Circular No. 03/2023/TT-BYT guides the positions, staffing norms, and the structure of civil servants according to occupational titles in public health institutions.

CIRCULAR

GUIDELINES ON JOB POSITIONS, STAFFING LEVELS, AND PROFESSIONAL STRUCTURE BY OCCUPATIONAL TITLES IN PUBLIC HEALTH INSTITUTIONS

Pursuant to Decree No. 95/2022/NĐ-CP dated November 15, 2022 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;

Pursuant to Decree No. 106/2020/NĐ-CP dated September 10, 2020 of the Government on job positions and staffing levels in public institutions;

At the proposal of the Director of the Personnel Department, Ministry of Health;

The Minister of Health issues this Circular guiding job positions, staffing levels, and professional structure by occupational titles in public health institutions. 1. Scope of Application This Circular guides job positions, staffing levels, and professional structure by occupational titles in public health institutions under ministries, sectors, and localities.

Article 1. Scope of Regulation and Applicability

b) Provincial Centers for Disease Control and Prevention under centrally governed cities;

Thông tư này áp dụng đối với tổ chức, cá nhân có liên quan đến hoạt động kinh doanh đối tượng thủy sản nuôi chủ lực trên lãnh thổ Việt Nam.

a) Medical examination and treatment facilities;

c) District Health Centers under provinces and centrally governed cities;

d) Emergency Medical Service 115;

đ) Pharmaceutical, cosmetic, and food testing and certification facilities;

e) Forensic medical, forensic psychiatric, and medical appraisal centers;

g) Relevant agencies, organizations, and individuals.

a) Research units in the field of healthcare and rehabilitation facilities under other ministries and sectors;

3. This Circular does not apply to:

b) In the process of medical examination and insurance payment for medical services.

4. Healthcare facilities under other ministries and sectors and non-public healthcare facilities may refer to these guidelines to implement them appropriately based on practical conditions.

Article 2. Principles and Bases for Determining Job Positions, Staffing Levels, and Professional Structure by Occupational Titles

1. Job positions, staffing levels, and professional structure by occupational titles are determined according to the principles stipulated in Articles 3 and 4 of Decree No. 106/2020/NĐ-CP dated September 10, 2020 of the Government on job positions and staffing levels in public institutions.

2. The minimum number of staff in healthcare facilities is determined based on approved hospital beds and adjusted according to the average bed utilization rate over the last three years; in preventive health and appraisal facilities, it is determined based on population size and adjusted according to the nature, specialty characteristics, workload of each facility, and geographical, economic, and social features of each locality; in testing and certification facilities, it is determined and adjusted based on the average annual sample testing volume; in Emergency Medical Service 115, it is determined based on the ambulance quota of the center.

3. The staffing level specified in this Circular is the minimum number of staff that public health institutions need to allocate to ensure the quality of healthcare services and the rights of employees regarding working hours and rest periods as prescribed by law. Depending on workload and financial capacity, healthcare institutions may allocate more staff to improve service quality and ensure efficiency.

4. The staffing level specified in this Circular serves as the basis for healthcare facilities to develop their annual staffing plans.

Article 4. The staffing norms prescribed in this Circular shall serve as the basis for healthcare facilities to develop their annual staffing plans.

Article 3. Positions, staffing norms, and occupational structure according to job titles at medical examination and treatment facilities

1. The positions at medical examination and treatment facilities shall be implemented in accordance with the regulations set forth in Appendix I attached hereto.

2. Staffing norms for medical examination and treatment facilities.

Table 1: Staffing norms for medical examination and treatment facilities by occupational group and type of bed No Classification Ratio of personnel/bed in department Ratio of personnel/bed overall in hospital Occupational groups in healthcare and related fields 1 Emergency beds

* Adjustment factor

Number of staff (increase or decrease) = General norm above x Percentage ratio of average bed utilization over three consecutive years (increase or decrease) compared to planned beds assigned;

3. Occupational structure according to job titles in medical examination and treatment facilities.

Table 2. Occupational structure according to job titles at medical examination and treatment facilities

Article 4. Positions, staffing norms, and occupational structure according to job titles at Provincial/Central City Disease Control Centers

1. The positions at Provincial/Central City Disease Control Centers (hereinafter referred to as Provincial Disease Control Center) shall be implemented in accordance with the regulations set forth in Appendix II attached hereto.

