Support to manage your practice hypertension targets

2nd September 2024

To mark Know Your Numbers Week, 2nd-8th September 2024, we caught up with Dr Raj Bethapudi, who discusses the vital role of supporting GP practices to manage their hypertension targets.

Dr Bethapudi is a partner at The Galleries Medical Practice in Washington and Cardiovascular Prevention Lead for Sunderland. Raj has a keen interest in reducing mortality and morbidities associated with cardiovascular disease along with ensuring sustainability of General Practice and the health economy.

In this Q&A Raj highlights why it is more important than ever before to tackle hypertension, and provides some practical tips and suggestions for practices and primary care staff, to help you to meet hypertension targets, including the Quality and Outcomes Framework (QOF).

Why is it important that practices manage and support patients with hypertension, and what is the potential impact on our patients?

As healthcare professionals, we understand the importance of prevention in tackling disease burden and one of the corner stones in reducing cardiovascular mortality and morbidity is early identification and treatment of hypertension.

High blood pressure is the leading modifiable risk factor for heart and circulatory disease in England. However, an estimated 30% of adults in England have high blood pressure and most are not receiving effective treatment.

It’s important that we remember that we make every contact count, so I would encourage all practice staff to include blood pressure checks in annual long term reviews especially for patients with diabetes and/or chronic kidney disease.

Identification and treatment of hypertension continues to be a key target in the  QOF, ensuring practices are financially remunerated for the effort they put in at a time when financial sustainability of practices has become a challenge.

What advice would you give to practices to support them to achieve hypertension targets?

Some practical suggestions that can help practices achieve targets might include:

  • Introducing a hypertension champion within your practice – with a clear understanding of the number of patients in your surgery with uncontrolled/non-coded hypertension and the number of new diagnoses of hypertension.
  • Communications and messaging to patients – promoting the know your numbers campaign to encourage patients to take ownership of their blood pressure control, use of patient messaging services, and facilitating contact using GP surgery websites can be tried based on practice and patients’ preference. You can find a patient information leaflet on the HI NENC website to download and print, providing information about ideal blood pressure reading and how patients can lower your risks of high blood pressure. Download it here.
  • Encouraging the use of BP monitors at home – in my clinical practice, it was interesting to note the high number of patients who either already had a BP monitor or were happy to buy their own and coding these patients as having a monitor would be helpful to reduce the burden on practice appointments, especially if their BP remains high or their last BP reading in their notes was recorded to be high.
  • Supporting patient self-management – ensuring our patients fully understand the risks of uncontrolled hypertension, their treatment targets and admin staff having a laminated chart of normal and abnormal readings can be helpful.
  • Investing in training – of HCAs, social prescribers, health and wellbeing coaches where they are confidently able to identify raised BPs and issue home blood pressure/ambulatory blood pressure monitors appropriately reduces burden on GP appointments.
  • Support from other primary care services – having a good understanding of local pharmacies signed up to the hypertension diagnosis initiative and signposting opportunistically, having BP pods in practice waiting areas, and investing in BP monitors can also help alleviate pressure on GP appointments. Consider speaking with your PCN Clinical Director to see if some of these measures can be funded using PCN development funds.
  • Make use of patient searches – including CDRC, to identify further patients who are not treated to target
  • Take a co–morbid approach to hypertension – hypertension is just one of the risk factors of cardiovascular disease. Offer all patients with CVD, chronic kidney disease and diabetes a blood pressure check annually.

If some or all of these measures can be implemented in primary care, we will be in a good position to reduce health inequalities and tackle cardiovascular disease.

How can HI NENC support practices?

HI NENC is working across the region to support practices with cardiovascular prevention targets, including blood pressure.

Contact Tracy Marshall, Pharmacy Technician and Programme Manager at HI NENC, to find out more about how HI NENC can support you.