Advanced services

The Hypertension Case-Finding Service was commissioned as an advanced service from October 2021.

In public-facing communications, the service is described as the NHS Blood Pressure Check Service.

Cardiovascular disease (CVD) is one of the leading causes of premature death in England and accounts for 1.6 million disability adjusted life years.

Hypertension is the biggest risk factor for CVD and is one of the top five risk factors for all premature death and disability in England. An estimated 5.5 million people have undiagnosed hypertension across the country.

In 2020, NHS England commenced a pilot involving pharmacies offering blood pressure checks to people 40 years and over. In some pharmacies within the pilot, where the patient’s initial blood pressure reading was elevated, they would be offered ambulatory blood pressure monitoring (ABPM), which is the gold-standard for diagnosis of hypertension.

Following the initial findings of the pilot, the Department of Health and Social Care (DHSC) and NHS England proposed the commissioning of a new Hypertension Case-Finding Service, as an advanced service.

The service aims to identify people aged 40 years or older, or at the discretion of pharmacy staff people under the age of 40 with high blood pressure, and to refer them to general practice to confirm diagnosis for appropriate management. It also aims to undertake ad hoc clinic and ambulatory blood pressure measurements, and provide another opportunity to promote healthy behaviours to patients.

From 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.

Webinar for pharmacy providers

Pharmacy owners and their teams can watch an on-demand recording of Community Pharmacy England’s January 2024 webinar on the re-launch of the Hypertension Case-Finding Service.

The webinar looked at how to make greater use of the whole pharmacy team and ways to maximise the number of eligible patients taking up ambulatory blood pressure monitoring (ABPM).

During the session, the presenters gave a brief review of the service requirements and the changes to the service from 1 December 2023.

Further information about the Hypertension Case-Finding Service can be found on the Community Pharmacy England website.

The Lateral Flow Device tests supply service (LFD service) for patients potentially eligible for COVID-19 treatments was commissioned as an advanced service from 6 November 2023.

The NHS offers COVID-19 treatment to people with COVID-19 who are at risk of becoming seriously ill. It is estimated that, in the short-term, the number of potentially eligible patients is around 3.9 million.

From November 2023, eligible patients are able to obtain LFD kits from participating community pharmacies. Community pharmacy is well placed within the local community to provide local and rapid access to LFD tests for patients.

The objective of this service is to offer eligible at-risk patients access to LFD tests to enable testing at home for COVID-19, following symptoms of infection. A positive LFD test result will be used to inform a clinical assessment to determine whether the patient is suitable for and will benefit from NICE recommended COVID-19 treatments.

You can read more about the LFD service on the Community Pharmacy England website.

The New Medicine Service (NMS) was the fourth advanced service to be added to the Community Pharmacy Contractual Framework (CPCF). It began in October 2011.

The service provides support for people with long-term conditions who are newly prescribed a medicine to help improve medicines adherence. It is focused on specific patient groups and conditions.

It is estimated that between 30 and 50 per cent of prescribed medicines are not taken as recommended. This represents a failure to translate the technological benefits of new medicines into health gain for individuals. Sub-optimal medicines use can lead to inadequate management of the long-term condition and a cost to the patient, the NHS and society.

The service provides support to people who are newly prescribed a medicine to manage a long-term condition, which will generally help them to appropriately improve their medication adherence and enhance self-management of their condition. The service covers specific conditions and medicines are covered by the service.

The service is split into three stages: patient engagement; intervention; follow up.

Forthcoming changes to the service

• Developments in NMS IT support planned for December 2023

• From a date to be determined, subject to positive evaluation of an ongoing pilot, the NMS will expand to include antidepressants to enable patients who are newly prescribed an antidepressant to receive extra support from their community pharmacist. Further details on this change will be published in due course

Further information about the New Medicines Service can be found on the Community Pharmacy England website

The Pharmacy Contraception Service (PCS), was commissioned by the NHS as an advanced service from April 2023. 

