Deep dive into Clin Pharm at St George’s

Clinical Pharmacology and Therapeutics

About us

Clinical Pharmacology and Therapeutics is the medical specialty focused on ensuring patients receive the safest, most effective and most appropriate medicines for their individual needs.

Clinical pharmacologists are medically qualified doctors who specialise in medicines and prescribing. In addition to caring for patients directly, they work with other healthcare professionals to improve medicines safety, optimise treatment and support the development of new therapies.

At St George’s, we are one of the UK’s largest Clinical Pharmacology teams. We work with inpatients and outpatients in the hospital to improve the way medicines are prescribed, monitored and used. Our team provides specialist advice on complex medication problems, supports medicines safety and governance, develops prescribing policies, and leads research and education in medicines and prescribing.

We work closely with patients, GPs, pharmacists and hospital specialists to help ensure patients receive the right medicine, at the right dose, at the right time.

Our vision

We aim to improve patient outcomes through safer, more effective and more personalised use of medicines.

Through our clinical services, medicines safety work, research and education, we strive to ensure that every patient receives the right medicine, at the right dose, at the right time.

Clinical care

Specialist Polypharmacy Service

We provide expert assessment and advice for patients who take multiple medicines (polypharmacy) and patients with complex medication. Click here to find out how to refer. Common reasons for referral include:

• Taking multiple medicines (polypharmacy)
• Suspected adverse drug reactions
• Difficult prescribing decisions
• Drug dependence and withdrawal concerns

We provide specialist assessment of suspected side effects and adverse reactions to medicines and can advise on alternative treatments where appropriate.

Our service includes a weekly outpatient clinic, multidisciplinary team meetings and advice for healthcare professionals across South West London.

Blood Pressure Unit

We provide specialist assessment and management for patients with high blood pressure. The Unit is a tertiary referral centre and provides emergency and inpatient care as well as dealing with routine referrals. It is recognised as a Hypertension Centre of Excellence by the European Society of Hypertension.

Inpatient care

We provide care for patients in our roles as specialists in Acute and General Medicine and Intensive Care.

Pharmacogenomics and personalised medicine

Not all medicines work in the same way for every person.

We are developing and implementing personalised approaches to prescribing, including pharmacogenomics, which uses genetic information to help identify the safest and most effective medicines for individual patients. We also support the use of pharmacokinetic principles to optimise dosing in complex clinical situations.

Medicines safety and governance

Safe use of medicines is at the heart of what we do.

Our consultants lead and support medicines governance locally, regionally and nationally through formulary development, medicines safety programmes, prescribing policy development and quality improvement initiatives.

Our leadership roles include:

• Chair and membership of the South West London Joint Formulary Committee, responsible for reviewing and approving medicines for use in clinical practice
• Chair and membership of the South West London Integrated Medicines Optimisation Committee consisting of clinical leaders from across the NHS to oversee medicines strategy, promote safe and cost-effective prescribing, reduce health inequalities, and support the adoption of new advances such as pharmacogenomics.
• Chair and membership of the Medicines Governance Group, responsible for ensuring that there are appropriate policies, guidelines and good practice in the use of medicines at St George’s.
• Medicine of the Medicines Safety Group, responsible for monitoring medication-related incidents, identifying opportunities for improvement and promoting safer use of medicines.
• Chair of the Hospital Thrombosis Group, responsible for the oversight of medication to reduce the risk of blood clots.
• Chair of the South London Immunoglobulin Assessment Panel (SLIAP), responsible for the review and approval of the use of immunoglobulins for patients with impaired immune systems.
• Editorial leadership of The Grey Book, a widely used handbook of emergency and acute care guidelines that supports safe and effective prescribing and patient management.

We work closely with pharmacy colleagues to ensure patients have access to effective, evidence-based treatments while minimising the risk of harm.

National leadership

Members of our team hold national leadership and advisory positions with organisations including:

• National Institute for Health and Care Excellence (NICE)
• British National Formulary
• British Pharmacological Society
• Commission on Human Medicines
• Ockenden Maternity Review
• Royal College of Physicians Medicines Safety Joint Working Group

Research and innovation

Our research aims to improve the way medicines are developed, prescribed and used. We have particular expertise in medicines safety, pharmacokinetics, polypharmacy, pharmacogenomics, maternal medicine, antimicrobial stewardship and population health.

