Hypertension is the biggest risk factor for cardiovascular disease (CVD) and is one of the top five risk factors for all premature death and disability in England. It is estimated that around 5.5 million people are living with undiagnosed hypertension in the UK.1 The NHS Long Term Plan has identified cardiovascular disease as a major cause of premature death and a priority area for improvement.2
As of 1 December 2023, the service can be provided by suitably trained and competent pharmacy staff. Previously, only pharmacists and pharmacy technicians could provide the service. For the rest of this page, the term ‘pharmacy staff’ will be used to denote pharmacists, pharmacy technicians and other non-registered members of the pharmacy team.
This Advanced service has two stages. Stage one involves pharmacy staff identifying people at risk of hypertension and offering them a blood pressure check. In the second stage, where clinically indicated, pharmacy staff offer 24-hour ambulatory blood pressure monitoring (ABPM). All blood pressure results are shared with the person’s GP. This service also supports the work that general practices and wider Primary Care Network (PCN) teams are undertaking on CVD prevention and management, under the PCN Directed Enhanced Service. General practices can also request blood pressure checks (clinic and ambulatory blood pressure checks) for individuals, with or without a prior diagnosis of hypertension, as part of this pharmacy service. This process should be agreed locally with general practices.
The service should be provided by suitably trained and competent pharmacy staff. The Responsible Pharmacist must ensure that competent pharmacy staff undertake delegated tasks safely.
On this page, we outline the training requirements for this service, as described in the service specification, and signpost to a selection of further learning resources that you can use to support you and your team's delivery of this service.
Further supporting information about the delivery of this service can be found on the Community Pharmacy England website.
Community Pharmacy England Hypertension case-finding service pageThere are several training requirements that pharmacy staff providing the service must meet. You can find these by clicking on 'Training requirements' below.
Pharmacy staff providing the service must be familiar with the following NICE guideline.
NICE guideline Hypertension in adults: diagnosis and management [NG136]This guideline provides information on the importance of managing hypertension under the Context section. The evidence-based Recommendations contained in this guidance can support you to work with those who use this service to make evidence-informed decisions.
Pharmacy staff providing the service must have read and understood the operational processes to provide the service, as described in this service specification.
Service specificationWhen purchasing the necessary equipment for this service, the pharmacy must use equipment that is validated by the British and Irish Hypertension Society (BIHS), as recommended by NICE. Please note that the BIHS are unable to answer contractor questions about stock availability and other questions relating to equipment, such as price. Pharmacy staff providing the service must complete training (e-learning or face-to-face) on how to use the blood pressure monitoring equipment which should be provided by their equipment manufacturer.
To provide the service, pharmacy staff must:
Depending on your team's existing level of knowledge and experience, you may wish to undertake further learning. To help you to direct this learning, we have developed a self-assessment framework – completing this framework is not a requirement for this service, however it can be used as a tool to help you direct your own learning. Once you have completed the self-assessment, you can visit the topic area(s) relevant to your personal learning needs. These topic areas correspond with the menu items below
In this section we provide resources to support you in learning more about:
There are several resources that can support you in learning more about hypertension.
CPPE Hypertension fact sheet
The CPPE Hypertension fact sheet is part of a portfolio of Clinical fact sheets. It has been developed to refresh your knowledge of hypertension and provide you with links to further resources. You will find the following within this hypertension fact sheet:
As with all our materials, topic experts have reviewed this fact sheet. You can download this fact sheet for your reference and you may also use it to support training your non-registered team members to support the service. You can also access it via the link above or the directory at any time that you need to.
CPPE Hypertension – focal point online workshop
The CPPE Hypertension – focal point online workshop aims to enable you to interpret and apply clinical guidance to support people with hypertension. You will consider how to optimise their treatment and use a shared decision-making approach to empower people with hypertension to self-manage their condition. The workshop is run by CPPE tutors who will ensure you have a fun, interactive learning experience, and you will have the opportunity for discussions with your peers in small groups.
CPPE Hypertension learning gateway
The CPPE Hypertension learning gateway contains further learning resources to help you develop and refresh your understanding of how to support those with this clinical condition.
CPPE Fundamentals of cardiovascular therapeutics e-course
The aim of this CPPE Fundamentals of cardiovascular therapeutics e-course is to develop your knowledge and skills in cardiovascular therapeutics. This will enable you to provide a person-centred approach to support the healthcare of people living with or at higher risk of cardiovascular disease. This programme is designed for pharmacy professionals working in all areas of practice.
Unit three of this e-course focuses on blood pressure, which is estimated to take up to three hours to complete. This will further help you to consider the role you have to deliver holistic and seamless care for people living with hypertension and consider evidence-based guidance to support medicines optimisation.
Most pharmacies will have their own standard operating procedure for the measurement of blood pressure. There are several resources that you can use to develop your competence to measure blood pressure.
British and Irish Hypertension Society resources
The British and Irish Hypertension Society (BIHS) offers a variety of different poster and video resources, including:
How to measure blood pressure and Ambulatory blood pressure monitoring
The videos on the BIHS website focus specifically on measuring blood pressure with an automated monitor and manual blood pressure measurement.
Please note that the BIHS are unable to answer contractor questions about stock availability and other questions relating to equipment, such as price.
