blood pressure and of those, almost 6m are undiagnosed. Even a small drop in blood pressure can lower the risk of strokes and heart attacks. Early detection is key given that cardiovascular disease is a leading cause of premature death in England and the biggest cause in deprived communities.
- The NHS Community Pharmacy Blood Pressure Check Service supports risk identification and prevention of cardiovascular disease (CVD). A community pharmacist will measure the blood pressure of consenting adults who come into the pharmacy, by offering anyone a free blood pressure check who:
- appears to be over the age of 40;
- has not previously been identified as having hypertension or related condition; and
- has not had their blood pressure measured by a health professional within the previous six months. Further information available here.
- Most deprived areas – Deprivation is defined and calculated according to the government’s 2019 Index of Multiple Deprivation (IMD). The Index of Multiple Deprivation (IMD) is the official measure of relative deprivation for small areas in England. It is the most widely used of the Indices of Deprivation (IoD). The IMD ranks every small area in England according to deprivation deciles: 1 (most deprived area) to 10 (least deprived area). Further information available here (see page 4).
- Following changes to the initial education and training for the profession, all pharmacist graduates will have a prescribing qualification from 2026. However, there are currently no clear roles in community pharmacy for them to use these skills. In 2023, only 5% of community pharmacists are trained to prescribe medicines. There is a need to accelerate current plans to train the other 95% of community pharmacists to prescribe by 2030.
- UCL Partners (2022) Size of the Prize – England, BP Optimisation to Prevent Heart Attacks and Strokes at Scale, https://uclpartners.com/project/size-of-the-prize-for-preventing-heart-attacks-and-strokes-at-scale/
- Pharmacy leaders join forces to write to the Secretary of State – PSNC Website
- Independent Prescribers – Regulations to allow pharmacists to prescribe came into effect in 2006. A pharmacist independent prescriber may prescribe autonomously for any condition within their clinical competence. Further information available here.
- Ahmad, S, and Webb, D (2022) How people can ‘know their numbers’ to prevent cardiovascular disease. https://www.england.nhs.uk/blog/how-people-can-know-their-numbers-to-prevent-cardiovascular-disease/
- A parliamentary written answer revealed the difference between real and nominal funding provided through the Community Pharmacy Contractual Framework, according for changes in GDP, in each year since 2015/16. In 2015/16, the value of the contract was £2.8bn. If the value of the contract increased in line with GDP, it would be worth £3.3684bn in 2022/23. This value (3.3684bn) minus the value of the current contract (£2.592) is £776.4m. Therefore, under the current five-year contract, there is currently an annual shortfall of more than £750m per year. Assuming there are 11,500 active community pharmacies (see NHSBSA, 2021/22 data) that equals a shortfall of £67,513 per pharmacy.