Clinical pharmacologists employed within the NHS usually combine their specialty with work as general physicians. About half of their time will involve the supervision of acute medical admissions, responsibility for medical inpatients and running outpatient clinics. These individuals will normally have another clinical specialty interest (e.g. cardiovascular risk management, toxicology) and will take a particular interest in prescribing issues on behalf of their employing NHS body.
The mission of the specialty is to improve the care of patients by promoting safe and effective use of medicines and to evaluate and introduce new therapies. Therefore, clinical pharmacologists will often make wider contributions to the NHS clinical service. At a local level, this may involve leading the Drug & Therapeutics Committee, developing and maintaining a drug formulary, assessing new products, creating prescribing guidelines, reviewing medication incidents and promoting evidence-based therapeutics. Some consultants may play a leading role in the provision of a medicines information service to local prescribers, usually with the support of a clinical pharmacist. At a national level, consultants in clinical pharmacology and therapeutics occupy many of the positions within key bodies such as the National Institute for Clinical Excellence, the Medicines Control Agency, the Committee on Safety of Medicines, the Joint Formulary Committee overseeing publication of the British National Formulary, the Medicines Commission and adverse drug reaction monitoring (pharmacovigilance) schemes. The National Poisons Information Service is run almost exclusively by NHS clinical pharmacologists.
The work programme of a consultant in clinical pharmacology and therapeutics varies greatly, depending on the job setting. Approximately two-thirds of consultants in clinical pharmacology and therapeutics held academic appointments within universities. While having a service commitment, many of these individuals will have a strong research emphasis in their work that will contribute to knowledge about drug actions and their clinical usage. They will also play an important role in the planning and delivery of undergraduate teaching in therapeutics.
Other clinical pharmacologists at consultant level are employed by the pharmaceutical industry and are involved in the development of new drugs and early clinical trials in patients. Some also hold joint appointments with academic units or trusts, a trend that may grow in the future.
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