Under draft guidance issued this week by NICE, GPs would offer ambulatory monitoring to confirm a diagnosis of hypertension following two in-clinic readings of 140/90mmHg or higher. The device is more accurate than manual reading and can reduce inappropriate treatment caused by ‘white coat’ hypertension.
But practices typically own only one ambulatory device and high prevalence of hypertension means almost all practices in England would be forced to spend vast amounts purchasing further units, which cost around £1,000 each.
Dr Kathryn Griffith, president of the Primary Care Cardiovascular Society (PCCS) said: ‘Guidance has to be practical and sensible to use in primary care. People can't make us do something that is unachievable.’
She warned practices in deprived areas with high prevalence of hypertension may be hit hardest. ‘No-one gives us the money to fund [the devices],’ she said. Extra consultations to instruct patients to use the device would also generate additional workload, she added.
NICE said the new approach would be cost effective and ‘ultimately be cost-saving for the NHS’ as it would reduce costs from inappropriate treatment. But a detailed costing analysis is still being developed, it said.
A consultation on the plans runs until 22 March.
