Pharmacy cholesterol testing reaches communities at greater risk of heart disease

Thirteen pharmacies across North East and North Central London introduced rapid finger-prick cholesterol tests alongside wider cardiovascular risk assessments, helping people access heart health checks closer to home.

The tests provide a full cholesterol reading in under seven minutes, while the wider assessment helps pharmacists identify a person’s risk of having a heart attack or stroke over the next 10 years.

Following the programme’s success, led by Barts Health NHS Trust and project managed and evaluated by UCLPartners, NHS England is supporting a pilot to expand the approach to around 100 pharmacies across England.

Our final evaluation report found that the pharmacies delivered more than 1,200 tests between January 2025 and February 2026. The wider cardiovascular risk assessment identified around one in five people assessed as being at high risk of heart attack or stroke over the next 10 years.

We found the programme successfully reached people living in more deprived communities who are at greater risk of cardiovascular disease, and who may not otherwise access GP or preventive services, such as NHS Health Checks. The programme also successfully engaged patients from diverse ethnic backgrounds, particularly people from Asian communities. The evaluation identified convenience, ease of access and trusted relationships with pharmacists as important factors in reaching these communities.

As a leading cause of heart attack and stroke, high cholesterol hits communities in the most deprived areas hardest due to higher risk factors and poorer access to care. There are often no symptoms, making proactive testing crucial.

When the cholesterol test and wider cardiovascular risk assessment identify someone as high risk, pharmacists can give immediate lifestyle advice and start treatment or refer to a GP for further care.

Most patients – 83% – were managed within their pharmacy, while a smaller number were referred to their GP for further investigation or treatment. Seventy-four patients began lipid-lowering therapy during the evaluation, reducing their future risk of heart attack and stroke.

The evaluation also found:

• The service was highly valued by patients and pharmacists. 98% of people tested said they would recommend it to a friend or family member.
• Language, cultural relevance and digital access remain important. Pharmacy teams described adapting advice to reflect local dietary practices and using multilingual staff and interpretation services.
• Expansion of the programme from North East London to North Central London, and expansion into wider testing, demonstrated its ability to scale.

The evaluation also highlighted key factors that will support scale. These include variation in activity between pharmacies, workforce capacity constraints, raising awareness of the service among patients, digital exclusion and language accessibility, and stronger engagement with GPs. The importance of sustainable commissioning was also identified.

John Craig, Chief Innovation Officer at UCLPartners, said:

“Our evaluation found that pharmacy cholesterol testing successfully identifies people at high risk of heart attack or stroke, reaches communities who are most at risk, and is highly valued by patients and pharmacists.

“The findings and learnings from this evaluation will be invaluable as the tests are scaled to more pharmacies across England to help reduce health inequalities and bring preventative care closer to home”.

Dr Sotiris Antoniou, Divisional Director of Clinical Services and Clinical Lead for Point of Care Testing at Barts Health NHS Trust, said:

“This programme creates a complete cardiovascular prevention pathway through pharmacies, combining testing with personalised and culturally appropriate lifestyle advice, referrals and, where available, lipid-lowering therapy from independent prescribing pharmacists.

“Our ambition is for high street pharmacies to become one of the front doors to cardiovascular prevention – finding the missing millions of people who are at risk and supporting them to live well for longer”.

Barts Health and UCLPartners worked with North East and North Central London ICBs, North East London Local Pharmaceutical Committee, HEART UK and NHS England to provide the tests.