Population Needs. National/local context and Evidence Base Hypertension is persistently raised arterial blood pressure (BP). It is one of several risk factors for diseases such as heart failure, myocardial infarction, stroke, and chronic kidney disease. Hypertension should be suspected if clinic systolic BP is sustained above or equal to 140 mmHg, or diastolic BP is sustained above or equal to 90 mmHg, or both. (NICE 2018) High blood pressure affects more than one in four adults in England, and is the second biggest risk factor for premature death and disability. Improvements in tackling blood pressure in the last decade have prevented or postponed many thousands of deaths, but at present only four in ten of all adults with high blood pressure are both aware of their condition and managing it to the levels recommended. People from the most deprived areas are 30% more likely than the least-deprived to have high blood pressure and the condition disproportionately affects some ethnic groups including black African and Caribbean. Therefore a focus on blood pressure has potential to address health inequalities and variation in outcomes (PHE 2014). Public Health England (PHE) published Tackling high blood pressure: from evidence into action (PHE 2014). This document provides evidence-based advice on how local government, the health system and others can effectively identify, treat and prevent high blood pressure. Actions identified included: Clinical Commissioning Groups (CCGs) should consider the case for local investment in Enhanced community pharmacy services to provide better information and support about blood pressure management; to introduce opportunistic screening in some areas; and to use the Medicines Use Review (MUR) service to review the blood pressure of those on anti- antihypertensive medication and others at high risk of developing high blood pressure Healthcare professionals, including pharmacists and their teams, should take the opportunity of client engagement to test the blood pressure of all adults regularly and carry out pulse checks as part of blood pressure measurement The General Practice Forward View acknowledges that ‘Pharmacists remain one of the most underutilised professional resources in the system and we must bring their considerable skills in to play more fully’ (NHSE 2016, p7). This sentiment is shared in the Community Pharmacy Forward View. (PSNC 2016). General Practice registered population for Hull and East Riding CCGs for January 2018 was 602,207. Public Health estimated that in 2015/16 155,267 patients had hypertension. The Quality Outcomes framework (QOF) register for this period was 93,917, leaving over 61,000 patients undiagnosed. Disease prevalence of CVD – Focussing on Heart Disease and hypertension, QOF 2016/17 indicates that ERY CCG has a disease register for Coronary Heart Disease (CHD) of 4.8 and Hull CCG 3.6, above the England rate of 3.2. ERY CCG is second highest within their RightCare peer group, whilst Hull CCG is third lowest. For Hypertension prevalence, each CCG is around 60% diagnosed of the Public Health estimate 2015/16. Potentially there are in excess of 60,000 residents in the region with undiagnosed hypertension, which this programme will look to cover. Premature mortality – From the PH England Fingertips website, for indicator: Coronary Heart Disease mortality under 75. ERY CCG at 39.8 is slightly higher than the England rate of 39.4, but third highest within their RightCare 10 most similar CCGs. Hull CCG at 59.4 are significantly higher than the England rate and second highest within their RightCare 10 most similar CCGs. Identified health inequalities – A review of the Public Health Fingertips, Health Profile, Inequalities, Premature Mortality data shows ERY CCG as better within the Yorkshire and Humber region, and below the England position. There are areas of high deprivation in the coastal areas of ERY CCG. Analysis of the registered to estimated prevalence for hypertension, shows these areas as having a high opportunity under this programme. Across the region current opportunities to identify potential essential hypertension are limited to NHS Health Checks and community Health Trainers, (where commissioned this is usually funded by Public Health), opportunistic testing within community pharmacy and when patients have contact with General Practice. At present there is no clear community based alternative. Over the past decade, there has been growing interest in the role of community pharmacies in addressing these major public health issues. With an estimated 95% of people visiting a pharmacy at least once per year and an estimated 99.8% of people from the most deprived areas living within just a 20 minute walk of a community pharmacy, this setting offers the ideal location to reach out to the public (RSPH 2015).
