Unawareness prevails among general practices and primary care commissioners regarding their performance against the National Institute for Health and Care Excellence (NICE) hypertension guidelines. Workload pressures pose a major challenge for quality improvement initiatives. A locally developed support package, Cheshire and Merseyside (C&M) Blood Pressure Quality Improvement (BPQI) package, is an effective and well-received way to improve practice-level BP care and control for general practice nursing team.
A recent report by Public Health England states that this package meets the national need for BP quality improvement solutions in general practice. As per estimates, optimisation of BP treatment for known patients across C&M would translate to 460 fewer heart attacks and 680 fewer strokes whilst saving around £13 million.
The British Heart Foundation, in collaboration with Sefton clinical commissioning groups, developed the BPQI package. The development was guided by primary care insights from a NICE-led workshop and other local developments. This package offered EMIS-embedded dashboard, audit tool and consultation templates, practice protocols, training support and printable patient information leaflet.
The C&M BPQI package proved to be an effective and acceptable tool to support and improve practice-level BP care. Practice-level performance against indicators for care and control improved between approximately 3% and 15% at 14 weeks. Practice nurses, health care assistants, practice managers and general practitioners from 3 practices provided positive responses. Nurses described the package as “intuitive, time-saving and effective”.
Next steps would be to scale-up the package use through a phased sub-regional roll out. For more patient-focused solution and improved sustainability and impact, further steps include incorporation of other cardiovascular disease risk factors like cholesterol and atrial fibrillation.