General introduction

In Denmark, the Ministry of Health is responsible for legislation on health care, including legislation on health provisions, personnel, hospitals and pharmacies. The Ministry also sets up overall guidelines and quality goals for health care services. The next political and administrative level is the five regions, and they run the 10 hospital pharmacies in Denmark. All hospital pharmacies are publicly owned. In 2009, 18303 hospital beds were recorded (http://www.sst.dk/Indberetning%20og%20statistik/Sundhedsdata/Sengepladser.aspx), and the average admission time was 4.2 days (http://www.regioner.dk/%C3%98konomi/ ~ /media/Filer/%C3%98konomi/Analyser/Styr%20p%C3%A5%20regionerne%202010/Styr%20p%C3%A5%20regionernes%20%C3%B8kono_Kap_6.ashx).

Three of the regions have only one hospital pharmacy, each delivering medicinal products and services to all hospitals within the region, while two regions have several hospital pharmacies. There is great variation among the size of the pharmacies, with the hospital pharmacy in Copenhagen having more than 500 employees and the smallest pharmacy having about 20 employees. Approximately 1500 people work in hospital pharmacies in Denmark. The largest group of staff consists of pharmaconomists, with a 3 year education (http://www.pharmakon.dk/Pages/International.aspx?PageID=152), followed by pharmacists (http://www.sdu.dk/en/uddannelse/kandidat/farmaceut, http://www.farma.ku.dk/index.php/BSc-and-MSc-programmes-in-Dani/4638/0/) and locally trained people. Despite variations in size, all hospital pharmacies have similar tasks and pursue goals within the same three areas:

• Meeting special hospital needs by manufacturing, preparing and developing medicinal products.

• Safe and efficient supply of medicine by optimising logistics including, IT systems.

• Rational pharmacotherapy by developing and implementing clinical pharmacy.

The pharmacies have a variety of functions to fulfil in order to meet these goals. All pharmacies buy, store and distribute medicine, and they all use the same ERP system, Apovision. They deliver profound top-up service and participate in drug and therapeutic committee work, including the elaboration and implementation of recommendations and drug use monitoring. Many pharmacists perform medication reconciliation and medication reviews, and participate in different national or local quality programmes and patient safety initiatives. The pharmacies all have central intravenous additive …