Who are we?

The National Poisons Information Service (NPIS) is the UK Departments of Health approved, and UK Health Security Agency (HSA) commissioned, national service that provides expert advice on all aspects of acute and chronic poisoning. Our clinical management advice is delivered either via telephone or through our bespoke database - TOXBASE^®.

The role of the NPIS is to reduce the burden of healthcare associated with poisoning by the provision of rapidly available, consistent and evidence-based advice to front-line NHS healthcare professionals. The purpose of this advice is to facilitate optimal clinical management of patients with confirmed or suspected poisoning and those who are (or may be) exposed to medicines or other potential poisons during pregnancy. Where toxicity is low, NPIS offers advice to minimise unnecessary hospital attendances and admissions.

The service comprises four Units, based in Birmingham, Cardiff, Edinburgh and Newcastle. Each Unit is staffed by Consultant Clinical Toxicologists and Specialists in Poisons Information who work together to provide a seamless national service that has been established for 50 years.

NPIS is funded mainly through ‘Government Grant in Aid’ from the UK Health Departments, some contract income and some research income.

What do we do?

Bespoke advice on individual cases of poisoning is available to healthcare professionals via the NPIS 24h telephone service.

The NPIS national telephone support service consists of a network of Specialists in Poisons Information based at four provider Units. Supporting them is a team of on-call consultant clinical toxicologists, attached to major teaching hospitals and therefore with first hand experience in the management of poisoning.

Enquirers can always gain access to the service (24/7) via a single national telephone number. An automatic call-routing system intelligently manages incoming phone calls, ensuring that every enquiry is directed to the next available specialist for a prompt and accurate response.

In exceptional circumstances, an emergency Service comes into effect, diverting calls to authorized mobile phones. At all times, the overriding aim is to ensure the reliability and continuity of the Service.

How we maintain our standards

The NPIS places the strongest emphasis on the quality of the clinical services it provides, with patient safety being our highest priority. To achieve excellent clinical outcomes, rigorous clinical governance standards are maintained. Key features of our approach include:

• appropriate induction, training and appraisal of all staff
• nationally organised continuous professional development with discussion of contentious issues, ensuring consistency of approach
• access to high quality information sources
• early peer review of enquiry answers and a programme of enquiry audit
• continuous support from senior staff including 24-hour availability of a consultant clinical toxicologist
• detailed and regularly updated national operational policies
• reporting and review of critical incidents, complaints and near misses so that lessons can be learned and shared throughout the service
• regular quality assurance exercises encompassing all aspects of NPIS work. This includes seeking feedback from service users. Questionnaires are sent to a random sample of callers to the telephone support service and posted on TOXBASE. Though, in general, the evidence from users indicates high or very high levels of satisfaction with the services, NPIS continues in its endeavours to develop and refine the support it gives to frontline NHS staff.

Who we advise

Healthcare professionals in the UK.

NPIS advises other UK and international agencies. NPIS experts contribute advice to official organisations across the healthcare sector, including occupational medicine.

NPIS Units provide information and advice to a number of organisations including:

• Advisory Council on the Misuse of Drugs (ACMD)
• British National Formulary (BNF)
• British National Formulary for Children (BNFC)
• Care Quality Commission (CQC) (previously the Healthcare Commission)
• Chemicals Regulation Division (CRD) (previously the Pesticide Safety Directorate (PSD))
• Department for Environment Food and Rural Affairs (DEFRA)
• Department of Health and Social Care (DHSC)
• Health and Safety Executive (HSE)
• Medicines and Healthcare Products Regulatory Agency (MHRA)
• Ministry of Defence (MoD)
• UK Health Security Agency (UK HSA)
• World Health Organisation (WHO)

A uniform national service

Although the NPIS is provided by Units embedded in separate NHS Trusts, a uniform national service is ensured by the following arrangements:

All NPIS Units work to common national standards as detailed in agreed operational procedures.

All telephone enquiries are recorded on the UK Poisons Information Database (UKPID). Comprehensive data protection arrangements that comply with national requirements are in place. The UKPID user group meets regularly to discuss operational issues relating to enquiry logging software.

The NPIS Clinical Standards Group meets quarterly to develop and finalise clinical advice and discuss clinical governance issues. In addition, the Group discusses urgent issues more frequently by teleconference.

The TOXBASE^® editing group meets quarterly to edit and agree TOXBASE^® entries.

NPIS National Continuing Professional Development meetings take place twice a year, with the location rotating around the NPIS Units. These are open to all NPIS staff and have sessions designed for Specialists in Poisons Information and for clinicians.

The NPIS website is maintained on behalf of all NPIS units by NPIS Birmingham.