Dehradun: On the instructions of Chief Minister Pushkar Singh Dhami, the Uttarakhand government has started taking strict action against unnecessary referrals of patients to government hospitals. Health Secretary Dr. R. Rajesh Kumar has clarified that now no patient will be referred from district and sub-district hospitals to higher institutions like medical colleges or big hospitals without a solid medical reason. The Health Secretary said that in line with the instructions of the Chief Minister, it is being ensured that every patient gets primary treatment and expert opinion at the district level itself. Unnecessary referral not only increases the pressure on resources but the patient is not able to get proper treatment on time.
SOP issued to prevent unnecessary referral
Health Secretary Dr. R. Rajesh Kumar said that the Health Department has issued a detailed Standard Operating Procedure (SOP) in this direction, so that transparency, accountability and medical justification can be ensured in the referral system. The following points have been given prominence in the SOP.
Referral only on unavailability of specialist – If the required specialist is not available in a hospital, then only the patient will be sent to a higher institution.
Decision by the senior doctor present on the spot – The on-duty doctor will examine the patient and take the decision of referral himself. Referral based on information received by phone or e-mail will now be invalid.
Exemption of quick decision in emergency- In critical condition, on-duty specialists can take life-saving decisions through WhatsApp/call, but it will be mandatory to document it later.
Written mention of reasons is necessary- It should be made clear in the referral form why the referral was made, lack of specialist, unavailability of resources etc.
Senior officers will be accountable- If inappropriate or non-urgent referral is found, the concerned CMO or CMS will be held responsible.
Special attention on ambulance management as well
Health Secretary Dr. R. Rajesh Kumar said that as per the instructions of Chief Minister Dhami, a clear guideline has also been issued on the use of ambulance services to bring transparency in the movement of referred patients. 108 ambulance should be used only under Inter Facility Transfer (IFT). Deployment of departmental ambulances should be done in a planned manner. Fitness should be ensured by reviewing the technical condition of all departmental ambulances. District wise status of ambulances and hearse
At present, a total of 272 “108 ambulances”, 244 departmental ambulances and only 10 hearse vehicles are operational in the state. Some districts- like Almora, Bageshwar, Champawat, Pauri and Nainital do not have hearse vehicles. The CMOs of these districts have been asked to ensure alternative arrangements immediately. The Health Secretary said that old vehicles whose registration age has completed 10 or 12 years can be deployed as hearse vehicles as per the rules. For this, area-wise operating expenses have also been fixed.
Transparency and accountability ensured
Health Secretary Dr. R. Rajesh Kumar said that the aim of this step is not only to provide timely and appropriate treatment to the patients, but also to strengthen transparency and accountability in the functioning of government hospitals. All MOICs and CMOs have been instructed to follow the SOP in letter and spirit and document every referral. Health Secretary Dr. R. Rajesh Kumar reiterated that the government’s intention is clear. Now referral will not be an administrative formality but will be done on the basis of medical need. This will make the health structure of the state more strong and responsible.
