latest news! The National Health and Health Commission and other five departments jointly issued a document, and the clinic industry has undergone major changes!
Recently, the National Health and Health Commission, the National Development and Reform Commission, the Ministry of Finance, the Ministry of Human Resources and Social Security and the National Medical Insurance Bureau have formulated the "Opinions on Promoting the Pilot Development of Clinics" (hereinafter referred to as "Opinions"), and released relevant policy interpretations.
Top ten cities for pilot work:
Beijing, Shanghai, Shenyang, Nanjing, Hangzhou, Wuhan, Guangzhou, Shenzhen, Chengdu, Xi'an.
aims
The standardization and standardization level of the clinic has been comprehensively improved. It has played a greater role in providing common diseases, frequently-occurring diagnosis and treatment services and family doctor contracting services at the grassroots level, and has formed more high-quality and high-level clinics, which has become an important supplement to the public medical service system.
In June last year, Jiao Yahui, deputy director of the Medical and Health Administration of the State Health Care Commission, revealed that relevant documents encouraging clinic development are being sought for advice. Doctors will be encouraged to open clinics full-time or part-time to simplify the examination and approval procedures. Now, the document is finally officially issued, and a big wave of opportunities is coming.
The main measures are:
1 clinic implementation of record management
Finally wait until this day! The "Opinions" stipulate that the medical institution setting plan does not impose restrictions on the clinic. The examination and approval of the clinic will be changed to the record-keeping system. If the clinic is held, it will be reported to the local county (district) level health and health administrative department for the record, and after the “medical institution practice license” is issued, the practice activities can be carried out.
The chain-oriented and group-based clinics across administrative areas shall be uniformly filed by the higher-level health and health administrative departments, and the provincial-level administrative administrative departments shall be filed separately by the provincial health administrative departments.
Prior to this, only the Chinese medicine clinic enjoyed the record system management. In the case of general practice clinics, only a number of districts have implemented a filing system. For example, in the “55 opinions on recommending health service construction” issued by Shanghai in July last year, medical practitioners with qualifications of general practitioners are supported to run general practice clinics and implement a filing system.
Today, the Opinions support the implementation of clinic filing management in the top ten pilot cities. It is no longer limited to traditional Chinese medicine clinics or general clinics. Specialized clinics can enjoy this treatment. This can be said that China is another important measure in deepening the reform of "distribution service".
2 Revise the "Basic Standards for Clinics", focusing on reviewing physician qualifications and abilities
The Opinions require adjustments to the Basic Standards for Clinics.
The "Opinions" suggest that the clinic is a medical institution that provides common diseases, frequently-occurring medical services and family doctors' contracting services.
The health and health administrative departments of each pilot site shall review the clinics that apply for filing in accordance with the Basic Standards for Clinics, and adjust the hardware from key auditing facilities and facilities to focus on the examination of physician qualifications and capabilities, and practice in clinics (excluding Chinese medicine clinics). Physicians must be qualified for intermediate and above titles. The National Health and Health Commission revised and issued the "Basic Standards for Clinics".
Therefore, according to the requirements of the "Opinions", in the future when the government will review the clinics that apply for filing, the focus of the audit will be changed from "hardware" to "software", paying more attention to the quality of physicians, thus fundamentally improving the quality of clinic services. At the same time, this also indicates that the supervision of doctors in the clinic will increase in the future.
3 Encourage physicians to open clinics part-time
The policy of allowing doctors to open a part-time clinic has finally risen to the national level, and both specialist clinics and general practice clinics can be implemented.
The "Opinions" pointed out that doctors who have been practicing in medical institutions for five years and who have obtained intermediate or higher professional titles are encouraged to run specialist clinics either full-time or part-time.
Encourage qualified general practitioners, or specialists who are enrolled in the practice of general practitioners, to run full-time or part-time clinics.
The doctors who set up a part-time clinic should clarify the responsibilities, rights and obligations of the two parties in accordance with the requirements of multi-point practice and sign the agreement with the main practicing medical institutions, and the working hours, tasks, service quality and salary of the main practicing medical institutions. Specific requirements such as performance allocation, to ensure that the doctors who work part-time clinics can complete the work of the main practicing medical institutions.
Prior to this, in 2017, the “Regulations on the Administration of Medical Institutions Regulations” was revised, which deleted “medical personnel who were employed by medical institutions, retired due to illness or left without pay, no application to set up medical institutions”. Since then, the state has released jobs. The doctor can signal the clinic.