2. Staffing norms for Provincial Disease Control Centers

Table 3. Staffing norms for Provincial Disease Control Centers

* Adjustment factor:

- Provinces/Central Cities with international health quarantine activities: Add 15 people to the general norm for each Provincial Disease Control Center. For provinces/Central Cities with two or more border gates, each gate will add five additional staff members, and each open passage will add three additional staff members.

- Provinces/Central Cities with industrial zones and economic zones: Add a minimum of six staff members to Provincial Disease Control Centers.

- Mountainous and highland provinces: The staffing norm for Provincial Disease Control Centers will be increased by a factor of 1.3.

3. Occupational structure according to job titles at Provincial Disease Control Centers

Table 4. Occupational structure according to job titles at Provincial Disease Control Centers

Article 5. Position of work, staffing quota, and occupational structure of medical civil servants according to job titles at District Health Centers, Urban District Health Centers, Town Health Centers, and Provincial City Health Centers under centrally governed cities

1. Position of work, occupational structure, and staffing quota of departments and divisions at District Health Centers, Urban District Health Centers, Town Health Centers, and Provincial City Health Centers under centrally governed cities (hereinafter referred to as District Health Centers)

a) The position of work at District Health Centers shall be implemented in accordance with the provisions set out in Appendix III attached hereto.

b) Staffing quota of District Health Centers

- For District Health Centers with inpatient beds, the staffing quota includes:

+ The staffing quota for departments specializing in outpatient and inpatient care, and departments in clinical support services, pharmacy, nutrition, and infection control at District Health Centers shall apply the quota as set forth in Table 1.

+ The staffing quota for departments specializing in preventive health, food safety, and population affairs shall be calculated as follows:

Table 5. Staffing quota for departments specializing in preventive health, food safety, and population affairs at District Health Centers

- For District Health Centers without inpatient beds, the staffing quota includes:

+ The staffing quota for departments specializing in preventive health, food safety, and population affairs shall apply the quota as set forth in Table 5;

+ The staffing quota for general outpatient clinics (at the center or in the area) shall be calculated based on the number of outpatient visits and health check-ups: 01 person for every 4,000 to 6,000 visits per year.

+ The staffing quota for functional and supporting service divisions shall be calculated as 50% of the total staffing quota for specialized departments.

c) Occupational structure of medical civil servants according to job titles at District Health Centers

Table 6. Occupational structure of medical civil servants according to job titles at District Health Centers

* Adjustment factor:

- For District Health Centers in mountainous and highland areas: The staffing quota shall be increased by a factor of 1.3.

- For District Health Centers in coastal and island areas: The staffing quota shall be increased by a factor of 1.5.

2. Position of work, staffing quota, and occupational structure of medical civil servants according to job titles at Commune Health Stations, Ward Health Stations, and Town Health Stations (hereinafter referred to as Commune Health Stations)

a) The position of work at Commune Health Stations shall be implemented in accordance with the provisions set out in Appendix IV attached hereto.

b) The staffing quota of Commune Health Stations is 05 persons per Commune Health Station.

* Adjustment factor:

- Adjustment based on population

+ For Commune Health Stations in Region I and Region II with over 6,000 people, if the population increases by 2,000 to 3,000 people, then one additional person will be added;

+ For Commune Health Stations in Region III with over 5,000 people, if the population increases by 1,000 people, then one additional person will be added.

- Adjustment based on geographic region:

+ Commune Health Stations in Region II shall be increased by a factor of 1.2.

+ Commune Health Stations in Region III shall be increased by a factor of 1.3.

c) Occupational structure of medical civil servants according to job titles at Commune Health Stations

Table 7. Occupational structure of medical civil servants according to job titles at Commune Health Stations

Article 6. Positions, staffing norms, and occupational structure of personnel at pharmaceutical, cosmetic, and food testing and certification facilities

Clause 1. The positions at pharmaceutical, cosmetic, and food testing and certification facilities shall be implemented in accordance with the provisions set out in Appendix V attached to this Circular.

