Drugs in frequent use in a ward, or likely to be required in an emergency, are usually supplied as ward stock. In most hospitals the pharmacy operates a top-up system with a pharmacy technician checking and supplying drugs to an agreed stock level on a weekly basis, thus removing the responsibility of ordering from the nurse. Whichever system is used, the aim must be to avoid both wasteful overstocking and running out at times when the pharmacy is closed.

Individual patient dispensing is used for less frequently required drugs and in cases where the preparation is tailored to the patient’s particular requirements. Although most drugs are manufactured by industry, hospital pharmacies are always able to prepare different dose forms or strengths; for example, a mixture for a patient unable to take solids, a paediatric mixture where the child needs a lower dose, or a suppository if the oral route is contraindicated. Some hospitals are able to prepare injections of novel or little-used chemicals, or formulate a chemical substance into preparations suitable for administration by a variety of routes. These more expert services, although concentrated in a few hospitals, are available to all through service contracts. The ward pharmacist can always advise on a suitable preparation and arrange for it to be made available.

The law requires that drugs of addiction, known as controlled drugs, must be supplied only against the signature of a qualified nurse or midwife, usually the nurse in charge of the ward or his or her deputy, and that the requisitions for these drugs must state precisely the name, form, strength and quantity of the drug required. Controlled drugs most likely to be met by the nurse include morphine, diamorphine (heroin), methadone, dextromoramide, buprenorphine and fentanyl. In addition, some hospitals place similar controls on other drugs liable to misuse, such as night sedatives, tranquillizers and antidepressants, and on spirits such as whisky and brandy.