Action A19: Deliver an increased number of blood pressure checks and pulse monitoring through GP, community and pharmacy routes, to increase the number of people diagnosed and treated for cardiovascular diseases

The ICB's York place team are working with Nimbuscare and healthya to deliver a city-wide hypertension screening project. Three health kiosks have been rolled out in York as part of a groundbreaking initiative to improve the health of the city's population. Free to use, the kiosks measure a person's height, weight, BMI, blood pressure, heart rate, and oxygen saturation. Three locations have been identified and kiosks are now live in areas of relative deprivation. These include Tang Hall Community Centre, Morrisons Foss Islands, and Energise Leisure Centre in Acomb.

The health kiosk provision aims to build upon the existing NHS Community Pharmacy Blood Pressure Check Service. Working with Community Pharmacy North Yorkshire LPC, the York place team identified that uptake of the blood pressure check service was low. This is especially troubling for patients living in deprived neighbourhoods, who experience a lower diagnostic rate than patients living in more affluent parts of the city. To bridge the gap, the health kiosks act as a feeder into the pharmacy blood pressure check service, by offering an initial check outside of a clinical setting.

Patient safety is at the heart of the project. Clinical pathways have been agreed with partners from Nimbuscare, ensuring that there are adequate escalation routes. Patients with a blood pressure reading indicative of hypertension are signposted to community pharmacy to commence ambulatory home blood pressure monitoring. Patients detected with an excessively high blood pressure are signposted to same day care GP appointments. In the rare event of a hypertensive crisis, patients are immediately informed to attend A&E or call 999 as appropriate.

Health Innovation Yorkshire and Humber have committed £40k to fund the scheme's evaluation. Work on this is underway and is being performed by the York Health Economics Consortium(YHEC). In total, 141 patients have used the health kiosks at least once. This represents 256 individual health assessments. Thus far, 8% of patients have provided a high BP reading (>=140/90). Additionally, 29% of patients have been identified as Obese (BMI >=30 or >=27.5).

Whilst initial throughput has been promising, the team are conscious that to make a meaningful difference to diagnostic rates, overall utilisation must increase. Initial communication and marketing of the project has been intentionally limited to ensure that the system does not become overwhelmed. With increased confidence in the backend processes, the team are now ready drive footfall with a several intentions:

· An SMS campaign targeted at patients most at risk of hypertension.

· A 'train the trainers' programme, upskilling staff at sites to promote the kiosk.

· An increase in local marketing materials to be displayed in general practice and online.

· A cardiovascular disease event to be held at York Designer Outlet to coincide with the national Know your Numbers week.