NHS England has confirmed that pharmacy technicians as well as pharmacists can provide blood pressure checks as part of the hypertension case-finding service in a range of changes to its service specification.

The updated guidelines, published on Monday by NHSE, also compel pharmacies to explain why they have stopped providing the service and warn they will not be eligible for the set-up fee if they withdraw within 30 days of signing up it.

Other changes include recording patients with high systolic and normal diastolic readings or high diastolic and normal systolic readings as having high blood pressure and removing the requirement for ambulatory blood pressure monitoring (ABPM) to be carried out over 24 hours and allowing it to be done during a patient’s “usual waking hours.”

Patients who need a same-day referral to a GP include those with a “very high” clinic reading (BP>180/120mmHg), a “high” clinic reading (BP>140/90mmHg) whose ABPM results indicate very high blood pressure ≥1 0/115mmHg, an irregular pulse and a “low” clinic reading (BP< 0/ 0mmHg) where an individual has experienced regular fainting or falls or feels like they may faint on a daily or near daily basis.

Patients who need an appointment within one week include those with a “high” clinic reading (BP≥140/ 0mmHg) whose ABPM results are indicative of stage 2 hypertension with readings of 150/95mmHg to 169/114mmHg.

Patients who need an appointment within three weeks include those with a “high” clinic reading (BP≥140/ 0mmHg) who subsequently give a “high” ABPM reading (ABPM≥1 5/85mmHg and <150/95 mmHg),  a “high” clinic reading (BP≥140/ 0mmHg) who subsequently decline an offer of ABPM or fail to attend an agreed ABPM consultation and a “low” clinic reading (BP<90/60mmHg) with symptoms of dizziness, nausea or fatigue.

Community Pharmacy England said members should “review the changes to the service, update their standard operating procedures and brief their teams accordingly.”

Last month, the government pledged to invest £645 million over the next two years to help community pharmacies in England provide a common conditions service as well as the contraception and hypertension case-finding services.