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Around half of community pharmacy contractors are not delivering ambulatory blood pressure monitoring (ABPM) consultations each month, an analysis by The Pharmaceutical Journal has shown.
The findings follow an announcement from Community Pharmacy England (CPE), published on 30 September 2025, that the requirement for pharmacies to deliver at least one ABPM consultation per month as part of ‘bundling’ requirements to receive a Pharmacy First fixed monthly payment from 1 October 2025 had been delayed.
The analysis of NHS dispensing contractors’ data on the number of ABPM consultations delivered each month from January to June 2025, which are the latest data available, show that the number of contractors that did not deliver any ABPM consultations ranged from 59% in January 2025 to to almost half (49%) in June 2025 (see Table).
Under the current requirements, which began in June 2025 and were agreed as part of the 2025/2026 pharmacy contract, pharmacy owners must deliver the hypertension case-finding service, the pharmacy contraception service and the Pharmacy First service — in addition to delivering at least 30 clinical pathway consultations — to receive the fixed payment.
These contractors would therefore have missed out on the £1,000 Pharmacy First monthly payment had the bundling requirements been in place and had they met the Pharmacy First consultation threshold, according to the analysis.
In its announcement, CPE said the decision to delay the ABPM requirement followed reports that pharmacy teams “struggle to get patients to agree to ABPM following a high clinic blood pressure reading”.
“We have been sharing this evidence with DHSC [Department of Health and Social Care] and NHS England over the past few months and, while the decision by ministers provides little notice to pharmacy owners of this change, we hope the news will be welcomed by them,” it said.
CPE added that NHS England is reviewing the use of home blood pressure monitoring, which “could be an appropriate way to meet the needs of patients who cannot tolerate or reject the offer of ABPM, whilst also reflecting the way many general practices choose to confirm a diagnosis of hypertension”.
“We will be having further discussions with DHSC and NHS England on the best way forward.”
Commenting on the announcement, Malcolm Harrison, chief executive of the Company Chemists’ Association (CCA), said: “We are pleased to see that the ABPM bundling requirement has been delayed.
“This follows the CCA’s previous analysis, which found that, as of February 2025, only around 30% of pharmacies were meeting the planned bundling requirements.
“Our latest analysis of the NHS’s dispensing contractors data for June 2025 shows that there has been some progress. Almost 45% of all contractors have now delivered at least one Pharmacy First consultation, one pharmacy contraception service consultation and an ABPM check.”
However, he noted: “Almost 1,800 pharmacies which met all other bundling requirements in June 2025 did not deliver at least one ABPM. This would have meant missed threshold payments worth £1.5m.”
“We are also pleased that NHS England are considering the inclusion of home blood pressure monitoring in addition to ABPM, as the CCA had recommended. This simple change would ensure more pharmacies are able to deliver the service and receive threshold payments, which are vital to ensuring that pharmacies are able to stay afloat.”
Analysis of Pharmacy First data by The Pharmaceutical Journal, published in September 2025, showed that community pharmacies in England have missed out on more than £71m in threshold payments, as of May 2025.
Payments were missed either because the pharmacies did not deliver the required number of clinical pathway consultations or because they have not signed up to provide the Pharmacy First service, which is estimated to be around 2% of pharmacies in England.
