History

History

A key milestone in the adoption of security measures into medicines supply occurred with the publication of the Aitken report in 1958, which recommended practices that are still followed today. However, the key driver in the development of systems has been the desire to improve medication safety. This was recognised as a major cause for concern during the 1960s and resulted in the introduction of new prescribing and administration recording systems, which form the basis for those in use, even today. Many hospital organisations are using prescription forms which have changed little in 20 years (an example is given in Chapter 9).

Most hospitals operated a ‘stock’ and ‘non-stock’ system for medicines on their wards, though few still operate this system. Stock medicines were those that were in routine use on that particular ward and specialty. ‘Non-stock items’ were supplied individually for those medicines that were not routinely used on that particular ward. This also applied to medicines that the hospital wanted to restrict or monitor. More recently, with the advent of payment by results, as mentioned in Chapter 1, English trusts may wish to issue medicines which are excluded from the regular tariff payment scheme to individual patients, so that dispensing data can be interrogated to ascertain which patients have received which medicines and, in some cases, for what purpose. It may be used to promote return to pharmacy of unused, less common medicines when the patient is discharged.