We funded a number of community projects to improve the detection and management of high blood pressure in the UK.
We wanted to encourage original ideas for how the UK can better identify and care for people with high blood pressure (BP). That's why we funded projects that developed, tested and implemented the next big ideas in detection and management.
Watch: How our fund has made a difference
Our short film tells David’s story. He was completely unaware he had extremely high BP until his community centre in Bradford was visited by an innovative local project - Health Action Local Engagement (HALE) - part-funded by the BHF.
What did we do?
An estimated 4.7 million adults have undiagnosed high BP, greatly increasing their risk of a devastating stroke or myocardial infarction (MI).
We awarded £1.5 million of funding to 15 sites across the UK, from local councils to CCGs and public health collaboratives.
Their work demonstrated the potential to protect countless lives – and change how the country thinks about finding and managing these individuals.
Why do we need this change?
High BP affects around 27% of UK adults, yet as many as 8 million of those with this symptomless risk factor are either undiagnosed or uncontrolled without effective treatment.1
High BP greatly increases the chance of an MI or stroke and is associated with half of all cases.2 In fact, it’s the third most common risk factor attributable to early death in the UK, after poor diet and smoking.2
But its effects are largely preventable with lifestyle changes and treatment.
We urgently need to identify these people and manage them appropriately. But we know existing approaches won’t deliver the pace of change we need.
How do we compare to other nations?
In Canada, 66% of all adults with high BP manage their condition to recommended levels; in England, this is just 38%.3
The NHS Long Term Plan calls on the health service in England to raise detection rates to be in line with high-performing nations. By doing so, we can greatly reduce cases of stroke and MI.
What did our programme do?
We made £1.5 million available to 15 sites to test new approaches to detection and management of high BP.
The programme consisted of two rounds. Round one got underway in April 2017, and round two commenced in April 2019. All sites are expected to conclude their projects by September 2021.
At each of our programme sites, our funding aimed to:
increase detection and management of people with undiagnosed high BP
improve access to BP testing in the community
strengthen support for patients to manage their high BP
empower people to test their BP routinely
add to the evidence base on the detection and management of high BP and how new ideas are adopted
Each site applying for funding had to have a population of at least 100,000 people, and demonstrate evidence of unmet need locally, such as high rates of cardiovascular disease, premature mortality or health inequalities. High BP must have been noted as a local priority and pathways were require for identified individuals to access medical and behaviour change support.
Each site’s funding ran for two years, in which time they committed to reach and test 5,000 people per year and undergo regular evaluation by an independent commissioned evaluation team.
The phase 1 evaluation report is now available and highlights the key learning and challenges faced by our round 1 sites:
31,529 people had their blood pressure checked as part of the programme
24% of these people were found to have high blood pressure
2,165 people were referred for further monitoring of BP
59% of stakeholders reported that identification of undetected hypertension has increased
Improved awareness of blood pressure numbers and risk factors in participants
We funded 15 sites across the UK - you can find more information about each site below.
Phase one: fact file
Number of sites: 7
Services began: March 2017
Total funding awarded: £700,000 Completion date: November 2020
Bradford Districts CCG and Health Action Local Engagement (HALE)
High-footfall community-based locations are being used to test the local population, such as community centres, places of worship and large employers. An awareness campaign including media interviews, social media, newspaper interviews and a presence at festivals and sporting events is also under way. See video above.
Cheshire and Merseyside
The Fire and Rescue service is being trained to take BP via ‘Safe and Well’ home visits, which include people at risk from falls, increasing bowel cancer screening rates, smoking cessation and alcohol reduction. The programme will also see interconnected devices (health kiosks) for use within the prevention hub, primary care clusters and community venues.
Haringey Council and Islington Council
Training a network of community and voluntary sector providers across Haringey and Islington with the skills to raise awareness of high BP and perform BP testing in community settings, including supermarkets, barber shops, football clubs, community centres and faith settings.
Leeds County Council
Health trainers and pharmacy technicians are being upskilled to carry out BP testing in workplaces. This programme is targeting deprived populations, BME communities and those identified as being less likely to attend primary care.
NHS 24, Scotland
Patients are being provided with BP monitors to measure their BP from home, and use their own mobile phones to text their BP via a telehealth system called FLO, which will capture the measurement in the GP Patient Record system. This site is working in partnership with NHS Lothian, NHS Lanarkshire and NHS Western Isles.
NHS Lambeth CCG
Community pharmacies, opticians and community providers such as football clubs and community trusts are being commissioned to opportunistically check BP, detect high BP and provide education and support to priority groups. Home monitoring and assessment work will assess patients’ capability to self-manage their condition.
Royal Borough of Greenwich
A high-profile campaign supported by an 8-10 week annual roadshow to raise the profile of high BP and, in particular, the importance of BP testing. It will also scale up testing and detection, including the delivery of new innovative models for follow-up, such as clinics that support ambulatory BP monitoring.
Phase two: fact file
Services began from: April 2019 Number of sites: 7 Total funding awarded: £800,000 Expected completion date: September 2021
Old Library Trust Healthy Living Centre, Northern Ireland
A collaborative approach between five existing centres and urban and rural community-based providers to identify ‘hotspots’ for high BP focusing on areas of high deprivation. These hotspots include the Traveller community.
Cheshire and Merseyside (CHAMPS) Public Health Collaborative
A collaborative project between nine local authorities and other partners in Cheshire and Merseyside to embed BP testing across workplaces and existing wellbeing at work programmes. CHAMPS was awarded during Round One of funding and this project builds on the original award.
East and North Hertfordshire CCG
A collaborative outreach programme expanding on existing services to include BP testing and outreach events at train stations, leisure centres and workplaces, targeting disadvantaged groups
East Riding of Yorkshire CCG
A targeted campaign through Healthy Living Pharmacies to deliver BP testing and lifestyle support. Individuals at high risk will be offered ‘take-home monitors’ and taught how to self-monitor.
Gloucestershire CCG
A collaborative approach between Healthy Living Pharmacies, Gloucestershire Fire Service and The Workplace Wellbeing Charter and Voluntary Community and Social Enterprise Alliance training ‘BP Champions’ to support testing events.
Lancashire County Council
Establishing BP testing services in new community locations, including football clubs, healthy lifestyle provider settings and healthy living pharmacies, focusing on the areas that will have greatest impact to reduce health inequalities.
Newcastle and Gateshead CCG
An innovative pharmacy-based model in which 40 pharmacies will be recruited and trained to provide a BP testing and diagnosis service and home BP monitoring, incorporating healthy living advice and brief interventions.
Telford and Wrekin Council
Recruiting and training two BP Advisors, based within the community, as well as upskilling existing health champions and volunteers with BP monitors placed at a wide range of community venues.
References
1. BHF estimates 2019 based on Health Survey for England data
2. Global Burden of Disease UK estimates 2017
3. NHS Digital, Health Survey for England 2017
Related links
Managing high blood pressure
Statistics and practical guidance to help general practices improve detection and management of hypertension in their area.
To find out more, or to support British Heart Foundation’s work, please visit www.bhf.org.uk. You can speak to one of our cardiac nurses by calling our helpline on 0808 802 1234 (freephone), Monday to Friday, 9am to 5pm. For general customer service enquiries, please call 0300 330 3322, Monday to Friday, 9am to 5pm.
British Heart Foundation is a registered Charity No. 225971. Registered as a Company limited by guarantee in England & Wales No. 699547. Registered office at Greater London House, 180 Hampstead Road, London NW1 7AW. Registered as a Charity in Scotland No. SC039426