The National Poisons Information Service (NPIS) is the Department of Health approved, and Health Protection Agency commissioned, National UK service that provides expert advice on all aspects of acute and chronic poisoning.

The Service comprises four individual Centres, based in Birmingham, Cardiff, Edinburgh and Newcastle. Each Centre has its own Specialist Consultant Clinical Toxicology staff and Poisons Information Specialists who work together to provide a seamless National service that has been established for more than 40 years.

In line with Department of Health Policy the NPIS promotes, supports and develops best practice for the management of cases of poisoning in UK health facilities.

All four NPIS Centres contribute to TOXBASE, the UK approved clinical toxicology database designed for all UK healthcare professionals. The NPIS also offers a National 24 hour telephone information line (Tel: 0870 600 6266) which provides clinical staff with case specific advice on more complex cases. This telephone line is manned by NPIS Poisons Information Specialists who are science graduates who have received additional training in clinical toxicology. They are supported by a National on-call rota of NPIS Consultant Clinical Toxicologists who collectively have personal experience of managing in excess of 6,000 cases of poisoning per annum, and therefore have extensive clinical experience on which to draw when answering enquiries on severe cases of poisoning. In addition, NPIS consultant staff are able to accept direct clinical referrals from colleagues who require specialist assistance in the management of less common types of poisoning, such as those due to heavy metals.

The NPIS also hosts the UK National Teratology Information Service (NTIS).

The NPIS also conducts surveillance activities on behalf of the HPA, MHRA and other Government Agencies on the toxic effects of products in the United Kingdom.

All NPIS Centres contribute to a National clinical governance system, and their staff participate in a National continuing education programme. NPIS Centre staff are heavily involved in teaching and research, both within the United Kingdom and at an international level. Staff contribute annually to the Congresses organised by the European Association of Poisons Centres and Clinical Toxicologists and the North American Congress of Clinical Toxicology and are involved closely in the work of the of the World Health Organisation (WHO), the International Programme on Chemical Safety (IPCS) and the EC.

The NPIS publishes an annual report which is available from the HPA website.

Since 1998 it has been Department of Health policy that the first point of contact for Poisons Information for health professionals in the UK should be TOXBASE. This database contains information on approximately 12,000 products, together with generic advice on the management of poisoning. It is available free of charge to registered NHS users.

By using TOXBASE, clinical staff can obtain key clinical information rapidly, including advice on potentially hazardous doses and appropriate management. A printable fact-sheet is available as a permanent record of the advice provided for that patient. The NPIS advises that it is important not to use a previously printed fact-sheet for newly presenting patients. Instead, staff should re-access TOXBASE to obtain the very latest advice, as updates on TOXBASE are performed virtually every day so it is important not to keep old fact sheets as they may become out of date.

Comments on the content and advice provided in TOXBASE are always welcome. Each entry is a written by the NPIS, approved by all NPIS directors and regularly reviewed. Registered users who wish to discuss how to improve their use of the database are encouraged to contact the NPIS as advice on training can be provided.

The NPIS 24 hour telephone helpline (Tel: 0870 600 6266) is always available for discussion of more complex cases. When appropriate, senior medical staff can discuss their cases directly with an NPIS consultant clinical toxicologist.

This service is only available to NHS professionals, and is manned 24 hours a day 365 days a year by trained NPIS Poisons Information Specialists. Calls are routed to the most appropriate UK NPIS Centre according to geographic location and availability of a telephone line that is not engaged. Details of enquiries are stored for clinical governance purposes and recorded within confidential case record databases held by the NPIS. Such a record is important in order that the management of poisoning in the United Kingdom can be improved, based on the experience of the NHS as a whole.

If deemed necessary, further direct consultation can occur with an experienced NPIS consultant clinical toxicologist who will be participating in the UK NPIS national consultant on-call rota. All Clinical Toxicologists working for the NPIS have day-to-day experience of managing cases of acute poisoning in NHS clinical units associated with NPIS centres. NPIS consultants are themselves directly responsible for managing in excess of 6,000 cases of poisoning per annum, and therefore have a large clinical experience to draw on when answering questions.

The NPIS centres are all located in major UK teaching hospitals which have associated laboratory facilities. In addition, TOXBASE also provides a link to "Assay Finder", a web-service providing information on availability of assays in the UK and details of sample requirements. NPIS Poisons Information Specialists, or NPIS consultant staff may also advise you from our 24 hour NPIS helpline (0870 600 6266).

The NPIS has details of National antidote holdings within UK pharmacy departments, and will, if appropriate, advise on contact details for the nearest supply.

14 Dec 2005