Detecting undiagnosed CVD is one of the services that will be piloted and could be funded as part of the five-year pharmacy contract, with referral to treatment within primary care networks (PCNs).
In a session on PCNs at the Pharmacy Show last week (October 7), pharmacist Andre Yeung pointed to a CVD project he is overseeing across 40 pharmacies in the Newcastle and Gateshead area, which he said has tested 700 people in its first four months.
CVD is “not a local problem”, and NHS England should look at commissioning a service “at a larger scale” than PCN level, Mr Yeung argued.
“I’m just wondering what you think about the scalability of PCNs and whether we should be thinking about this in a different way?” he asked NHS England deputy chief pharmaceutical officer Bruce Warner, who was speaking at the session.
Mr Warner praised Mr Yeung’s example, and said “we need to understand what elements of that can be scaled up”.
“Certain elements of the service specification can be worked up at a national level” – such as building a CVD service into the PCN contract – he suggested.
“What we don’t want to do, and what we’ve been asked not to do by local organisations, is tell them exactly what to do and how to do it,” Mr Warner added.
More about the CVD service
Mr Yeung – who is chair of the north-east England local professional network – explained that the CVD service is being run in partnership with the British Heart Foundation (BHF) to improve the diagnosis of high blood pressure.
The BHF told C+D that the “innovative” initiative is one of 15 community blood pressure projects it is currently funding across the UK.
It involves 40 pharmacies “providing a blood pressure testing and diagnosis service and home blood pressure monitoring, incorporating healthy living advice and brief interventions”, it said.
Sharing the initial results at the Pharmacy Show, Mr Yeung said that in its first four months, a third of the 700 patients tested have had “a high read for hypertension”.
“Of those people, 63% undertake home blood pressure monitoring, so we can diagnose them,” he added. “Of the people that we have given a blood pressure monitor to take home, 86% bring it back and 60% of those are referred to general practice.”
Saving the NHS money
According to Mr Yeung’s calculation, it costs £76.52 to detect a hypertensive patient.
“We know we have millions of these people walking around with undetected hypertension. When you compare that to the cost of a stroke or an admission to hospital, it just seems to me it’s something that should be scaled up way beyond PCN level,” he said at the Pharmacy Show.