On this page
The benefits of this project
Benefits for Your Patients
- Reduced risk of heart attacks & strokes
- Reduced health inequalities
Benefits for Your Practice
- Prevents future ill-health and the associated burden on healthcare system
Benefits for The Planet
- Encouraging disease prevention and healthy lifestyles will reduce need for medication and its carbon impact
Opportunity for improvement
- Cardiovascular disease (CVD) affects over 6 million people in England and is responsible for 1 in 4 deaths in the UK. People with CVD risk factors need to be identified and offered treatment, to avoid large numbers of CVD events. High blood pressure (BP) is a common risk factor for CVD and significantly increases the risk of having a heart attack or stroke.
- Studies have shown links between hypertension and deprivation. Those living in the most deprived areas of England are 30% more likely to have high blood pressure than those in the least deprived areas. They are also about twice as likely to have a stroke.
- Hypertension is such a major issue that it is included as a national medicine optimisation opportunity.
- The NICE guideline hypertension in adults: diagnosis and management recommends that people aged over 40 should be considered for treatment of hypertension if they have high BP. Detecting hypertension early helps people live longer, healthier lives and supports risk identification and prevention of CVD.
- This project aims to improve identification of patients with hypertension so they can be offered lifestyle advice and antihypertensive drug therapies (see disclaimers).
- You might like to create a SMART goal for your project. E.g. Reduce the number of patients with a single BP reading of systolic >=140mmHg or diastolic >=90mmHg (at risk of hypertension), who do not have a record of GP recorded hypertension by >70% over the next 2 months.
How to carry out this project
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Investigate & Plan
Check with the practice leads, nursing team and reception team about the current processes for identifying and treating hypertension and adjust the steps below to suit your practice.
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Community Pharmacy
Check with your local community pharmacists if they offer a free BP check service and discuss this project with them. They can help with consistent messaging to patients and in taking BP readings. Your practice pharmacist will likely know how best to get in touch with them.
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Identify patients
Search for any patients with a single BP reading of systolic >=140mmHg or diastolic >=90mmHg (at risk of hypertension), who do not have a record of GP recorded hypertension.
We hope to provide downloadable IT searches for EMIS & System 1 soon. In the meantime, you could use our EMIS and SystmOne search guides to create your own
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Contact patients
Send these patients a text message asking them to repeat their BP measurement and send in the reading.
Resource: Example Test Message
We do not have a recent normal blood pressure (BP) measurement for you. High BP increases the risk of heart attacks and strokes so we want to make sure yours is ok. Please check your BP and let us know the measurement via the link below, or you can write it down and hand it to reception. You can check your BP at your local pharmacy or using our waiting room BP machine or using a home BP machine. If your reading is high, our reception team will book you a nurse appointment to discuss next steps.
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Reception Team
Make sure the reception team are happy with what is normal and abnormal for BP measurements and when to book appointments and who to book with. This could be via face-to-face chats, online training and email communications. You might want to make a flowchart for them to follow.
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Data collection
Re-run the search 1-2 months after the patients were contacted to assess the change.
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Study
Review the results, summarise learning, share with practice team + decide if any changes are needed to improve the process. Decide when to re-audit again to ensure the change has lasted e.g. 6-12 months and use the Project Monitoring form to keep track. Many practices run automatic searches at regular intervals – speak to your practice team about including this project in those searches.
Top tip
If your practice uses birthday month recalls, you can stratify your patient search list into their month of birth to make sure you are not contacting patients ahead of their birthday month
How to scale this project up or down
| Please note - Use of this project requires NetworkPLUS membership. If you would like to share this project with others, please invite them to purchase their own membership—access must not be shared with non-members. |
This could also be a great opportunity to promote healthy habits and lifestyle interventions to prevent cardiovascular disease.
This is a helpful project for your PCN as the PCN Network Contract DES guidance outlines the expectations that PCNs should proactively review patient records to identify patients who are not on the hypertension register but have a most recent blood pressure recording of 140/90mmHg or higher.
You could expand this project to include other parameters such as hypertension treatment. CVD Prevent can be helpful to find metrics needing improvement in your practice. You might like to work with the nurses and social prescribers to maximise antihypertension lifestyle advice and options offered by the practice.
Have you completed this QIP?
Tell us a little about your project and enter your data in order to generate a certificate showing the probable benefits. This project may help with CQC evidence submission (see disclaimers).
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