Later, some places began to allow in-service or retired physicians to go to the grassroots clinic to supplement primary medical resources. This "Opinions" no longer only stays at the grassroots part-time clinic, but as long as the requirements are met, it is indeed a leap step to open a clinic part-time.
4 Support the large-scale group development of clinics
The era of doctors has come. The Opinions encourages different specialists to set up partnership doctor groups of appropriate size to hold specialist clinics.
Encourage social forces to organize chained and grouped clinics to form a standardized and standardized management and service model.
Chain clinics have a good sense of “brand trust”, and their development has great potential. Now the country actively provides policy support, which is an excellent opportunity for the development of chain clinics.
5 Encourage the inclusion of clinics in the medical association to achieve medical resource sharing
In the process of establishing the urban medical group and the county medical community, the health and administrative departments of the pilot localities can be included in the construction of the medical association according to the wishes of the clinic, and establish a two-way referral system between the clinic and other medical institutions.
In the pilot areas, when establishing specialist alliances and telemedicine collaboration networks, clinics were included in the membership units to help them improve their medical services.
Encourage medical institutions in the secondary hospitals, primary health care institutions, and independently set up medical testing centers, medical imaging centers, disinfection supply centers, pathology centers and other institutions to establish collaborative relationships with clinics to achieve medical resources sharing.
6 Encourage clinics to provide family doctor signing services
Encourage the government to purchase services to include qualified clinics in the scope of medical institutions that can provide family doctors to sign services, and to provide personalized sign-up services to further meet the diverse and diverse health needs of residents.
Strengthen the assessment of the quality of contracted services provided by clinics, and incorporate the health status and satisfaction of clients into the assessment to ensure the quality of contracted services.
7 Encourage clinics to provide basic medical services
Encourage the clinic to provide basic medical and health services in the form of government procurement services. For clinics that provide basic medical and health services, the implementation of the same subsidy policy as the government-run primary health care institutions in terms of personnel training, and the development and construction expenditures for the basic construction and equipment purchase of basic medical and health services provided by qualified places can be given. Appropriate support.
It seems that clinics, like public primary medical institutions, will gradually participate in basic medical and health services to achieve quality development of primary medical resources through competition and cooperation.
8 separate grouping of full-time clinic physicians, targeted review
The Opinions adjusted the review of physician titles for full-time practice in the clinic.
When a full-time physician practicing in the clinic declares a senior professional title, in accordance with the relevant policies and regulations for the reform and improvement of the professional title of grassroots health professional and technical personnel, it can be divided into separate groups and directed assessments. Foreign language results are not used as reporting conditions, and the papers and scientific research are not mandatory. Evaluate clinical work capacity and quality of service.
In principle, the title obtained by the targeted review should be limited to the use of primary health care institutions such as clinics. When moving to higher-level medical and health institutions, it should obtain the unified senior professional title of the province (region, city).
9 clinics implement independent pricing
The price of medical services provided by the clinic is subject to independent pricing. The clinics that actively implement the medical service price policy of public medical institutions and meet the requirements shall be included in the scope of medical insurance according to the regulations, and the medical service fees provided may be paid according to regulations. Simplify the examination and approval procedures for environmental impact assessment and fire protection in clinics.
10 pairs of clinics to carry out information supervision
The clinic is required to establish an information system to record medical information and upload the medical information to the medical service supervision information system. Incorporate the clinic into the local medical quality control system and rely on the information supervision platform to strengthen supervision of clinic operations and medical services, real-time supervision and ensure medical quality and safety.
Encourage the pilot cities to include the clinic's start-up status as the personal integrity record of the main person in charge of the clinic into the personal credit system and establish a long-term mechanism for joint punishment.
11 Start the pilot work before the end of September 2019
The "Opinions" require that before the end of June 2019, the provincial health administrative departments of the pilot cities should cooperate with the development and reform, finance, human resources, social security and medical insurance departments, and implement specific implementation plans according to local work. All relevant departments should synchronize. Introduce corresponding supporting policies.
Before the end of September 2019, pilot cities should start pilot work.
Pilot projects for clinic reform and development are encouraged in non-pilot provinces and non-pilot cities.
This "Opinion" can be described as sincerity. After years of exploration and practice, the clinic filing system and the doctor's part-time clinic have finally been implemented on a large scale. After the completion of the pilot phase, on the basis of summing up experience, the whole country will be promoted. The clinic industry and clinic people will all embark on a new level, and the primary medical industry will usher in a new round of transformation.