Clause 2. Staffing norms for pharmaceutical, cosmetic, and food testing and certification facilities: The minimum norm for each facility is 25 staff members corresponding to 750 samples tested annually. * Adjustment factor: For every increase or decrease of 30 samples per year, there will be a corresponding increase or decrease of one staff member.

Clause 3. Occupational structure of personnel at pharmaceutical, cosmetic, and food testing and certification facilities

Table 8. Occupational structure of personnel according to occupational titles at pharmaceutical, cosmetic, and food testing and certification facilities

Article 7. Positions, staffing norms, and occupational structure of personnel at forensic medical facilities

Clause 1. The positions at forensic medical facilities shall be implemented in accordance with the provisions set out in Appendix VI attached to this Circular.

Clause 2. Staffing norms for forensic medical facilities

Table 9. Number of staff at forensic medical facilities

(For Hanoi City and Ho Chi Minh City, the minimum number of staff at forensic medical facilities is 55.)

Clause 3. Occupational structure of personnel at forensic medical facilities

Article 8. Positions, staffing norms, and occupational structure of personnel at medical appraisal centers

Clause 1. The positions at medical appraisal centers shall be implemented in accordance with the provisions set out in Appendix VII attached to this Circular.

Clause 2. Staffing norms for medical appraisal centers

Table 11. Number of staff at medical appraisal centers

Clause 3. Occupational structure of personnel at medical appraisal centers

Article 9. Positions, staffing norms, and occupational structure of personnel at forensic psychiatric facilities

Clause 1. The positions at forensic psychiatric facilities shall be implemented in accordance with the provisions set out in Appendix VIII attached to this Circular.

Clause 2. Staffing norms for forensic psychiatric facilities:

a) Each forensic psychiatric facility has a staffing norm of 35 staff members;

b) For facilities with hospital beds, the number of staff working in specialized departments for diagnosis and treatment, and in clinical support, pharmacy, nutrition, and infection control departments of the facility shall be applied according to the staffing norms in Table 1.

Clause 3. Occupational structure of personnel

Table 13. Occupational structure of personnel according to occupational titles at forensic psychiatric facilities

Article 10. Positions, staffing norms, and occupational structure of personnel at Emergency Medical Service Center 115

Clause 1. The positions at Emergency Medical Service Center 115 shall be implemented in accordance with the provisions set out in Appendix IX attached to this Circular.

Clause 2. Staffing norms for Emergency Medical Service Center 115:

a) Minimum of 15 staff members per center;

b) Centers with two or more ambulances: additional six staff members per ambulance;

c) Centers with emergency response points outside the main center premises, in addition to the staffing norms based on ambulances, each emergency response point shall have three additional staff members.

Clause 3. Occupational structure of personnel at Emergency Medical Service Center 115

Table 14. Occupational structure of personnel according to occupational titles at Emergency Medical Service Center 115

Article 11. Effective Date

Clause 1. This Circular takes effect from April 5, 2023.

2. Transitional Provisions

a) Public health institutions using personnel in occupational titles not included in the list of positions by organizational type specified in the appendices attached to this Circular must develop plans for reassignment and conversion of occupational titles for personnel to match new job requirements, to be completed by December 31, 2025.

b) Public health institutions with current staffing levels below the minimum staffing norms stipulated in this Circular must develop plans for recruitment, allocation, and reassignment of personnel to meet these norms, to be completed by December 31, 2025.

Article 12. Responsibility for Implementation

Clause 1. The Department of Organization and Cadres of the Ministry of Health shall be responsible for organizing, supervising, and inspecting the implementation of this Circular.

Clause 2. Agencies and organizations under the Ministry of Health assigned state management functions in healthcare, relevant agencies under provincial and district People's Committees performing state management functions in healthcare, and public health institutions, related organizations, and individuals shall be responsible for implementing this Circular.

Clause 3. During the implementation process, if any issues arise or difficulties occur, agencies, organizations, and individuals should promptly report them to the Ministry of Health for guidance and resolution.