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The pharmacy sector must do more to realise the "full expectations" of the hypertension case-finding service, Community Pharmacy England has said as it warned that the number of patients receiving ambulatory blood pressure monitoring (ABPM) is "frankly too low". 

Speaking at the Sigma Pharmaceuticals conference today (May 12) via videolink, CPE services director Alastair Buxton told P3pharmacy that out of the hundreds of thousands of blood pressure readings carried out by pharmacies each month "we've got 30 per cent of patients who require ABPM and we're getting absolutely nowhere near that number... these are people with potential hypertension that need treating".

From October this year pharmacies will need to complete at least one ABPM provision per month to qualify for monthly activity payments of £500-£1,000 as service 'bundling' kicks in.

This was agreed as part of the new contractual settlement, which also saw the fee for ABPM provision rise by 13 per cent to £50.85 and the fee for clinic blood pressure checks drop by a third to £10.

When asked by P3pharmacy if CPE may be forced to request flexibility on the one-ABPM-per-month target - just 4,314 pharmacies carried out one or more ABPM provisions in January this year - Mr Buxton replied: "We'll see what happens on that."

He went on: "We need to tackle this ourselves within the sector. The level of ABPM conversion from clinic checks is frankly too low."

He said there are "a multitude of reasons" for this, for example issues around patient preference. Mr Buxton said he had asked NHSE to  engage its behavioural insights team to carry out work and develop "top tips and psychological tools" to help pharmacies persuade those patients who are reluctant to engage with ABPM provision.

Mr Buxton added that as an alternative to the "NICE gold standard" of providing 24-hour ABPM to patients with high in-clinic readings, NHSE is exploring whether patients could be loaned a BP meter to take readings over the course of a week. 

"This is something we've wanted from the start of the service," he said.

Speaking on the same panel as Mr Buxton, Community Pharmacy North East London chief executive Shilpa Shah said she shared his concerns: "We are supposed to be helping people that have hypertension and don't know they do. 

"Part of that is that a certain percentage of people will need an ABPM. We need to get better at offering this."

Ms Shah also said LPCs should have oversight of live service data so they can support pharmacies in their area who are struggling to hit payment targets.

However, concerns were raised about GPs' level of engagement with the hypertension service. 

National Pharmacy Association chair Olivier Picard told the conference that after he referred a patient to her surgery after her ABPM indicated high blood pressure, she came back a month later with a prescription for BP medication. 

When he asked her about the patient journey, she told him: "They didn't even know you'd done an ABPM. They asked me to take my blood pressure for 10 days and made another appointment to come back and see them."

Mr Picard commented: "As long as I will be undermined by my fellow colleagues in primary care, then that will make my life impossible."