Attached to the full text:
Opinions on piloting the development of clinics
Promoting the healthy development of clinics is an important measure to deepen the reform of the medical service system and improve the medical service system. It is of great significance for attracting high-quality medical resources to sink and meet the needs of the people's multi-level and diversified medical services. The following comments are made on the pilot of promoting clinic development.
First, the overall requirements
(1) Guiding ideology.
Guided by Xi Jinping's new era of socialism with Chinese characteristics, comprehensively implement the spirit of the 19th and 19th Central Committees of the Party, implement the health and health work guidelines under the new situation, give full play to the role of the government and the market, and reform and improve the clinic. Policies to improve the quality of medical services in clinics, form a multi-disciplinary medical model, and promote the establishment of a quality and efficient medical and health service system.
(2) Work objectives.
The standardization and standardization level of the clinic has been comprehensively improved. It has played a greater role in providing common diseases, frequently-occurring diagnosis and treatment services and family doctor contracting services at the grassroots level, and has formed more high-quality and high-level clinics, which has become an important supplement to the public medical service system.
(3) Pilot arrangements.
From 2019 to 2020, pilot projects to promote clinic development in 10 cities including Beijing, Shanghai, Shenyang, Nanjing, Hangzhou, Wuhan, Guangzhou, Shenzhen, Chengdu, and Xi'an will improve clinic construction and management policies based on pilot experience and promote them nationwide. .
Second, optimize the clinic practice permit policy
(4) Simplify the access procedure.
The medical institution setting plan does not impose restrictions on the clinic. The examination and approval of the clinic will be changed to the record-keeping system. If the clinic is held, it will be reported to the local county (district) level health and health administrative department for the record, and after the “medical institution practice license” is issued, the practice activities can be carried out. The chain-oriented and group-based clinics across administrative areas shall be uniformly filed by the higher-level health and health administrative departments, and the provincial-level administrative administrative departments shall be filed separately by the provincial health administrative departments.
(5) Adjusting the basic standards of the clinic.
The clinic is a medical institution that provides common diseases, frequently-occurring medical services, and family doctors' contracting services. The health and health administrative departments of each pilot site shall review the clinics that apply for filing in accordance with the Basic Standards for Clinics, and adjust the hardware from key auditing facilities and facilities to focus on the examination of physician qualifications and capabilities, and practice in clinics (excluding Chinese medicine clinics). Physicians must be qualified for intermediate and above titles. The National Health and Health Commission revised and issued the "Basic Standards for Clinics".
(6) Encourage doctors to hold clinics.
Encourage doctors who have been practicing in medical institutions for 5 years and have obtained intermediate and above professional titles, and run specialist clinics full-time or part-time.
Encourage qualified general practitioners, or specialists who are enrolled in the practice of general practitioners, to run full-time or part-time clinics.
The doctors who set up a part-time clinic should clarify the responsibilities, rights and obligations of the two parties in accordance with the requirements of multi-point practice and sign the agreement with the main practicing medical institutions, and the working hours, tasks, service quality and salary of the main practicing medical institutions. Specific requirements such as performance allocation, to ensure that the doctors who work part-time clinics can complete the work of the main practicing medical institutions.
Third, improve the quality of clinic medical services
(7) Encourage the inclusion of clinics in the construction of medical associations.
In the process of establishing the urban medical group and the county medical community, the health and administrative departments of the pilot localities can be included in the construction of the medical association according to the wishes of the clinic, and establish a two-way referral system between the clinic and other medical institutions. In the pilot areas, when establishing specialist alliances and telemedicine collaboration networks, clinics were included in the membership units to help them improve their medical services. Encourage medical institutions in the secondary hospitals, primary health care institutions, and independently set up medical testing centers, medical imaging centers, disinfection supply centers, pathology centers and other institutions to establish collaborative relationships with clinics to achieve medical resources sharing.
(8) Supporting the large-scale group development of clinics.
Encourage different specialists to set up a partnership doctor group of appropriate size and hold a specialist clinic. Encourage social forces to organize chained and grouped clinics to form a standardized and standardized management and service model.
(9) Encourage clinics to provide family doctors to sign services.
Encourage the government to purchase services to include qualified clinics in the scope of medical institutions that can provide family doctors to sign services, and to provide personalized sign-up services to further meet the diverse and diverse health needs of residents. Strengthen the assessment of the quality of contracted services provided by clinics, and incorporate the health status and satisfaction of clients into the assessment to ensure the quality of contracted services.
(10) Encourage clinics to provide basic medical and health services.
