Consultant physicians working with patients - Royal College of ...

2 Specialties Clinical pharmacology and therapeuticsClinical pharmacology and therapeuticsDr Jeffrey Aronson Honorary consultant in clinical pharmacologyDr Stephen Jackson Professor of clinical gerontologyProfessor Munir Pirmohamed Consultant physician pharmacologyProfessor James Ritter Honorary consultant physician1 Description of the specialtyClinical pharmacologists at consultant level may beemployed by universities (the majority), the NHS orpharmaceutical companies. Within industry, clinicalpharmacologists are involved in the development ofnew drugs and early clinical trials in patients.Clinical pharmacologists employed in the NHS anduniversities usually combine their specialty work withresponsibilities as a general physician. This involves thesupervision of acute medical admissions, managingmedical inpatients and running outpatient clinics.These individuals will normally have a clinicalsubspecialty interest (eg cardiovascular riskmanagement or toxicology) and will take a particularinterest in prescribing issues on behalf of theiremploying NHS body.The mission of the specialty is to improve the care ofpatients by promoting the safe and effective use ofmedicines and to evaluate and introduce newtherapies. 1 Therefore, clinical pharmacologistswill often make wider contributions to the NHS clinicalservice. At a local level this will usually involve leading adrug and therapeutics committee, advising onnon-medical prescribing policy, developing andmaintaining a drug formulary, assessing new products,creating prescribing guidelines, reviewing adversemedication incidents and promoting evidence-basedtherapeutics.Some consultants may play a leading role in a‘medicines information service’ for local prescribers,with the support of a clinical pharmacist. At a nationallevel, consultants in clinical pharmacology andtherapeutics occupy many positions in key bodies suchas the National Institute for Health and Care Excellence(NICE), the Medicines and Healthcare productsRegulatory Agency (MHRA), the Commission onHuman Medicines (CHM), the joint formularycommittees that oversee publication of the BritishNational Formulary (BNF) and the BNF for children(BNFC), and adverse drug reaction monitoring(pharmacovigilance) schemes. The National PoisonsInformation Service (NPIS) is run almost exclusively byNHS clinical pharmacologists. They are also involved inresearch, both basic and clinical.2 Organisation of the service and patternsof referralSources of referral from primary, secondary andtertiary levelsClinical pharmacologists are active in promoting thesafe and effective use of medicines at all levels. At theprimary care level they develop and maintainformularies; at the secondary care level they lead drugand therapeutics committees and run drug informationservices; and at the tertiary level they are involved inorganisations such as the CHM’s adverse drug reactionmonitoring systems, the NPIS and the HealthTechnology Assessment (HTA) programme of theNational Institute for Health Research (NIHR).Locality-based and/or regional services;community models of careThe viability of local clinical networks is restricted bythe small number of consultants. However, clinicalpharmacologists often come together at a national levelin the setting of the adverse drug reactions monitoringsystem of the MHRA, NPIS and HTA.Clinical pharmacologists will usually have a closerelationship with one or more of the following: clinical pharmacy service medicines information unit clinical risk management committee primary care prescribing advisersC○ Royal College of Physicians 2013 73