From October 1 – when the 2019-20 pharmacy contract for England comes into force – “community pharmacists will start to develop and test an early detection service to identify people who may have undiagnosed, high-risk conditions – like blood pressure – for referral for further testing and treatment”, NHS England announced yesterday (September 2).
The announcement was picked up by several national media outlets – and lauded by health secretary Matt Hancock on Twitter, who claimed that “from next month, pharmacies will offer on-the-spot free heart health checks to boost early detection of heart attacks and strokes”.
However, the Pharmaceutical Services Negotiating Committee (PSNC) clarified to C+D that the details of the pharmacy cardiovascular disease (CVD) service are still being planned.
It is “one of a range of new services” to be piloted that could be funded by the five-year contract, PSNC stressed. If successful, it could be rolled out as a fully funded national service from 2021-22.
Under the pilot, pharmacists will be asked to proactively identify patients at risk of heart disease and stroke and offer them on-the-spot blood pressure checks, provide clinical and lifestyle advice and, where appropriate, refer patients on to treatment within primary care networks (PCNs), complementing the CVD service specification in the GP contract, PSNC explained.
NHS England has not yet selected which pharmacies will pilot the service, PSNC told C+D.
PSNC director of NHS services Alastair Buxton said: “The CVD pilot in pharmacies…represents an important example of community pharmacy’s wider service ambitions and we are keen to see its commencement as soon as possible.
“By making a success of pilots such as this, the sector will become more integrated with, and valuable to, the rest of the NHS,” he added.
Success of other pilots
Pharmacists and other healthcare professionals across England have already piloted similar early CVD detection services in Cheshire and Merseyside, Lambeth and Southwark in London, Dudley and West Hampshire, and have seen “substantial improvement” in diagnosis and treatment rates, NHS England said.
It referred to a pilot in Cheshire and Merseyside, where a network of more than 320 healthy living pharmacies offer blood pressure screening. At the end of the first phase of the pilot in April 2019, 116 of the participating pharmacies had delivered more than 3,500 blood pressure measurements, NHS England said.
In a separate pilot with Lambeth and Southwark clinical commissioning groups (CCGs), GPs, specialist nurses and specialist atrial fibrillation (AF) pharmacists worked together to identify patients who had been diagnosed with AF, but had not received anticoagulation medication.
Following this joint intervention, the CCGs saw a 25% reduction in the rate of AF-related strokes, the commissioning body said.
In February this year, the Company Chemists’ Association called for more pharmacy blood pressure tests to be commissioned, after an audit of pharmacies from seven of the largest multiples across Great Britain revealed that 30,169 blood pressure measurements had been taken over a one-week period in 2017, with “high” and “pre-high” readings identified in more than half of these tests.