Initiative brings high blood pressure under control

Patients in Cheshire and Merseyside are benefiting from an innovative project to improve the management of high blood pressure (BP).

High blood pressure, or hypertension, is linked to around 50 per cent of heart attacks and strokes in the UK and is the main modifiable risk factor for cardiovascular disease (CVD).

Up to 30 per cent of adults are thought to have hypertension and half of them are not being effectively treated. NHS England’s target is for 80 per cent of hypertension patients to have controlled blood pressure.

Health Innovation North West Coast led a quality improvement project, commissioned by NHS Cheshire and Merseyside, to support GP practices in managing more patients on the hypertension register.

The Health Innovation North West Coast project supported 15 GP practices with the knowledge and resources to manage more patients. The team also helped identify the measures that would allow the initiative to spread sustainably across Cheshire and Merseyside.

The project aimed to tackle health inequality and a wide variation in performance among GP surgeries, and focused on education, information and systems, and leadership. Communities of practice were also established to share insights and overcome obstacles to improvement.

At the end of the six-month project all surgeries reported they would undertake a similar quality improvement project again, while 93 per cent said the project had led to sustainable improvements; 93 per cent also said they were investing in further blood pressure monitoring equipment.

Greg Musial, Deputy Head of Medicines Management at PrimaryCare:24, the Liverpool social enterprise delivering a range of primary care services and covering several GP surgeries, said: “Health Innovation North West Coast did a great job in coordinating the work.

“The blood pressure quality improvement toolkit was extremely useful, and we hope to use it to find more hypertension cases.

“The project has made sure that managing people with hypertension is a priority for us now in a way it wasn’t before, and we’re working to make sure the processes are embedded.

“The Health Innovation North West Coast team made sure we kept our focus and we’d definitely want to do something like this again.”

Examples of sustainable improvements to patient care include:

• A surgery trained reception staff to take BP readings to avoid patients waiting for a medical appointment
• Several practices trained healthcare coordinators to take readings
• Several practices sent out thousands of texts to encourage patients to visit a pharmacy for a BP check

The Health Innovation North West Coast team has also made recommendations about how the package of support could be extended to surgeries in other areas. They include developing a toolkit for surgeries, featuring protocols for patients to manage their blood pressure and other digital resources; guidance on annual reviews; and a communications strategy for blood pressure optimisation.

 Molly Bridgewood, who managed the project for Health Innovation North West Coast, said: “It’s very rewarding to lead a project such as this because hypertension is such a crucial area of focus in tackling CVD.

“The feedback we’ve had from surgeries is excellent and we were very pleased that the surgery teams were so keen to become involved.

“Practices are telling us the project will have a lasting impact on the way they manage hypertension which gives us the confidence we’re heading in the right direction. That gives us the impetus to spread the process to other areas.”