Thông tư 43/2013/TT-BYT Quy định chi tiết phân tuyến chuyên môn kỹ thuật đối với hệ thống cơ sở khám, chữa bệnh do Bộ Y tế ban hành

CIRCULAR

PROVIDING FOR TECHNICAL AND PROFESSIONAL LEVELS IN THE NETWORK OF HEALTH FACILITIES

Pursuant to the Law on Medical Examination and Treatment dated November 23, 2009;

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

At the request of Director of Administration of Medical Examination and Treatment;

Minister of Health promulgates a Circular providing for technical and professional levels in the network of health facilities.

Article 1. Scope and regulated entities

This Circular provides for technical and professional levels, the list of medical techniques and corresponding technical and professional levels, and the power to grant approval for the lists of medical techniques in the network of health facilities.

This Circular applies to both public and private health facilities nationwide, except health facilities under the management of the Ministry of National Defence.

Article 2. Rules for determination of technical and professional levels in the network of health facilities

1. Determination of technical and professional levels in the network of heath facilities refers to the classification of health facilities into corresponding technical and professional levels laid down in Article 81 of the Law on medical examination and treatment.

2. A health facility shall be classified into a corresponding technical and professional level based on professional operation requirements, its scope of operation, facilities, equipment, personnel and capacity to perform medical techniques.

3. Determination of technical and professional levels shall not adversely influence the technical development of any health facilities.

Article 3. Technical and professional levels

1. Central level (hereinafter referred to as “level 1”) includes the following health facilities:

a) Special-class hospitals;

b) Class-I hospitals affiliated to the Ministry of Health;

c) Class-I hospitals affiliated to a Provincial Department of Health or another Ministry and assigned by the Ministry of Health to take charge of duties of the highest technical and professional level;

2. Provincial level (hereinafter referred to as “level 2”) includes the following health facilities:

a) Hospitals of class II or lower class and affiliated to Ministry of Health;

b) Class-I and Class-II hospitals affiliated to Provincial Departments of Health or other ministries, except the hospitals prescribed in Point c Clause 1 of this Article;

3. District level (hereinafter referred to as “level 3”) includes the following health facilities:

a) Hospitals of Class III, Class IV or unknown class, district medical centers functioned to provide healthcare services in areas where district hospitals are not established, and infirmaries of provincial public security agencies;

b) Polyclinics, specialized clinics and maternity wards.

4. Communal level (hereinafter referred to as “level 4”) includes the following health facilities:

a) Medical stations of communes, wards or commune-level towns;

b) Dispensaries or medical stations affiliated to specific agencies or organizations;

c) Family doctor's clinics.

5. Technical and professional levels of private health facilities:

a) The competent authority (affiliated to the Ministry of Health of the Provincial Department of Health) that issues the operating license to the private health facility shall make written decision on technical and professional level of that private health facility based on its capacity to perform medical techniques, scope of professional operations, organizational structure, operating scope, facilities, equipment and personnel.

Article 4. List of medical techniques

1. The List of medical techniques is promulgated together with this Circular, including 28 specialties and the following components:

a) Column 1: Specify ordinal numbers started at 01.

b) Column 2: Specify technical items and names of medical techniques.

c) Column 3: Specify technical and professional levels, including 4 sub-columns:

- Column 3A: Medical techniques provided at level 1.

- Column 3B: Medical techniques provided at level 2.

- Column 3C: Medical techniques provided at level 3.

- Column 3D: Medical techniques provided at level 4.

2. The list of medical techniques promulgated together with this Circular includes medical techniques licensed to be adopted in Vietnam. A medical technique may be adopted in different specialties/ departments but herein classified in the most appropriate specialty.

3. The list of medical techniques herein shows medical techniques adopted by each technical and professional level. A health facility must be able to apply the majority of medical techniques of its corresponding technical and professional level as classified.

4. Each health facility is encouraged to develop their technical and professional capacity so as to be able to adopt medical techniques of a higher level. Health facilities of a specific level should limit the application of medical techniques which may be applied by health facilities of lower levels.

Article 5. Compilation of lists of medical techniques by health facilities

1. Based on the List of medical techniques promulgated together with this Circular, each health facility shall compile its own list of medical techniques and submit to the competent authority prescribed in Article 6 hereof for consideration and approval. Such list of medical techniques is compiled based on:

a) The scope of professional operations, organizational structure, and operating scope of the health facility as approved by a competent authority.

b) Facilities, medical equipment, personnel and professional capacity of the health facility.

Article 6. Power to grant approval for lists of medical techniques of health facilities

1. Minister of Health shall:

a) Consider granting approval for lists of initial and additional medical techniques of health facilities affiliated to Ministry of Health, health facilities affiliated to other ministries and private health facilities which operate under license granted by Ministry of Health;

b) Consider granting approval for lists of medical techniques of health facilities prescribed in Point b Clause 2 of this Article.

2. Director of each Provincial Department of Health shall:

a) Consider granting approval for lists of initial and additional medical techniques of health facilities affiliated to that Provincial Department of Health, health facilities affiliated to other ministries and operating in this province, and private health facilities which operate under license granted by that Provincial Department of Health, except health facilities prescribed in Point b Clause 1 of this Article.

b) If a Provincial Department of Health is incapable of carrying out professional appraisal of a list of medical techniques which is under its competence, the Director of that Provincial Department of Health shall request the Ministry of Health to carry out appraisal and give approval.

