The core role of a pharmacist is and has always been to supply the patient with the most appropriate medicines according to their needs. As we can see in the following papers patients have differing needs. Not all patients fit the ‘normal profile’ upon which the efficiencies of scale allow the pharmaceutical industry to mass produce medicines. A significant proportion of patients require medicines to be specifically made to suit their needs. The fact that the pharmaceutical industry has become so international and many of the smaller national industries have been swallowed up in the process means that any small effect on the supply chain leads to the observed shortages now felt in all countries around the world.

Pharmacists are then faced with many challenges with respect to regulations and quality standards which have to be rationalised with real patient needs and financial and managerial constraints. These are not new pressures but they are becoming national and international, leaving the individual pharmacist further from the decision-making process. However, the fact is that the pharmacist–patient interface remains local.

Historically the pharmacist was responsible for all aspects of the preparation of medicines. This would consist of collecting the raw materials (eg, herbs) through the compounding in all its stages, including delivery to the patient. Every stage of the process was within the control of the individual pharmacist. …