Gloucestershire Blood Pressure Monitoring Service
Gloucestershire Blood Pressure Service
Introduction
The Optical Hypertension Case Finding Service will be provided within Gloucestershire Optical practices by suitably trained members of staff. The proposed service aims to identify patients over 40 years old who do not have a hypertension diagnosis and have not had their blood pressure (BP) measured in recently. Also patients under 40 will be able to be seen within the service if a recent episode of optical care (i.e. CUES, Sight Test) has identified an issue where it is possible/suspected that raised blood pressure is a cause e.g. sub-conjunctival haemorrhage diagnosed. The service will focus on opportunistic BP measurement. Clinical protocols will align with community pharmacy practices, emphasising consistency across primary care providers.
In addition, optometry practices will maximise utilisation of MECC (Making Every Contact Count) by providing patient health and wellbeing information e.g. https://primaryeyecare.co.uk/your-health/health-wellbeing/
Eligibility criteria:
- Over 40 years of age AND
- Not had their blood pressure checked in recent past or already undergoing BP monitoring AND
- Does not already have a hypertensive diagnosis AND
- GP in Gloucestershire
OR
- Under 40 years of age AND
- Signposted into service following optical care where finding/diagnosis is suggestive of raised BP AND
- Not had their blood pressure checked in recent past or already undergoing BP monitoring AND
- Does not already have a hypertensive diagnosis AND
- GP in Gloucestershire
Practice Guide
Pathway and Protocols - LINK
Printable Outcomes - LINK
Clinical Pathway – LINK
Training
Training Checklist - LINK
Training video 1 (Taking a BP reading) - LINK
Link to video 2 LINK
Launch Event and Opera Demo - LINK
Launch Event Presentation - LINK
Providing the service/ Printable Resources
Practice Poster- LINK
Service Leaflet - LINK
Frequently Asked Questions
Do community pharmacies follow the same criteria as above?
Yes – our optical/optometry service aligns with the pharmacy criteria
Does this depend on the location of the patient, or the location of their registered GP Practice?
This depends purely on the GP surgery, i.e. if the patient lives in the Forrest of Dean, but has a Herefordshire GP they are not eligible for the service.
Does this only apply for patients that have attended for an NHS sight test at the Optical Practice?
No, this could apply to anyone attending the practice for any reason – NHS or private sight tests, patients coming to collect spectacles or asking after a spectacle adjustment, or even people that come along to the practice to accompany a patient at the practice.
Could we buy an additional Blood Pressure Monitor for our Practice?
Yes, but this will need to be an identical make and model to the one used in the pilot, please contact Primary Eyecare for the Amazon link. The monitor and extra large cuff bundle is currently just under £33. Gloucestershire ICB will fund up to two monitors per practice (if the size of the practice warrants it), but larger practices are welcome to buy additional machines. .
For some outcomes patients will be able to be signposted to a participating pharmacy, what service will the pharmacist offer as opposed to the GP?
Some providing pharmacists provide the ABPM service (Ambulatory Blood Pressure Monitoring Service) where a patient is fitting with a monitoring cuff for a set period of time. This aims to take 14 readings at 30 minute intervals during a patient’s waking hours i.e. between 8am and 10pm, so 2pm is the latest time a monitor could be fitted. This helps to rule out issues like ‘white coat syndrome’ and gives an idea of normal fluctuations during the day. Following this the pharmacist is able to get a good idea of the patient’s normal readings and action accordingly.
Will there we scope for optometrists to fit 24 hour blood pressure monitors?
This pilot aims to see how well placed this is in optometry practice with a simple readings service. Following this, the results of the pilot will be analysed and there could well be scope in the future to expand this, but not for the course of this pilot.
What about if a patient isn’t eligible for the service but would like to pay privately to have an assessment?
The equipment is provided by Gloucestershire ICB for the purposes of this pilot with NHS funding, and should not be used outside of the scope of the service. We ask that practices do not use the device on patients ineligible for the service or private purposes (except where the practice staff are practising to use the device).
We’re a domiciliary practice and sometimes test at homeless shelters where there is no fixed address or registered GP – can we measure these patients?
Unfortunately for the purposes of this pilot the patient needs to have a registered GP surgery. If the patient has no fixed abode, the homeless shelter or practice address could be used. But in order to refer onwards to BP monitoring services, the patient needs to have a registered GP. Following evaluation of the pilot this will be one of the areas we highlight to the national team as of course these patients are highly deprived, so thank you for raising.
What is the practice fee?
£15 to the practice per patient
Will OPERA flag if the patient has already had their BP checked within 6 months?
No, we are relying on patient honesty for the purposes of the pilot. A simple yes/no from the patient is all that’s needed.