NHSE’s primary care recovery plan, released this week (May 9), set out plans to expand the blood pressure check service offered at community pharmacies.

The expanded service will be one of three to benefit from a funding boost worth up to £645 million, alongside the existing oral contraception service and a new Pharmacy First service for England that will allow pharmacists to prescribe medication to patients directly for seven common ailments.

NHSE told C+D that “as part of the announced £645m, there is funding for up to an additional 2.5 million [blood pressure] checks per year in each of 2023/24 and 2024/25 – subject to a consultation with the sector”.

 

278% increase

 

According to the plan, the service currently provides “up to” 120,000 hypertension checks monthly.

But announcing the publication of the plan on Tuesday (May 9), NHSE said that community pharmacies performed 900,000 blood pressure checks last year.

This means that the recovery plan’s proposed expansion to the blood pressure service would amount to a 278% increase in checks provided via the service – up 2.5 million from 900,000 last year to 3.4 million.

Read more: NHSE reveals it will ‘review’ future of ARRS PCN recruitment

NHSE said that the expansion will “support ongoing monitoring in partnership with GP practices – subject to consultation”.

The hypertension service was introduced in many community pharmacies in October 2021.

Read more: Government injects £645m investment into community pharmacy

In the first six months of the service, 7,200 community pharmacies signed up to offer the service, which aims to identify undiagnosed hypertension, and performed over 100,000 checks.

But this number may have fallen in the interim, as the recovery plan said that at present “over 6,000 community pharmacies are supporting the identification and prevention of cardiovascular disease”.

 

Preventing over 1,000 heart attacks and strokes?

 

The NHSE plan estimated that the “increase in capacity in community pharmacy” could prevent more than 1,350 heart attacks, strokes and other heart conditions in the first year of the service’s expansion - leading to approximately £13 million in savings for the NHS and social care.

These figures come from a research paper on the impact of increasing blood pressure checks in community pharmacy on cardiovascular disease, also published on May 9 by the Office for Health Improvement and Disparities (OHID).

The paper estimates the “potential benefits of a policy to increase numbers of blood pressure checks in community pharmacies based on the assumption that an additional 2.5 million people would undergo a blood pressure check…in line with the ambitions of the current policy proposal”.

Read more: PSNC stance on contraception service ‘unchanged’ despite funding pledge

However, the OHID model described the estimate of 1,350 prevented cardiovascular events as “a very optimistic scenario”.

In the “more likely scenario”, 90 cardiovascular events would be avoided in the first year that 2.5 million more blood pressure checks are offered, and £632,000 would be saved.

The “very optimistic” scenario assumes that hypertension would be detected in 10% of checks performed in community pharmacies, while the “more likely scenario” assumes that hypertension would be found in 6% of checks.

 

Recovery plan

 

The recovery plan was lacking in details about how the £645 million earmarked for expanded community pharmacy services will be distributed across the hypertension, contraception and Pharmacy First programmes.

This will be determined following “detailed negotiations” between NHSE, the Department of Health and Social Care (DH) and the Pharmaceutical Services Negotiating Committee (PSNC), the negotiator said.

Read more: Pharmacy hypertension service: Over 100k blood pressure checks in 6 months

According to PSNC, the consultations on the service details and funding allocation “will also look at the cost of IT integration and marketing of pharmacy services to the public”.

Meanwhile, the primary care recovery plan also announced that NHSE will “review and evaluate” the future of the controversial additional roles reimbursement scheme (ARRS).

Pharmacy leaders cautiously welcomed the plans but stressed that detail remains scant.

Check the C+D site for the latest coverage on this developing story