Encourage the clinic to provide basic medical and health services in the form of government procurement services. For clinics that provide basic medical and health services, the implementation of the same subsidy policy as the government-run primary health care institutions in terms of personnel training, and the development and construction expenditures for the basic construction and equipment purchase of basic medical and health services provided by qualified places can be given. Appropriate support.
(11) Promote the professional development of full-time physicians in clinics.
When a full-time physician practicing in the clinic declares a senior professional title, in accordance with the relevant policies and regulations for the reform and improvement of the professional title of grassroots health professional and technical personnel, it can be divided into separate groups and directed assessments. Foreign language results are not used as reporting conditions, and the papers and scientific research are not mandatory. Evaluate clinical work capacity and quality of service. In principle, the title obtained by the targeted review should be limited to the use of primary health care institutions such as clinics. When moving to higher-level medical and health institutions, it should obtain the unified senior professional title of the province (region, city).
(12) Improve relevant policies that are conducive to the development of clinics.
The price of medical services provided by the clinic is subject to independent pricing. The clinics that actively implement the medical service price policy of public medical institutions and meet the requirements shall be included in the scope of medical insurance according to the regulations, and the medical service fees provided may be paid according to regulations. Simplify the examination and approval procedures for environmental impact assessment and fire protection in clinics.
Fourth, strengthen industry supervision
(13) Innovative industry supervision means.
The clinic shall establish an information system to record medical and medical information, and upload medical and medical information to the medical service supervision information system in accordance with the requirements of health and health administrative departments and standards. The health and health administrative department should incorporate the clinic into the medical quality control system, rely on the information supervision platform, strengthen the supervision of the clinic operation and medical services, realize real-time supervision, and ensure the quality and safety of medical care; regularly organize training of clinics to improve the quality and safety management of clinics. Consciousness, the formation of a normal operating mechanism to ensure medical quality and safety; to strengthen the supervision and management of the clinic, to find out the problem within a time limit rectification, rectification is not implemented, cancel the "medical institution practice license." The medical security department shall strengthen the supervision and management of the medical insurance designated clinics, and the medical insurance funds shall be terminated if the medical insurance funds are fraudulently obtained for fictitious medical services. Encourage innovative ideas in pilot cities, incorporate the status of clinics as the personal integrity record of the main responsible person of the clinic into the personal credit system, establish a long-term mechanism for joint punishment, and explore specific measures for effective supervision.
(14) Guarantee medical quality and safety.
The clinic must be practised in strict accordance with the law. Medical personnel must have the corresponding qualifications and qualifications, strictly implement the "Medical Quality Management Measures", "Medical Quality and Safety Core System Essentials" and other rules and regulations, strengthen medical technology and hospital infection management, and strictly implement diagnosis and treatment. Standards and guidelines for the rational use of drugs to ensure the quality and safety of medical care. It is necessary to strengthen communication between doctors and patients, respect patients' right to know, and protect patient privacy. It is necessary to establish an electronic medical record system, standardize the writing and management of medical documents, register patients for medical treatment, implement an infectious disease epidemic reporting system, and timely and accurately upload medical information. Encourage clinics or medical staff to purchase Medicare insurance.
V. Safeguard organization implementation
(15) Strengthen organizational leadership.
All pilot sites should fully understand the importance of promoting the development of clinics, and promote them as an important part of deepening the reform of “distribution management”, deepening medical reform and developing social medicine, strengthening organizational leadership, strengthening departmental cooperation, and ensuring various policy measures. Landing is effective. The health and health administrative department should play the role of the lead department, reform and improve the relevant policies and measures for clinic management, formulate specific rules for the government to purchase services, and strengthen the supervision of clinics. Development and reform, finance, human resources, social security, and medical insurance departments must implement relevant support policies in accordance with regulations to encourage the sustainable development of clinics. Before the end of June 2019, the provincial health administrative departments in the pilot cities should cooperate with the development and reform, finance, human resources, social security and medical insurance departments, and implement specific implementation plans according to local work. All relevant departments should simultaneously introduce corresponding supporting policies. . Before the end of September 2019, pilot cities should start pilot work. Pilot projects for clinic reform and development are encouraged in non-pilot provinces and non-pilot cities.
(16) Do a good job in evaluation and summary.
Each pilot city shall timely evaluate the pilot situation and form an annual assessment report each year. For the problems found in the pilot, it is necessary to study and solve in time, and the pilot experience should be summarized and reported in time. The National Health and Health Commission should strengthen policy training with the relevant departments, strengthen the work guidance and inspection and evaluation according to the task division, promote the advanced experience of the pilot areas in a timely manner, and summarize the policy measures to promote the development of the national clinic.
