NHS England has told community pharmacists they should not carry out free blood pressure checks more than once every five years, a move that has sparked concern from medical experts. The checks can flag whether someone is at risk of a heart attack or stroke.
Change could leave heart problems undiagnosed
The National Pharmacy Association (NPA) warns the change could leave people with undiagnosed heart problems. Berkshire pharmacist Olivier Picard, who also chairs the NPA, told the Mirror: “People might be walking around with this silent killer. A lot can change with your health in 12 months, never mind five years.”
Pharmacies are increasingly becoming almost drop-in GP services for minor ailments. They often have private rooms for consultations and staff are proactive in offering tests, reports the Mirror. The change appears to scale that back by reducing the number of £10 blood tests it has to pay pharmacies to do.
NPA calls for pause
The NPA is calling for an immediate pause to the plan, which is due to come into force next month. Henry Gregg, chief executive of the NPA, said the move “flies in the face of efforts to prevent disease”, adding: “This will undermine the government’s ambition to promote health prevention and could leave health problems undiagnosed.”
Olivier Picard, who has been a pharmacist for over 20 years, told the Mirror: “Often we won’t know whether someone has had their blood pressure checked in the last five years. I had one lady come and see me for a headache and I checked her blood pressure and it was over 220 mmHg. I sent her straight to A&E. If we can’t do these kind of checks it will put more burden on hospitals and GPs.”
Why blood pressure checks matter
A third of UK adults have high blood pressure - known as hypertension - but an estimated four to five million are undiagnosed. It is diagnosed if your reading is 140/90 mmHg or higher when checked by a healthcare professional in a clinic, or an average of 135/85 mmHg or higher when monitored at home.
Cardiology Care says blood pressure directly affects heart health, as well as the health of your brain, kidneys, and blood vessels. It adds that uncontrolled hypertension significantly increases your risk of heart attack, stroke, heart failure, kidney disease, and even vision loss. It says routine monitoring “isn’t optional” and that “it can genuinely save your life”.
NHS England said last year that community pharmacies had carried out seven million blood pressure checks since the launch of the hypertension case-finding service in October 2021. This included one million people being checked in the top 10% most deprived areas in England where people often go undiagnosed. The update stated “repeat clinical checks” for hypertension should not be carried out by pharmacists outside of “exceptional clinical cases”.
Henry Gregg added: “If the NHS has evidence that blood pressure checks are being done unnecessarily frequently on some individuals, they need to take this up with the individual contractors rather than put in place arbitrary rules that undermine our shared goal of reducing the number of cases of undiagnosed hypertension. This is a sledge hammer to crack a nut. Pharmacies need the freedom to make public health interventions without constantly worrying about whether they will be reimbursed for their work. If some people are checked more frequently than every five years, that is a small price to pay. We need to focus on the real risk – which is people walking around not knowing that they are at an increased risk of an early heart attack or stroke.”
An NHS England spokesman said: “Thousands of pharmacies across England will continue to offer blood pressure checks in line with clinical guidance set by NICE and as part of NHS efforts to spot people at risk of hypertension. Pharmacies deliver 300,000 blood pressure checks a month and anyone aged 40 or over who hasn’t had a check in the last five years is encouraged to come forward.”
