Licensed medicines represent regulatory excellence in quality, safety and efficacy but there are circumstances when there is no licensed medicine which meets the clinical needs of a particular group of patients such as the elderly or children unable to swallow tablets or capsules. The preparation of individual doses from licensed products may require complex manipulations and is therefore error-prone. In these circumstances unlicensed, specially-made medicines play an essential role in ensuring that treatment can be delivered safely. The White Paper for Pharmacy Services in England has specifically identified our responsibility to rationalise the range of specials made by the NHS, in order to ensure the highest possible product quality and that limited technical resources are used efficiently.