Recently, the National Health and Health Commission, the National Development and Reform Commission, the Ministry of Finance, the Ministry of Human Resources and Social Security and the National Medical Insurance Bureau have formulated the "Opinions on Promoting the Pilot Development of Clinics" (hereinafter referred to as "Opinions"), and released relevant policy interpretations.
Top ten cities for pilot work:
Beijing, Shanghai, Shenyang, Nanjing, Hangzhou, Wuhan, Guangzhou, Shenzhen, Chengdu, Xi'an.
aims
The standardization and standardization level of the clinic has been comprehensively improved. It has played a greater role in providing common diseases, frequently-occurring diagnosis and treatment services and family doctor contracting services at the grassroots level, and has formed more high-quality and high-level clinics, which has become an important supplement to the public medical service system.
In June last year, Jiao Yahui, deputy director of the Medical and Health Administration of the State Health Care Commission, revealed that relevant documents encouraging clinic development are being sought for advice. Doctors will be encouraged to open clinics full-time or part-time to simplify the examination and approval procedures. Now, the document is finally officially issued, and a big wave of opportunities is coming.
The main measures are:
1 clinic implementation of record management
Finally wait until this day! The "Opinions" stipulate that the medical institution setting plan does not impose restrictions on the clinic. The examination and approval of the clinic will be changed to the record-keeping system. If the clinic is held, it will be reported to the local county (district) level health and health administrative department for the record, and after the “medical institution practice license” is issued, the practice activities can be carried out.
The chain-oriented and group-based clinics across administrative areas shall be uniformly filed by the higher-level health and health administrative departments, and the provincial-level administrative administrative departments shall be filed separately by the provincial health administrative departments.
Prior to this, only the Chinese medicine clinic enjoyed the record system management. In the case of general practice clinics, only a number of districts have implemented a filing system. For example, in the “55 opinions on recommending health service construction” issued by Shanghai in July last year, medical practitioners with qualifications of general practitioners are supported to run general practice clinics and implement a filing system.
Today, the Opinions support the implementation of clinic filing management in the top ten pilot cities. It is no longer limited to traditional Chinese medicine clinics or general clinics. Specialized clinics can enjoy this treatment. This can be said that China is another important measure in deepening the reform of "distribution service".
2 Revise the "Basic Standards for Clinics", focusing on reviewing physician qualifications and abilities
The Opinions require adjustments to the Basic Standards for Clinics.
The "Opinions" suggest that the clinic is a medical institution that provides common diseases, frequently-occurring medical services and family doctors' contracting services.
The health and health administrative departments of each pilot site shall review the clinics that apply for filing in accordance with the Basic Standards for Clinics, and adjust the hardware from key auditing facilities and facilities to focus on the examination of physician qualifications and capabilities, and practice in clinics (excluding Chinese medicine clinics). Physicians must be qualified for intermediate and above titles. The National Health and Health Commission revised and issued the "Basic Standards for Clinics".
Therefore, according to the requirements of the "Opinions", in the future when the government will review the clinics that apply for filing, the focus of the audit will be changed from "hardware" to "software", paying more attention to the quality of physicians, thus fundamentally improving the quality of clinic services. At the same time, this also indicates that the supervision of doctors in the clinic will increase in the future.
3 Encourage physicians to open clinics part-time
The policy of allowing doctors to open a part-time clinic has finally risen to the national level, and both specialist clinics and general practice clinics can be implemented.
The "Opinions" pointed out that doctors who have been practicing in medical institutions for five years and who have obtained intermediate or higher professional titles are encouraged to run specialist clinics either full-time or part-time.
Encourage qualified general practitioners, or specialists who are enrolled in the practice of general practitioners, to run full-time or part-time clinics.
The doctors who set up a part-time clinic should clarify the responsibilities, rights and obligations of the two parties in accordance with the requirements of multi-point practice and sign the agreement with the main practicing medical institutions, and the working hours, tasks, service quality and salary of the main practicing medical institutions. Specific requirements such as performance allocation, to ensure that the doctors who work part-time clinics can complete the work of the main practicing medical institutions.
Prior to this, in 2017, the “Regulations on the Administration of Medical Institutions Regulations” was revised, which deleted “medical personnel who were employed by medical institutions, retired due to illness or left without pay, no application to set up medical institutions”. Since then, the state has released jobs. The doctor can signal the clinic.
