Thông tư 14/2014/TT-BYT

CIRCULAR

ON TRANSFER BETWEEN MEDICAL FACILITIES

Pursuant to the Law on Medical examination and treatment No. 40/2009/QH12 dated November 23, 2009;

Pursuant to the Decree No. 63/2012/ND-CP dated August 31, 2012 by the Government defining the functions, tasks, entitlements and organizational structure of the Ministry of Health;

At the request of Director of Medical service administration;

The Minister of Health promulgates Circular providing for the transfer between medical facilities.

Chapter I

GENERAL PROVISIONS

Article 1. Scope of regulation

This Circular provides for the form, conditions, competence, procedures and management of the transfer of patients between medical facilities according to medical techniques (hereinafter referred to as transfer between medical facilities).

Article 2. Regulated entities

1. Any public medical facilities and private medical facilities prescribed in the Law on Medical examination and treatment;

2. Any medical facilities affiliated to the Ministry of National Defense that provides healthcare service for people.

Article 3. Classification of medical facilities according to medical techniques

1.  The classification of medical facilities according to medical techniques for the transfer of medical facilities shall comply with regulations in Circular No. 43/2013/TT-BYT dated December 11, 2013 by the Minister of Health.

2. The classification of medical facilities according to medical techniques for the transfer of medical facilities affiliated to the Ministry of National Defense that provides healthcare service for people shall be regulated by the Ministry of National Defense.

Article 4. Form of transfer

1. Transfer of patients from an inferior facility to a superior facility:

a) Patients shall be transferred from an inferior facility to the directly superior facility in ascending order;

b) The transfer of patient may not comply with regulations in point a of this Clause if conditions specified in Point b clause 1 Article 5 of this Circular are satisfied.

2. Transfer of patients from a superior facility to an inferior facility.

3. Transfer of patients between medical facilities of the same level.

Chapter II

CONDITIONS, COMPETENCE, PROCEDURES FOR TRANSFER BETWEEN MEDICAL FACILITIES

Article 5. Conditions for transfer of medical facilities

1. The medical facility shall transfer a patient to a superior facility if the following conditions are satisfied:

a) The disease is not suitable to the capacity in diagnosis and treatment and the list of techniques of the medical facility approved by a regulatory authority in healthcare or, the disease is suitable to the capacity in diagnosis and treatment and the list of techniques of the medical facility approved by a regulatory authority in healthcare but, due to an objective reason, such medical facility is not qualified to provide diagnosis and treatment;

b) Depending on the list of techniques approved by a regulatory authority in healthcare, if the directly superior facility does not have suitable medical techniques, patients shall be transferred to a higher-rank facility;

c) Before the patient is transferred, a medical consultation shall be held to appoint the receiving facility (excluding rank 4 clinics and medical facilities).

2. A medical facility may transfer the patient to a suitable inferior facility if the patient is diagnosed no longer in emergency conditions and the disease has eased up and suitable for receiving treatment from an inferior facility.

3. Conditions for transfer of patients between medical facilities of the same level:

a) The disease is not suitable to the list of techniques of the medical facility approved by a regulatory authority in healthcare or, the disease is suitable to the list of techniques of the medical facility approved by a regulatory authority in healthcare but, due to an objective reason, such medical facility is not qualified to provided diagnosis and treatment;

b) The disease is suitable to the list of techniques of the medical facility that is planned to receive the patient that is approved by a regulatory authority.

4. Transfer between medical facilities in neighboring areas to ensure good conditions for patients:

a) Directors of Departments of Health of provinces shall detail the transfer between medical facilities in neighboring areas in central-affiliated cities and provinces within their management;

a) Directors of Departments of Health of provinces shall cooperate with each other in guiding the transfer between medical facilities in neighboring areas in central-affiliated cities and provinces within their management;

5. The transfers of patients according to regulations in clauses 1, 2, 3 and 4 of this Article are considered on-line transfer. The transfers of patients uncomfortable with regulations in clauses 1, 2, 3 and 4 of this Article are considered off-line transfer

If the patient does not satisfy the conditions for transfer of facilities specified in clauses 1, 2, 3 and 4 of this Article but he/she or his/her legal representative requests the transfer, the medical facility shall carry out the transfer procedures to ensure the right of choosing medical facility of the patient. The transferring facility shall provide the patient with information about the rights and charge of medical treatment after deducting the amount covered by medical insurance when receiving off-line treatment.

Article 6. Power to sign the slip of transfer

1. Regarding public medical facilities: the Head of the medical facility or the person authorized by the Head of the medical facility is in charge of signing the slip of transfer.

2. Regarding public medical facilities: the person in charge of professional skills of the medical facility or the person authorized by him/her is in charge of signing the slip of transfer.

3. In a shift, the leader of the team is in charge of signing the slip of transfer.

Article 7. Procedures for transfer of medical facilities

1. Medical facility shall transfer the patient to a superior facility or a facility of same level as follows:

a) Medical facility shall notify and explain the patient or his/her legal representative the reasons for transfer of facility;

b) Medical facility shall sign the slip of transfer according to the form in Appendix 1 enclosed with this Circular;

c) If the patient needs emergency treatment, the medical facility shall contact with the receiving facility; re-check the conditions of the patient before transferring; prepare vehicles and equipment for providing emergency treatment on the way to the receiving facility;

d) If the patient needs technical assistance from the receiving facility, the transferring facility shall provide the receiving facility with information about conditions of the patient and necessary assistance for preparation;

dd) The slip of transfer shall be given to the medical officials going with the patient or the legal representative of the patient to provide for the receiving facility;

e) The transferring facility shall transfer the patient and the slip of transfer to the receiving facility.