Appears in 1 contract
Population Needs. National/local context and Evidence Base Hypertension is persistently raised arterial blood pressure (BP). It is one of several risk factors for diseases such as heart failure, myocardial infarction, stroke, and chronic kidney disease. Hypertension should be suspected if clinic systolic BP is sustained above or equal to 140 mmHg, or diastolic BP is sustained above or equal to 90 mmHg, or both. (NICE 2018) High blood pressure affects more than one in four adults in England, and is the second biggest risk factor for premature death and disability. Improvements in tackling blood pressure in the last decade have prevented or postponed many thousands of deaths, but at present only four in ten of all adults with high blood pressure are both aware of their condition and managing it to the levels recommended. People from the most deprived areas are 30% more likely than the least-deprived to have high blood pressure and the condition disproportionately affects some ethnic groups including black African and Caribbean. Therefore a focus on blood pressure has potential to address health inequalities and variation in outcomes (PHE 2014). Public Health England (PHE) published Tackling high blood pressure: from evidence into action (PHE 2014). This document provides evidence-based advice on how local government, the health system and others can effectively identify, treat and prevent high blood pressure. Actions identified included: • Clinical Commissioning Groups (CCGs) should consider the case for local investment in Enhanced community pharmacy services to provide better information and support about blood pressure management; to introduce opportunistic screening in some areas; and to use the Medicines Use Review (MUR) service to review the blood pressure of those on anti- antihypertensive medication and others at high risk of developing high blood pressure • Healthcare professionals, including pharmacists and their teams, should take the opportunity of client engagement to test the blood pressure of all adults regularly and carry out pulse checks as part of blood pressure measurement The General Practice Forward View acknowledges that ‘Pharmacists remain one of the most underutilised professional resources in the system and we must bring their considerable skills in to play more fully’ (NHSE 2016, p7). This sentiment is shared in the Community Pharmacy Forward View. (PSNC 2016). General Practice registered population for Hull and East Riding CCGs for January 2018 was 602,207. Public Health estimated that in 2015/16 155,267 patients had hypertension. The Quality Outcomes framework (QOF) register for this period was 93,917, leaving over 61,000 patients undiagnosed. Disease prevalence of CVD – Focussing on Heart Disease and hypertension, QOF 2016/17 indicates that ERY CCG has a disease register for Coronary Heart Disease (CHD) of 4.8 and Hull CCG 3.6, above the England rate of 3.2. ERY CCG is second highest within their RightCare peer group, whilst Hull CCG is third lowest. For Hypertension prevalence, each CCG is around 60% diagnosed of the Public Health estimate 2015/16. Potentially there are in excess of 60,000 residents in the region with undiagnosed hypertension, which this programme will look to cover. Premature mortality – From the PH England Fingertips website, for indicator: Coronary Heart Disease mortality under 75. ERY CCG at 39.8 is slightly higher than the England rate of 39.4, but third highest within their RightCare 10 most similar CCGs. Hull CCG at 59.4 are significantly higher than the England rate and second highest within their RightCare 10 most similar CCGs. Identified health inequalities – A review of the Public Health Fingertips, Health Profile, Inequalities, Premature Mortality data shows ERY CCG as better within the Yorkshire and Humber region, and below the England position. There are areas of high deprivation in the coastal areas of ERY CCG. Analysis of the registered to estimated prevalence for hypertension, shows these areas as having a high opportunity under this programme. Across the region current opportunities to identify potential essential hypertension are limited to NHS Health Checks and community Health Trainers, (where commissioned this is usually funded by Public Health), opportunistic testing within community pharmacy and when patients have contact with General Practice. At present there is no clear community based alternative. Over the past decade, there has been growing interest in the role of community pharmacies in addressing these major public health issues. With an estimated 95% of people visiting a pharmacy at least once per year and an estimated 99.8% of people from the most deprived areas living within just a 20 minute walk of a community pharmacy, this setting offers the ideal location to reach out to the public (RSPH 2015).
Appears in 1 contract