Later, some places began to allow in-service or retired physicians to go to the grassroots clinic to supplement primary medical resources. This "Opinions" no longer only stays at the grassroots part-time clinic, but as long as the requirements are met, it is indeed a leap step to open a clinic part-time.
4 Support the large-scale group development of clinics
The era of doctors has come. The Opinions encourages different specialists to set up partnership doctor groups of appropriate size to hold specialist clinics.
Encourage social forces to organize chained and grouped clinics to form a standardized and standardized management and service model.
Chain clinics have a good sense of “brand trust”, and their development has great potential. Now the country actively provides policy support, which is an excellent opportunity for the development of chain clinics.
5 Encourage the inclusion of clinics in the medical association to achieve medical resource sharing
In the process of establishing the urban medical group and the county medical community, the health and administrative departments of the pilot localities can be included in the construction of the medical association according to the wishes of the clinic, and establish a two-way referral system between the clinic and other medical institutions.
In the pilot areas, when establishing specialist alliances and telemedicine collaboration networks, clinics were included in the membership units to help them improve their medical services.
Encourage medical institutions in the secondary hospitals, primary health care institutions, and independently set up medical testing centers, medical imaging centers, disinfection supply centers, pathology centers and other institutions to establish collaborative relationships with clinics to achieve medical resources sharing.
6 Encourage clinics to provide family doctor signing services
Encourage the government to purchase services to include qualified clinics in the scope of medical institutions that can provide family doctors to sign services, and to provide personalized sign-up services to further meet the diverse and diverse health needs of residents.
Strengthen the assessment of the quality of contracted services provided by clinics, and incorporate the health status and satisfaction of clients into the assessment to ensure the quality of contracted services.
7 Encourage clinics to provide basic medical services
Encourage the clinic to provide basic medical and health services in the form of government procurement services. For clinics that provide basic medical and health services, the implementation of the same subsidy policy as the government-run primary health care institutions in terms of personnel training, and the development and construction expenditures for the basic construction and equipment purchase of basic medical and health services provided by qualified places can be given. Appropriate support.
It seems that clinics, like public primary medical institutions, will gradually participate in basic medical and health services to achieve quality development of primary medical resources through competition and cooperation.
8 separate grouping of full-time clinic physicians, targeted review
The Opinions adjusted the review of physician titles for full-time practice in the clinic.
When a full-time physician practicing in the clinic declares a senior professional title, in accordance with the relevant policies and regulations for the reform and improvement of the professional title of grassroots health professional and technical personnel, it can be divided into separate groups and directed assessments. Foreign language results are not used as reporting conditions, and the papers and scientific research are not mandatory. Evaluate clinical work capacity and quality of service.
In principle, the title obtained by the targeted review should be limited to the use of primary health care institutions such as clinics. When moving to higher-level medical and health institutions, it should obtain the unified senior professional title of the province (region, city).
9 clinics implement independent pricing
The price of medical services provided by the clinic is subject to independent pricing. The clinics that actively implement the medical service price policy of public medical institutions and meet the requirements shall be included in the scope of medical insurance according to the regulations, and the medical service fees provided may be paid according to regulations. Simplify the examination and approval procedures for environmental impact assessment and fire protection in clinics.
10 pairs of clinics to carry out information supervision
The clinic is required to establish an information system to record medical information and upload the medical information to the medical service supervision information system. Incorporate the clinic into the local medical quality control system and rely on the information supervision platform to strengthen supervision of clinic operations and medical services, real-time supervision and ensure medical quality and safety.
Encourage the pilot cities to include the clinic's start-up status as the personal integrity record of the main person in charge of the clinic into the personal credit system and establish a long-term mechanism for joint punishment.
11 Start the pilot work before the end of September 2019
The "Opinions" require that before the end of June 2019, the provincial health administrative departments of the pilot cities should cooperate with the development and reform, finance, human resources, social security and medical insurance departments, and implement specific implementation plans according to local work. All relevant departments should synchronize. Introduce corresponding supporting policies.
Before the end of September 2019, pilot cities should start pilot work.
Pilot projects for clinic reform and development are encouraged in non-pilot provinces and non-pilot cities.
This "Opinion" can be described as sincerity. After years of exploration and practice, the clinic filing system and the doctor's part-time clinic have finally been implemented on a large scale. After the completion of the pilot phase, on the basis of summing up experience, the whole country will be promoted. The clinic industry and clinic people will all embark on a new level, and the primary medical industry will usher in a new round of transformation.
