The Future Hospital Commission identified enhancing the role of the generalist physician as a strategic priority for the NHS, complementing consultants in other specialties and providing high-quality, coordinated hospital care. Most CPT consultants are dual-accredited in CPT and general internal medicine (although some also practise in other specialties including geriatric medicine, cardiology, oncology, respiratory medicine and rheumatology) and are therefore well placed to take on this enhanced role.
For many CPT consultants, activities are normally devoted to supervising the management of acute and continuing care of medical patients and the specialist work of the individual consultant. This work typically requires two ward rounds per week at fixed times. The consultant’s team should ideally be responsible for no more than 20 patients, but can provide support particularly after on-calls. Part of this time will be dedicated to inpatient referrals for patients with pharmacological or toxicological problems. A typical case mix of general medical patients is expected; however, given the increasing number of older patients with multiple comorbidities and polypharmacy (and who cannot easily be triaged to a single organ-based specialty), it is increasingly likely that such complex patients may benefit from clinical pharmacological input.
In addition to acute and general medicine services, CPT consultants may also provide:
- specialist services eg specialist poisons treatment unit or care of patients on a stroke unit
- management of difficult therapeutic areas eg drug-resistant hypertension, drug-drug interactions, and adverse drug reactions.
Read the report by the British Pharmacological Society (BPS), Clinical Pharmacology: A dynamic medical specialty essential for UK healthcare (p 15, case studies on person-centred care).