In this section, we provide resources to support you in learning more about the risks associated with hypertension and other associated conditions. This includes:
CPPE Vascular risk and the NHS health check programme e-learning
The CPPE Vascular risk and the NHS health check programme was originally developed to support those delivering NHS health checks. It contains information on vascular risk, risk assessment tools and modifiable risk factors, such as hypertension.
CPPE Coronary heart disease fact sheet
The CPPE Coronary heart disease fact sheet is part of a portfolio of clinical fact sheets. It has been developed to refresh your knowledge of coronary heart disease and provide you with links to further resources. You will find the following in this coronary heart disease fact sheet:
As with all our materials, topic experts have reviewed this fact sheet. You can download this fact sheet for your reference and you may also use it to support training your non-registered team members to support the service. . You can also access it via the link above or the directory at any time that you need to.
Northern Ireland Centre for Pharmacy Learning and Development (NICPLD) cardiovascular disease programmes
The NICPLD offers a series of programmes on cardiovascular disease which can be accessed via the CPPE website. These programmes cover the hypertension as a risk factor for cardiovascular disease and management of hypertension as a way to reduce cardiovascular risk.
Hypertension is a major risk factor for the development of atrial fibrillation. As part of delivering this service there is also the potential that you will identify an irregular pulse, a potential symptom of atrial fibrillation.
CPPE Atrial fibrillation detection in community pharmacy: what you need to become service ready e-learning
The CPPE Atrial fibrillation detection in community pharmacy: what you need to become service ready was originally developed to support those who are looking to deliver an atrial fibrillation service. Section 1 – What is atrial fibrillation and why is early detection and effective management important? contains information which will help you to refresh your understanding of this condition.
CPPE Atrial fibrillation fact sheet
The CPPE Atrial fibrillation fact sheet is part of a portfolio of Clinical fact sheets. It has been developed to refresh your knowledge of atrial fibrillation and provide you with links to further resources. You will find the following in this atrial fibrillation fact sheet:
As with all our materials, topic experts have reviewed this fact sheet. You can download this fact sheet for your reference and you may also use it to support training your non-registered team members to support the service. . You can also access it via the link above or the directory at any time that you need to.
CPPE Atrial fibrillation and arrhythmias gateway page
The CPPE Atrial fibrillation and arrhythmias gateway page contains further learning resources to help you develop and refresh your understanding of how to support those with these clinical conditions.
In this section we provide resources to support you to learn more about:
elearning for healthcare (elfh) Making Every Contact Count programme
The elfh Making Every Contact Count programme has been developed for all healthcare staff to help them to make the most of the contact that they have with people and have conversations about health and wellbeing. It can be accessed without a login directly via the elfh website - Making Every Contact Count programme. GPhC registrants who wish to have this programme recorded on their elfh learning record can access the programme via the elearning for healthcare learning modules on the CPPE website.
Consultation skills for pharmacy practice
The CPPE programme Consultation skills for pharmacy practice: taking a person centred approach is a downloadable resource that enables you to describe the key communication and consultation skills and techniques required for person-centred care and shared decision making. The CPPE Consultation skills for support staff distance learning can be used to help all pharmacy staff improve their consultation skills.
A key part of this service is sharing information about healthy lifestyles when this is appropriate. This may include discussing a person’s diet, smoking, physical activity, alcohol and/or weight. There are several resources that can help you to successfully engage in these conversations.
elearning for healthcare (elfh) Population Wellbeing Portal
The elfh Population Wellbeing Portal aims to:
All Our Health
The Population Wellbeing Portal is linked to the All Our Health framework - a resource for all health and care professionals to help you use your knowledge, skills and relationships to prevent illness, protect health and promote wellbeing.
To support the All Our Health framework NHS England have developed a series of All Our Health e-learning sessions to provide a bite-size introduction to the wide range of topics covered in the All Our Health framework. There are several that you can use to directly support your delivery of this service:
CPPE Dealing with difficult discussions e-learning
The CPPE Dealing with difficult discussions e-learning builds on CPPE’s basic communication and consultation skills learning programmes to help staff undertake more difficult discussions with people. This includes conversations around weight management.
elearning for healthcare (elfh) Alcohol Identification and Brief Advice programme
The elfh Alcohol Identification and Brief Advice programme includes a module specifically for community pharmacy teams. It will support you to undertake screening and then give routine, opportunistic ‘simple brief advice’.
CPPE Weight management for adults: understanding the management of obesity e-learning
The CPPE Weight management for adults: understanding the management of obesity e-learning Section 1, What is overweight and obesity and why is it a public health problem? And Section 3, Patient journeys provide you with practical advice on how you can support patients on their own weight loss journey, including how to initiate the difficult discussion around weight management.
Supporting a person to make a behavioural change may be challenging. The following resources offer tools and techniques to support you to achieve this.
Better conversation health coaching tools.
One technique that you can use to support people to make a change is health coaching. “Health coaching gives people the knowledge, skills and confidence to become more active in their care to maximize personal well-being and overall health.”3 Better conversation offers a range of training and resources to support you in developing your skills in health coaching.
Consultation skills for pharmacy practice: taking a person-centred approach distance learning programme
Section 5 of the CPPE Consultation skills for pharmacy practice: taking a person-centred approach distance learning programme is titled Health coaching in patient consultations. This section will help you to deliver health coaching and motivational interviewing.