Attached to the full text:
Opinions on piloting the development of clinics
Promoting the healthy development of clinics is an important measure to deepen the reform of the medical service system and improve the medical service system. It is of great significance for attracting high-quality medical resources to sink and meet the needs of the people's multi-level and diversified medical services. The following comments are made on the pilot of promoting clinic development.
First, the overall requirements
(1) Guiding ideology.
Guided by Xi Jinping's new era of socialism with Chinese characteristics, comprehensively implement the spirit of the 19th and 19th Central Committees of the Party, implement the health and health work guidelines under the new situation, give full play to the role of the government and the market, and reform and improve the clinic. Policies to improve the quality of medical services in clinics, form a multi-disciplinary medical model, and promote the establishment of a quality and efficient medical and health service system.
(2) Work objectives.
The standardization and standardization level of the clinic has been comprehensively improved. It has played a greater role in providing common diseases, frequently-occurring diagnosis and treatment services and family doctor contracting services at the grassroots level, and has formed more high-quality and high-level clinics, which has become an important supplement to the public medical service system.
(3) Pilot arrangements.
From 2019 to 2020, pilot projects to promote clinic development in 10 cities including Beijing, Shanghai, Shenyang, Nanjing, Hangzhou, Wuhan, Guangzhou, Shenzhen, Chengdu, and Xi'an will improve clinic construction and management policies based on pilot experience and promote them nationwide. .
Second, optimize the clinic practice permit policy
(4) Simplify the access procedure.
The medical institution setting plan does not impose restrictions on the clinic. The examination and approval of the clinic will be changed to the record-keeping system. If the clinic is held, it will be reported to the local county (district) level health and health administrative department for the record, and after the “medical institution practice license” is issued, the practice activities can be carried out. The chain-oriented and group-based clinics across administrative areas shall be uniformly filed by the higher-level health and health administrative departments, and the provincial-level administrative administrative departments shall be filed separately by the provincial health administrative departments.
(5) Adjusting the basic standards of the clinic.
The clinic is a medical institution that provides common diseases, frequently-occurring medical services, and family doctors' contracting services. The health and health administrative departments of each pilot site shall review the clinics that apply for filing in accordance with the Basic Standards for Clinics, and adjust the hardware from key auditing facilities and facilities to focus on the examination of physician qualifications and capabilities, and practice in clinics (excluding Chinese medicine clinics). Physicians must be qualified for intermediate and above titles. The National Health and Health Commission revised and issued the "Basic Standards for Clinics".
(6) Encourage doctors to hold clinics.
Encourage doctors who have been practicing in medical institutions for 5 years and have obtained intermediate and above professional titles, and run specialist clinics full-time or part-time.
Encourage qualified general practitioners, or specialists who are enrolled in the practice of general practitioners, to run full-time or part-time clinics.
The doctors who set up a part-time clinic should clarify the responsibilities, rights and obligations of the two parties in accordance with the requirements of multi-point practice and sign the agreement with the main practicing medical institutions, and the working hours, tasks, service quality and salary of the main practicing medical institutions. Specific requirements such as performance allocation, to ensure that the doctors who work part-time clinics can complete the work of the main practicing medical institutions.
Third, improve the quality of clinic medical services
(7) Encourage the inclusion of clinics in the construction of medical associations.
In the process of establishing the urban medical group and the county medical community, the health and administrative departments of the pilot localities can be included in the construction of the medical association according to the wishes of the clinic, and establish a two-way referral system between the clinic and other medical institutions. In the pilot areas, when establishing specialist alliances and telemedicine collaboration networks, clinics were included in the membership units to help them improve their medical services. Encourage medical institutions in the secondary hospitals, primary health care institutions, and independently set up medical testing centers, medical imaging centers, disinfection supply centers, pathology centers and other institutions to establish collaborative relationships with clinics to achieve medical resources sharing.
(8) Supporting the large-scale group development of clinics.
Encourage different specialists to set up a partnership doctor group of appropriate size and hold a specialist clinic. Encourage social forces to organize chained and grouped clinics to form a standardized and standardized management and service model.
(9) Encourage clinics to provide family doctors to sign services.
Encourage the government to purchase services to include qualified clinics in the scope of medical institutions that can provide family doctors to sign services, and to provide personalized sign-up services to further meet the diverse and diverse health needs of residents. Strengthen the assessment of the quality of contracted services provided by clinics, and incorporate the health status and satisfaction of clients into the assessment to ensure the quality of contracted services.
(10) Encourage clinics to provide basic medical and health services.