Working with academic, NHS and industry partners, we undertake clinical trials and applied health research that support safer prescribing, more personalised treatments and better use of medicines. Our work spans laboratory science, clinical research and healthcare evaluation, helping to translate new discoveries into improvements in patient care.

Below is a selection of recent publications and ongoing research projects from our team.

1. Bowen, L. et al. (2026) ‘Medicines prescribed in pregnancy: Protocol for a signal detection study using routinely collected data in England’. PLOS ONE. Available at: https://doi.org/10.1371/journal.pone.0349045
2. Dale, C.E. et al. (2026) ‘Patterns of medication use across society from national primary care dispensing data’. Nature Health. Available at: https://doi.org/10.1038/s44360-026-00134-w
3. Dernie, F. and Ng, F.L. (2026) ‘Modes of drug elimination and bioactive metabolites’, Anaesthesia & Intensive Care Medicine, 27(5), pp. 309–314. Available at: https://doi.org/10.1016/j.mpaic.2026.03.010
4. Dernie, F. et al. (2026) ‘Antibiotic prescribing in people with and without diabetes: A population-based matched cohort study’. JAC-Antimicrobial Resistance. Available at: https://doi.org/10.1093/jacamr/dlag074
5. Johnson, H. et al. (2026) ‘British National Formulary Guidance on prescribing in pregnancy: A descriptive cross-sectional study’. British Journal of Clinical Pharmacology. Available at: https://doi.org/10.1002/bcp.70613
6. Khawaja, M., Safir, Z., Hitchings, A. and Carden, R. (2026) ‘Cerebral fat embolism syndrome and the use of multimodal neuromonitoring and corticosteroid treatment’. BMJ Case Reports. Available at: https://doi.org/10.1136/bcr-2025-269489
7. Lambarth, A. and Threapleton, C.J.D. (2026) ‘Drugs and the liver’, Anaesthesia & Intensive Care Medicine, 27(7), pp. 444–451. Available at: https://doi.org/10.1016/j.mpaic.2026.06.001
8. Mustafa, A. et al. (2026) ‘A British Pharmacological Society Position Statement on Medications in Pregnancy and Lactation’. British Journal of Clinical Pharmacology. Available at: https://doi.org/10.1002/bcp.70664
9. Swire, C.C., Shah, R.V. and Lonsdale, D.O. (2026) ‘Quantitative pharmacokinetics’, Anaesthesia & Intensive Care Medicine, 27(5), pp. 305–308. Available at: https://doi.org/10.1016/j.mpaic.2026.03.009
10. Swire, C. et al. (2026) ‘Penicillin allergy de-labelling in the critical care unit: Simulations to design an intravenous drug provocation test that mirrors the plasma profile of an enteral challenge’. British Journal of Clinical Pharmacology. Available at: https://doi.org/10.1002/bcp.70388
11. Swire, C.C. et al. (2026) ‘Exposure to CYP2C19-metabolized drugs following acute stroke: A longitudinal cohort study to inform implementation of CYP2C19 genotype testing’. British Journal of Clinical Pharmacology. Available at: https://doi.org/10.1002/bcp.70722

Education and training

St George’s has a long tradition of excellence in clinical pharmacology education.

We teach medical, pharmacy and science students, provide postgraduate education for doctors and pharmacists, and support the development of future clinical pharmacologists and clinical academics. Our team contributes to undergraduate and postgraduate teaching, prescribing education and national assessment programmes.

Our involvement includes:

Undergraduate education

• Programme module and theme leads of the BSc in Clinical Pharmacology
• Theme lead and assessment leads in Medicine MBBS
• Clinical lead in Master of Pharmacy (MPharm)
• Lecturers on Physician Associate Studies MPAS

Postgraduate education

• Supervisors for PhD students
• Induction, education and training for doctors, pharmacists and other professional colleagues

National education roles

• Lead author of the curriculum for clinical pharmacology and prescribing education in UK medical schools, published by the British Pharmacology Society
• Board members of the Prescribing Safety Assessment, a nation-wide assessment of prescribing competency