Hypertension Case Finding Service

• Identify people with high blood pressure aged 40 years or older (who have previously not had a confirmed diagnosis of hypertension), and to refer them to general practice to confirm diagnosis and for appropriate management;
• At the request of a general practice, undertake ad hoc clinic and ambulatory blood pressure measurements; and
• Provide another opportunity to promote healthy behaviours to patients

Another situation that sticks in my mind is a conversation with a friend who is a GP partner in a different area. They were late home one Friday, because several patients had contacted the surgery at in the half hour before they were due to close because they had been told by the pharmacist that they had raised blood pressure – but not what their blood pressure was! So, the GP had to bring the patients in to check that the blood pressure was not in the very high range. I shared the service pathway and patient letter that I use, with me friend and they went to the local pharmacy to ask them to use this too. When they found out that they could refer patients to the pharmacy they were delighted, the service in their area is now, in their view, running well.

Lots of GPs are pleased to be able to refer patients to my pharmacy. I popped to a surgery this morning, to see a receptionist and a GP asked me about the service and told me how pleased they were that we were offering this. Then they asked about our current capacity, because so many patients would benefit from this service”.

My top tips are:

• Clear communication with everyone concerned. See the GP receptionists and give them written information as well as giving this to GPs and nurses. Let the receptionists know that if you can, you will provide a measurement there and then. If not, you will book an appointment within the next week at a quieter time. Give the patient written results and write down what to do next – i.e., do they need a routine appointment in the next three weeks or to be seen in 24 hours, or not to be seen at all.
• Make sure that all pharmacy staff know about the service and their role in promoting it and booking appointments. Specifically, whilst we should be offering those service to specific demographics who do not already have a diagnosis of hypertension in the pharmacy, GP surgery can refer anyone to us.
• When you book an appointment for ABPM, give the patient clear written information about what to expect. My meter doesn’t like water so the patient may want to bathe or shower before they come in. I ask patients to wear a T-shirt too. I want patients to know upfront that the meter will go off every hour at night, rather than surprising them with this information on the day.
• Going forward, I hope that I can get some referrals between pharmacies in my PCN as I think we will be at capacity quickly.

Emma Anderson
Community Pharmacy PCN lead for Rushcliffe South