Patients with high cholesterol could be diagnosed and given statins by pharmacists for the first time under NHS plans to cut the number of people dying from heart attacks and strokes.

If approved, the change in medical practice would lead to patients with the potentially fatal condition being diagnosed in high street chemists rather than in GP surgeries.

Someone a pharmacist suspects of having dangerously high levels of “bad” cholesterol could have a health check on the spot and receive the drugs without needing to get a prescription from a GP. However, it is unclear when and where they would have the blood test needed to accurately assess cholesterol levels.

NHS England says the move “could prevent thousands more deaths and countless more heart attacks and strokes” by getting hundreds of thousands more people on to statins, which experts say can significantly cut the risk of dying from those conditions.

Eight million Britons already take statins. However, millions more are believed to be at a heightened risk of having a heart attack or stroke because they have high cholesterol but do not take a daily statin tablet.

However, the Royal College of GPs (RCGP) voiced alarm at the proposed change, saying it could lead to people being misdiagnosed and wrongly treated by pharmacists.

The British Heart Foundation is also thought to have concerns about whether it is appropriate to give people statins in such circumstances, before they have discussed their health with their GP, and whether pharmacists are the right people to take on this new role.

Simon Stevens, NHS England’s chief executive, proposed the change at a gathering of NHS bosses in Manchester on Wednesday. It would help patients get key medical care in a more convenient way, he said.

“Since the NHS will be funding local chemists to undertake health checks it makes sense to consider whether there is a broader range of medicines that patients could access conveniently and locally on the high street,” he said.

NHS England is setting up a review to examine the plan, headed by Dr Keith Ridge, its chief pharmaceutical officer, and Dr Nikki Kanani, its acting director of primary care.

However, the Medicines and Healthcare products Regulatory Agency (MHRA), the UK’s medicines watchdog, would have to give its approval before pharmacists could extend their role in this way.

Pharmacists can already give patients low doses of statins without a prescription. In practice, that rarely happens because drug companies do not make them available that way. NHS England’s proposal would enable pharmacists to issue high doses of the cholesterol-cutting drugs.

Prof Helen Stokes-Lampard, the chair of the Royal College of GPs, says there were concerns about making statins more easily accessible, without a prescription. Photograph: Andy Hall/The Observer

Hundreds of thousands more people could improve their health by taking statins if manufacturers boosted efforts to make high doses of them available in chemists, said Ridge. “Used appropriately, statins are effective and can save lives,” he said.

High cholesterol can run in families but is often caused by eating too much fatty food, taking too little exercise, being overweight, smoking and drinking too much alcohol. Those deemed at high risk are initially offered advice about changing their lifestyles and then, if that does not reduce their cholesterol levels, offered statins.

Prof Helen Stokes-Lampard, the chair of the RCGP, said: “Extensive medical evidence has shown that statins are usually a safe and effective preventative measure against heart disease, and thousands of patients already benefit from statin therapy.

“But GPs are also mindful of the risks of over-diagnosis and over-treatment – a concern we expressed in response to recent Nice [National Institute for Health and Care Excellence] guidelines that lowered the threshold for eligibility of statins – and we also have concerns about making these drugs more easily accessible without a prescription.”

A recent study of 165,000 UK patients found almost half of those taking statins did not experience the 40% drop in their levels of low-density “bad” lipoprotein cholesterol that guidelines seek.

Prof Sir Nilesh Samani, the BHF’s medical director, also expressed apprehension, saying: “Currently, high-dose statins are used in patients who have already had a heart attack or stroke as they are at very high risk of further events.

“For people who haven’t had a heart attack or stroke, starting a statin on a long-term basis is an important decision. It requires a dialogue between a patient and their GP or healthcare provider after an assessment of their overall risk and taking into account patient preference.”