Article 7. Documentation submitted to apply for approval for list of initial medical techniques

1. The written request.

2. The minutes of the meeting of the technical and professional board as prescribed in Article 9 hereof.

3. The list of medical techniques for which approval is requested, including:

a) Medical techniques which have been applied and the ones which will be applied by the health facility according to its technical and professional level;

b) Medical techniques of higher levels which have been applied and the ones which will be applied by the health facility;

c) Capacity profile of the health facility in terms of its facilities, personnel and medical equipment; social – economic efficiency and plan for application of medical techniques.

The list of medical techniques for which approval is requested must be presented according to the structure (specialty, ordinal number and name of medical technique) of the list of medical techniques prescribed in Clause 1 Article 4 hereof.

Article 8. Documentation submitted to apply for approval for list of additional medical techniques

1. The written request.

2. The minutes of the meeting of the technical and professional board as prescribed in Article 9 hereof.

3. The list of additional medical techniques for which approval is requested, including:

a) Prescribed medical techniques of its technical and professional level to be added;

b) Medical techniques of a higher level to be added because the health facility is capable of implementing them;

c) Capacity profile of the health facility in terms of its facilities, personnel and medical equipment; social – economic efficiency and plan for application of medical techniques.

The list of additional medical techniques for which approval is requested must be presented according to the structure (specialty, ordinal number and name of medical technique) of the list of medical techniques prescribed in Clause 1 Article 4 hereof.

Article 9. Procedure for granting approval for list of medical techniques

1. Health facilities are required to submit 01 set of documents under the provisions of Article 7 or Article 8 hereof to the Administration of Medical Examination and Treatment affiliated to the Ministry of Health or the Provincial Department of Health. Particularly, health facilities affiliated to the Ministry of Public Security shall submit 01 set of documents to the Department of Health affiliated to the Ministry of Public Security; health facilities affiliated to the Ministry of Transport shall submit 01 set of documents to the Department of Health affiliated to the Ministry of Transport.

2. Within a maximum period of 05 working days from the receipt of such documentation which is submitted either by hand or by post (based on the date specified in the official dispatch-received logbook), the receiving agency is obliged to verify whether it is licit or illicit. As for illicit documentation, the receiving agency shall send a written notification of continuing to improve such documentation to the health facility applying for approval for list of medical techniques. The written notification must detail documents that need to be further provided and contents required to be amended or modified. The health facility must make any change or modification in conformity with the contents mentioned in this notification, and send the changed or modified documentation to the receiving agency. In case the changed or modified documentation remains unconformable to the statutory requirements, the health facility is required to continue to improve its submitted documentation.

3. Within a permitted period of 20 working days from the date of receiving the licit documentation (based on the date specified in the official dispatch-received logbook), the receiving agency is obliged to carry out professional appraisal and promulgate a decision on approval for the list of medical techniques applied by the health facility. Professional appraisal is conducted based on the documentation. When necessary, the receiving agency shall establish a professional council to consider a part or all of medical techniques implemented at the health facility. The Department of Health affiliated to the Ministry of Public Security and the Department of Health affiliated to the Ministry of Transport shall send results of appraisal of health facilities under their management, including the written appraisal report and list of medical techniques appraised, to the Administration of Medical Examination and Treatment affiliated to the Ministry of Health or the Provincial Department of Health to request for grant of approval within their competent under the provisions of Article 6 hereof.

4. As for medical techniques beyond the appraisal capacity of the documentation-receiving agency, the receiving agency shall instruct the health facility to submit the documentation to the Administration of Medical Examination and Treatment affiliated to the Ministry of Health for appraisal and approval.

Article 10. Implementation organization

1. Health facilities of a specific level shall provide technical and professional instructions and assistance for health facilities of lower levels in implementation of the provisions of Clause 3 Article 81 of the Law on medical examination and treatment and as assigned by the Ministry of Health.

2. Health facilities shall maintain their satisfaction of facilities, equipment and personnel requirements for implementing medical techniques according to the list of medical techniques approved. Health facilities shall publicly announce, in an appropriate form, the list of its medical techniques approved by competent authorities.

Article 11. Transition

Lists of medical techniques adopted by health facilities with the approval from competent authorities under the provisions of the Decision No. 23/2005/QD-BYT dated August 30, 2005 by Minister of Health providing for technical levels and list of medical techniques before the date of entry into force of this Circular shall be applied until they are amended or modified.

Article 12. Implementation

1. This Circular shall come into force as from February 01, 2014.

2. Decision No. 23/2005/QD-BYT dated August 30, 2005 by Minister of Health providing for technical levels and list of medical techniques shall be null and void from the date of entry into force of this Circular.

3. The Director of the Administration of Medical Examination and Treatment, Directors of Provincial Departments of Health, heads of health agencies affiliated to ministries, heads of health facilities, relevant authorities and organizations, and relevant individuals shall implement this Circular.

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

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