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Hypertension action plan fails to 'recognise practice nurse potential'

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National plans released last week to tackle hypertension are “disappointing”, because they do not go far enough in highlighting the role that practice nurses play in the prevention and management of the condition, the Royal College of Nursing has claimed.

Public Health England’s action plan included a recommendation that practice nurses should carry out more opportunistic testing to improve rates of diagnosis, but the RCN said this could alternatively be achieved by people testing themselves on blood pressure machines.

“This report is a missed opportunity to highlight the benefits of the role of the practice nurse”

Marina Lupari

The RCN said the plan – called Tackling high blood pressure: From evidence into action – should have instead stated that practice nurses were “ideally placed” to develop patient management plans, offer lifestyle advice, agree medication with them and empower them to self-manage the condition.

“This report is a missed opportunity to highlight the benefits of the role of the practice nurse,” said Marina Lupari, RCN professional lead for primary care and community nursing.

“It’s not the opportunistic screening that will actually contribute to the reduction of the impact of hypertension,” she said. “All you’re doing with that is identifying the number of people that you know have the condition.

“It’s the preventative work beforehand and the opportunity for self-management techniques that are important,” she noted.

Dr Lupari said: “With the technology that we now have and with the emphasis of moving across the responsibility of people’s health back to themselves, what we should be doing is encouraging people to go and test themselves.”

Royal College of Nursing

Marina Lupari

She added that increasing opportunistic testing by practice nurses could “waste the valuable and limited resource that we have in primary care doing blood pressure checks on people who don’t need it”.

The action plan – developed by 12 member organisations of the Blood Pressure System Leadership Board, which includes the British Heart Foundation and Association of Directors of Public Health – pointed to figures suggesting conditions linked to hypertension cost the NHS in England more than £2bn a year.

It claimed that a 15% increase in hypertension diagnosis among adults could, over the next decade, save the healthcare system around £120m currently spent on related health and social care services.

In addition, it estimates that around £850m spent on these services could be saved over the next decade if the average population blood pressure level were reduced through prevention methods.

A further £120m that is currently spent on related services could be avoided over the next 10 years if those receiving treatment for hypertension levels saw it controlled to a lower level through lifestyle changes and drug therapy, added the plan.

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