BP@Home Programme

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The Blood Pressure @ Home Programme is a pilot service within the ACERS Heart Failure team at Homerton Hospital (St Leonard’s Hospital site), supporting patients in the City & Hackney area with uncontrolled hypertension and confirmed heart failure. The service is being delivered in collaboration with local GP practices, currently live within the Shoreditch Park and City Primary Care Network (PCN), with plans to extend to the London Fields PCN soon.

 


Eligibility criteria

Inclusions

The Blood Pressure @ Home Programme is a pilot service within the ACERS Heart Failure team at Homerton Hospital (St Leonard’s Hospital site), supporting patients in the City & Hackney area with uncontrolled hypertension and confirmed heart failure. The service is being delivered in collaboration with local GP practices, currently live within the Shoreditch Park and City Primary Care Network (PCN), with plans to extend to the London Fields PCN soon.

Eligible patients must have:

  • A confirmed diagnosis of heart failure, and

  • Uncontrolled hypertension, defined by:

    • For patients aged under 80:

      • Clinic BP target: Consistently above 140/90 mmHg

      • Home BP target: Consistently above 135/85 mmHg

    • For patients aged 80 and over:

      • Clinic BP target: Consistently above 150/90 mmHg

      • Home BP target: Consistently above 145/85 mmHg

For patients with hypertensive crisis (clinic BP above 180/110 mmHg):

  • Although the programme will accept these patients, it is encouraged that they are signposted directly to their registered GP or, if accompanied by red alert symptoms (e.g., chest pain, severe headache, shortness of breath, vision problems, confusion, or difficulty speaking), to emergency services for immediate evaluation and management.

These targets follow NICE guidelines (NG136) for managing hypertension and heart failure. By enabling patients to monitor their blood pressure at home, the programme empowers them to take control of their health and reduce cardiovascular risks.


Patients should be registered at the following practices/PCN:

Shoreditch Park & City PCN

  • Shoreditch Park Surgery

  • De Beauvoir Surgery

  • The Hoxton Surgery

  • The Lawson Practice

  • The Neaman Practice (City)

London Fields PCN

 

  • London Fields Medical Centre

  • Richmond Road Medical Centre

  • Beechwood Medical Centre

  • The Dalston Practice

  • Queensbridge Group Practice

  • Sandringham Practice

Exclusions

 

Although the programme will accept these patients, it is encouraged that they are signposted directly to their registered GP or, if accompanied by red alert symptoms (e.g., chest pain, severe headache, shortness of breath, vision problems, confusion, or difficulty speaking), to emergency services for immediate evaluation and management.


How to refer

The following clinicians can refer to this service: GPs, Nurses, Clinical Staff e.g GP Pharmacist, Physician Associate etc

Editable PDF / Word document Download Form

Referral methods: Email

Please see page 2 of referral criteria attached.  Please ensure the requested information is filled out before sending email referral.