The service allows the on-going supply of oral contraception (OC) from community pharmacies.

The NHS Long Term Plan Chapter 2 highlighted the importance of NHS services complementing the action taken by local government to support the commissioning of sexual health services. A Public Health England resource for commissioners (2019) also highlighted the role community pharmacy can play in supporting ongoing contraception. 

In May 2023, NHS England announced The Delivery Plan for recovering access to primary care. This highlighted the ambition to expand the PCS to increase access to and convenience of contraception services in line with the Government’s Women’s Health Strategy for England. The strategy flagged that community pharmacy had a part to play in increasing choice in the ways people can access contraception.  

From 1 December 2023, an expansion of the OC service was agreed to include both initiation and on-going supply of OC, and provide ongoing clinical checks and annual reviews. 

The service provides another opportunity for pharmacy owners to help address health inequalities by providing wider healthcare access in their communities and signposting service users into local sexual health services in line with NICE guideline NG 102.  

The service aims to provide greater choice from where people can access contraception services; and extra capacity in primary care and sexual health clinics (or equivalent) to support meeting the demand for more complex assessments. 

Webinars 

Two webinars are available from Community Pharmacy England on the Pharmacy Contraception Service:

• Pharmacy Contraception Service: Initiating contraception webinar – aimed at helping pharmacy teams who are already providing the service to expand their offering to include initiating contraception
• Pharmacy Contraception Service: getting going with the service – aimed at helping pharmacy teams who have not yet started to get ready to offer it to their patients

Further information about the Pharmacy Contraception Service can be found on the Community Pharmacy England website.

In November 2023, Community Pharmacy England reached an agreement with the Government and the NHS on the launch of a new national Pharmacy First service from 31 January 2024.

The deal sets out how the £645 million investment pledged within the Delivery plan for recovering access to primary care will be used to support community pharmacy services.

Under the agreement, the new Pharmacy First service includes providing advice and NHS-funded treatment, where appropriate, for the following seven common conditions:

• sinusitis

• sore throat

• earache

• infected insect bite

• impetigo

• shingles

• uncomplicated urinary tract infections in women

Consultations for these seven clinical pathways can be provided to patients presenting to the pharmacy as well as those referred by NHS 111, general practices and others.

Webinars for pharmacy providers

Two webinars are available from Community Pharmacy England on the Pharmacy First service:

• Pharmacy First: Getting to know the service – this webinar provides the initial launch information

• Pharmacy First: Getting ready for launch – this webinar focuses on how to prepare for the service launch, building on the content of the earlier webinar and providing additional practical information

Further information about the Pharmacy First service can be found on the Community Pharmacy England website and on the PCB Pharmacy First website page.

The Smoking Cessation Service (SCS) was commissioned as an advanced service from March 2022.

Smoking rates have fallen significantly in the last 10 years, but smoking still accounts for more years of life lost than any other modifiable risk factor.

Around 5.7 million people or nearly 14% of the adult population in England were reported to smoke in 2019. Smokers see their GP over a third more often than non-smokers, and smoking is linked to nearly half a million hospital admissions each year.

The NHS Long Term Plan set a goal that by 2023/24, all people admitted to hospital who smoke will be offered NHS-funded tobacco treatment services. The plan committed to the adoption of the Ottawa Model for Smoking Cessation (OMSC), which has been evidenced across Canada to improve smoking quit rates by 11%.

This Smoking Cessation Service has been designed to enable NHS trusts to undertake a transfer of care on patient discharge, referring patients (where they consent) to a community pharmacy of their choice to continue their smoking cessation treatment, including providing medication and support as required. The ambition is for referral from NHS trusts to community pharmacy to create additional capacity in the smoking cessation pathway.

The service can only be provided by a pharmacist or pharmacy technician.

Further information about the Smoking Cessation Service can be found on the Community Pharmacy England website.