Encourage the clinic to provide basic medical and health services in the form of government procurement services. For clinics that provide basic medical and health services, the implementation of the same subsidy policy as the government-run primary health care institutions in terms of personnel training, and the development and construction expenditures for the basic construction and equipment purchase of basic medical and health services provided by qualified places can be given. Appropriate support.
(11) Promote the professional development of full-time physicians in clinics.
When a full-time physician practicing in the clinic declares a senior professional title, in accordance with the relevant policies and regulations for the reform and improvement of the professional title of grassroots health professional and technical personnel, it can be divided into separate groups and directed assessments. Foreign language results are not used as reporting conditions, and the papers and scientific research are not mandatory. Evaluate clinical work capacity and quality of service. In principle, the title obtained by the targeted review should be limited to the use of primary health care institutions such as clinics. When moving to higher-level medical and health institutions, it should obtain the unified senior professional title of the province (region, city).
(12) Improve relevant policies that are conducive to the development of clinics.
The price of medical services provided by the clinic is subject to independent pricing. The clinics that actively implement the medical service price policy of public medical institutions and meet the requirements shall be included in the scope of medical insurance according to the regulations, and the medical service fees provided may be paid according to regulations. Simplify the examination and approval procedures for environmental impact assessment and fire protection in clinics.
Fourth, strengthen industry supervision
(13) Innovative industry supervision means.
The clinic shall establish an information system to record medical and medical information, and upload medical and medical information to the medical service supervision information system in accordance with the requirements of health and health administrative departments and standards. The health and health administrative department should incorporate the clinic into the medical quality control system, rely on the information supervision platform, strengthen the supervision of the clinic operation and medical services, realize real-time supervision, and ensure the quality and safety of medical care; regularly organize training of clinics to improve the quality and safety management of clinics. Consciousness, the formation of a normal operating mechanism to ensure medical quality and safety; to strengthen the supervision and management of the clinic, to find out the problem within a time limit rectification, rectification is not implemented, cancel the "medical institution practice license." The medical security department shall strengthen the supervision and management of the medical insurance designated clinics, and the medical insurance funds shall be terminated if the medical insurance funds are fraudulently obtained for fictitious medical services. Encourage innovative ideas in pilot cities, incorporate the status of clinics as the personal integrity record of the main responsible person of the clinic into the personal credit system, establish a long-term mechanism for joint punishment, and explore specific measures for effective supervision.
(14) Guarantee medical quality and safety.
The clinic must be practised in strict accordance with the law. Medical personnel must have the corresponding qualifications and qualifications, strictly implement the "Medical Quality Management Measures", "Medical Quality and Safety Core System Essentials" and other rules and regulations, strengthen medical technology and hospital infection management, and strictly implement diagnosis and treatment. Standards and guidelines for the rational use of drugs to ensure the quality and safety of medical care. It is necessary to strengthen communication between doctors and patients, respect patients' right to know, and protect patient privacy. It is necessary to establish an electronic medical record system, standardize the writing and management of medical documents, register patients for medical treatment, implement an infectious disease epidemic reporting system, and timely and accurately upload medical information. Encourage clinics or medical staff to purchase Medicare insurance.
V. Safeguard organization implementation
(15) Strengthen organizational leadership.
All pilot sites should fully understand the importance of promoting the development of clinics, and promote them as an important part of deepening the reform of “distribution management”, deepening medical reform and developing social medicine, strengthening organizational leadership, strengthening departmental cooperation, and ensuring various policy measures. Landing is effective. The health and health administrative department should play the role of the lead department, reform and improve the relevant policies and measures for clinic management, formulate specific rules for the government to purchase services, and strengthen the supervision of clinics. Development and reform, finance, human resources, social security, and medical insurance departments must implement relevant support policies in accordance with regulations to encourage the sustainable development of clinics. Before the end of June 2019, the provincial health administrative departments in the pilot cities should cooperate with the development and reform, finance, human resources, social security and medical insurance departments, and implement specific implementation plans according to local work. All relevant departments should simultaneously introduce corresponding supporting policies. . Before the end of September 2019, pilot cities should start pilot work. Pilot projects for clinic reform and development are encouraged in non-pilot provinces and non-pilot cities.
(16) Do a good job in evaluation and summary.
Each pilot city shall timely evaluate the pilot situation and form an annual assessment report each year. For the problems found in the pilot, it is necessary to study and solve in time, and the pilot experience should be summarized and reported in time. The National Health and Health Commission should strengthen policy training with the relevant departments, strengthen the work guidance and inspection and evaluation according to the task division, promote the advanced experience of the pilot areas in a timely manner, and summarize the policy measures to promote the development of the national clinic.
