The Pressure Drop 

Diversity and Wellbeing in Health CiC in partnership with 

Ravensbourne PCN and Sevenfields PCN

 

Know Your Numbers. Know Your Risk.

A community-embedded blood pressure and kidney disease screening programme,  bringing trusted testing, education and direct clinical pathways to the Black African and Black Caribbean communities who need it most.

 

Programme Overview

Part of the Lewisham Public Health, Health Equity Team (HET) Programme, partnering Black led Voluntary Community Sector Organisations (VCSOs) with local GPs to work together to for HETs. Our HET embeds trained facilitators and community champions in trusted community spaces, screening for high blood pressure and early kidney disease, building health literacy, and creating direct pathways into clinical care for Black African and Black Caribbean communities.

 

Who we screen: Black African, Black Caribbean and other underserved residents at elevated risk of hypertension and chronic kidney disease (CKD).

What we test: Blood pressure at all venues; urine protein testing at hub events to identify early CKD markers.

 

Why Blood Pressure Matters in Black Communities

Black African and Caribbean people develop high blood pressure at an earlier age, experience more severe complications and due to lower renin levels and higher salt sensitivity, respond differently to treatment. NICE prescribing guidelines reflect this biological difference. Yet diagnosis and treatment rates remain disproportionately low.

 

Key statistics:

• 1 in 3 adults has high blood pressure — most don't know it.

• Black communities face a 5 times higher risk of CKD.

• Black people in Lewisham are 1.7 times more likely to have high blood pressure compared to White British people.

 

Blood Pressure Classification and Response

• Optimal (below 139/89): Self-monitoring advice and healthy lifestyle tips.

• Elevated (140–179 / 90–119): lifestyle advice and organising repeat readings including referrals for 24 hour Blood pressure monitoring. If confirmed hypertension GP follow up is arranged

• Very High (180/120 or above): Direct referral to GP or A&E for urgent follow-up. Support from GP to help manage and treat and reduce your risk

 

Urine Protein Screening Classification and Response

Normal <3mg/g: healthy lifestyle tips 

Intermediate 3-30mg/g: Advised needs to have a repeat test organised through GP to confirm if there’s a problem 

High >30mg/g: Repeat test and kidney blood test to confirm likely Kidney Disease and then support from GP to help manage and treat and reduce your risk 

 

Screening Pathway at Hub Events

Step 1: Welcome and consent

Step 2: Blood pressure reading

Step 3: Urine ACR test

Step 4: Knowledge quiz and learning points

Step 5: Data recorded and signpost or refer to clinical partner

 

Hub and Event Venues

We bring screening to accessible community spaces including:

Churches and faith spaces

Public libraries

Leisure centres

Community halls

 

Barbershop Screening Model

Barbershops are culturally embedded access points in Black communities. Our trained champions deliver blood pressure checks only creating a familiar, non-clinical space that normalises testing and identifies those needing clinical support.

 

Unique to Lewisham

This Barbershop Project is unique to Lewisham, the first of its kind in the borough, bringing community-led blood pressure screening directly into barbershops for the local Black African and Caribbean population. It is aligned to the Croydon Barbershop Project, applying that proven South London model within our own community.

 

Champions do: Blood pressure checks, recording readings, signposting and flagging elevated results for follow-up.

Champions do not: Interpret clinical results or advise on medication — that stays with our clinical team.

 

Aligned to the Croydon Barbershop Project — LSBU and Croydon BME Forum

Led by London South Bank University and the Croydon BME Forum, the Croydon project trained barbers across South London to offer free on-the-spot blood pressure checks targeting Black and Asian men at greater risk yet lower diagnosis rates. Men with elevated readings were connected to the Wellness Centre for follow-up. Our Lewisham project replicates this model for the first time in the borough.

 

Flavour Without Pressure — The Salty Truth

Salt is the leading modifiable driver of high blood pressure  and the picture for Black African and Caribbean communities is stark. Unlike the wider UK population where 75% of salt comes from processed food, in Black African households the majority comes from salt added in cooking and at the table. Traditional dishes, saltfish, salt-beef, seasoned fried chicken, stews and curries, carry significant hidden sodium. The cultural and culinary roots of these foods are a strength, not a problem: our programme works with food traditions, not against them.

 

• 83% of Black men add salt when cooking.

• 85% of Black women add salt when cooking.

• 28% add salt at the table as well.

 

Our Intervention at Hub Events

Attendees taste food samples prepared with herbs and spices as salt replacements - scotch bonnet, thyme, allspice, scallion, ginger, rooted in Caribbean and West African flavour traditions. Facilitators explain labels, portion sizes and practical swaps without removing cultural identity from the plate. The maximum 6g salt per day target is made real and achievable.

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Engagement and Empowerment Activities:

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1. Pressure Drop Quiz - Blood pressure and CKD knowledge questions on playing cards. Measures baseline awareness, delivers key learning points, and makes data collection engaging and culturally relevant.

2. Know Your Numbers - BP Pipe Demo - A hands-on demonstration using a copper pipe, watering can and straw to visualise blood pressure in plain language. Memorable, jargon-free and conversation-starting.

3. Stress Busting Workshop - A 3-minute guided session on breathing techniques and mindfulness rooted in Caribbean and African traditions, making stress management resonant, practical and accessible.

4. Flavour Without Pressure - Food tastings with herb and spice alternatives to salt. Hands-on dietary education that respects cultural food traditions while addressing a key blood pressure risk factor. See The Salty Truth section above.

5. Panel discussion with our clinical partners and residents with lived experience We bring our clinical partners into community spaces where we can have real talk with them. Ask questions, address any myths and have more time with a health professional in a comfortable space. 

 

What This Means for GP Practices: -

 

• Warm, motivated referrals: Patients arrive knowing their readings and ready to engage with clinical care.

• Supports clinical targets: Case finding and referrals directly feed hypertension and CKD indicators.

• Population intelligence: Anonymised BP and ACR data and knowledge gap insights fed back to PCN leads.

• Reaches the unreached: Culturally grounded outreach engages groups that typically avoid or delay clinical contact.

• Supported by our Integrated Neighbourhood team and HEF: careful clinical governance makes sure only patients who need to see the GP are brought to you 

• Support from your HEF: ask your HEF to support your practice to review your CVD recall processes and make suggestions for how to make this more equitable and reach our underserved communities 

 

Linking to Primary Care Networks (PCN’s) and Primary Care

 

• Promote GP services: PCN and Integrated Neighbourhood Team offers actively promoted at every event, with clear signposting to registration and services.

• Resident voice: Community barriers, concerns and service feedback gathered and reported directly to PCN leads to inform equity planning.

• Case finding support: Identifying unregistered or under-screened residents to support PCN equity and population health goals.

• Direct referral pathway: Anyone with elevated blood pressure or abnormal ACR receives a direct referral withing our clinical governance pathways to allow timely follow-up.

 

Partner With Us

 

• To refer patients, attend a hub event, or discuss direct referral arrangements, please contact the Health Equity Fellow for our HET 

 

Diversity and Health & Well-being CiC

Ravensbourne PCN |  Sevenfields PCN

Lewisham's first barbershop blood pressure project — aligned to the Croydon Barbershop Project (LSBU / Croydon BME Forum)