2. Procedures for transfer of patients to an inferior facility shall comply with regulations in points a, b, dd and e Clause 1 of this Article.

Article 8. Transport of patients during the transfer of patient

1. For emergency cases: the medical facility shall prepare for transport of the patient as follows:

a) Ambulances or other suitable vehicles;

b) Medical equipment, emergency medicines for the patient (if any) during the transport;

c) The medical officials going with the patient shall be doctors, physician assistants and/or midwives in charge of supervising the handling promptly the development of condition of the patient during the transport and transporting the patient with conformable techniques according to the condition of the patient.

2. For non-emergency cases:

Depending on the medical condition of the patient and the actual conditions, the medical facility shall guide the patient or his/her legal representative to choose a suitable form and vehicle of transport.

Chapter III

MANAGEMENT OF TRANSFER IN HEALTHCARE SERVICE

Article 9. Management of information of transfer in healthcare service

1. Collect and make statistics of information about transfer of medical facilities:

a) Information about the transfer of patients to other facilities of a medical facility shall be collected according to the form the Appendix 2 enclosed with this Circular;

b) Information about the receipt of patients from other facilities of a medical facility shall be collected according to the form the Appendix 2 enclosed with this Circular.

2. Response to the information about transfer of patients

a) Every month, periodic response to the transferring facilities about the diagnosis of diseases and results of treatment shall be made according to the form the Appendix 3 of this Circular;

b) Irregular response shall be made in case of professional mistake or other necessary cases according to the form in Appendix 4 enclosed with this Circular.

3. Medical facilities shall manage, retain and provide information about transfer of faculties according to law provisions.

Article 10. Reporting and handover of transfer of patients

1. Contents of reports:

a) Monthly reports: medical facilities shall make reports according to the form in Appendix 2 enclosed with this Circular;

b) Biannual reports and annual reports shall be made according to the form in Appendix 5 enclosed with this Circular.

2. Reporting:

a) Medical faculties affiliated to the Ministry of Health shall send the reports to the Ministry of Health (via Medical Service Administration);

b) Medical facilities affiliated to the Ministry of Public Security, the Ministry of National Defense or the Ministry of Transport shall send the reports to health authorities of Ministries (Health Administration - Ministry of Public Security, Military Health Administration - Ministry of National Defense, Health Administration - Ministry of Transport);

c) Medical facilities affiliated to the Departments of Health/Ministries/authorities (excluding medical facilities affiliated to the Ministry of Public Security, the Ministry of National Defense, the Ministry of Transport) and private medical facilities shall send the reports to the Departments of Health of the local areas;

d) Departments of Health, health authorities of the Ministry of Public Security, the Ministry of National Defense or the Ministry of Transport shall collect information and make a general report then send it to the Ministry of Health (via Medical Service Administration).

3. Periodic and irregular handover in transfer of patients to learn from experience

a) The handover of transfer of patients between departments and divisions in a medical facility shall be carried out periodically every month;

b) Medical facilities shall carry out the handover with the directly inferior facilities periodically every 03 months;

c) The Ministry of Health, Departments of Health, Health authorities shall carried out the handover with medical facilities under their management periodically every 06 months;

d) The Ministry of Health shall carry out the handover of transfer nationwide every year.

Chapter IV

IMPLEMENTARY CLAUSE

Article 11. Effect

1. This Circular comes into effect from June 01, 2014.

2. Regulations on transfer between clinics specified in Section 4 Part IV of the Regulation on hospital enclosed with the Decision No. 1895/1997/QD-BYT dated September 19, 1997 by the Minister of Health are annulled by the effect of this Circular.

Article 12. Terms of reference

If a document that is mentioned this Circular is replaced or amended, the new one shall prevail.

Article 13. Organization of implementation

1. Medical Service Administration shall:

a) Work as the focus point creating the cooperation between relevant units in implementing, guiding, inspecting and assessing the implementation of this Circular;

b) Carry out the collection, reporting and handover of transfer according to regulations in this Circular.

2. Departments of Health, Health agencies of Ministries/authorities shall;

a) Work as the focus point creating the cooperation between relevant units in implementing, guiding, inspecting and assessing the implementation of this Circular within the management of Ministries, sectors and localities;

b) Carry out the collection, reporting and handover of transfer according to regulations in this Circular.

3. Medical Service Administration shall:

a) Organize the implementation of this Circular at medical facilities;

b) Reinforce and perfect training centers and direct the management of transfer of medical facilities;

c) Carry out the collection, reporting and handover of transfer according to regulations in this Circular.

4. The implementation of regulations on transfer between medical facilities is the standard for checking the performance, grading and awarding (for individuals/organizations affiliated to medical facilities) and assessing the quality and grading (for medical facilities).

5. Depending on the results of reporting on the transfer of medical facilities and results of the annual inspection, competent agencies/organizations shall consider assessing the performance of the head of the medical facilities; issue decision on refusal to grading medical facilities that have the ratio of unconformable transfer of patients to the total cases is over 1 : 10.

Article 14. Responsibilities

Director of Medical Service Administration, the Chief of the Ministry Office, Chief Inspector of the Ministry Office, Director of Departments, Directors of General Directorate affiliated to the Ministry of Health, Director of the Department of Health, Heads of Health agencies and Heads of relevant agencies, organizations and units shall be responsible for implementing this Circular.

Difficulties that arise during the implementation of this Circular should be reported to the Ministry of Health (via Medical Service Administration) for consideration and solution./.