Chapter 9/2004/CT-BYT on Strengthening Supervisory Work in the Field of Medical Examination and Treatment

DIRECTIVE OF THE MINISTER OF HEALTH

On strengthening the guidance line work in the field of medical examination and treatment

The guidance line work is one of the important tasks of the Health sector. In recent years, the Ministry of Health has directed healthcare facilities to implement guidance line work to bring medical technical services closer to the people, contributing to achieving fairness and improving the quality of medical examination and treatment in health care for the people.

However, in recent times, the guidance line work has revealed some shortcomings such as: Some healthcare facilities with guidance line functions have not implemented the guidance line plan well; the guidance line work has not paid enough attention to guiding practical skills; training medical staff to use modern and expensive equipment has not been prioritized, leading to many healthcare facilities not fully utilizing their equipment capacity, especially at district, city, town, and provincial hospitals. As a result, the demand for medical examination and treatment, which is increasing day by day, is limited, and patients still have to be transferred to higher-level hospitals for treatment, causing overload at these hospitals.

To gradually address the above situation and further strengthen the guidance line work, the Minister of Health issues the following directive:

1. Consolidating and perfecting the guidance line network

The guidance line network needs to be consolidated and built up according to three levels.

a) Central level: Including hospitals under the Ministry of Health, institutes with hospital beds, University of Medicine and Pharmacy, hospitals assigned by the Ministry of Health to guide regions (hereinafter referred to as central-level healthcare facilities) must establish a guidance line department responsible for guiding specialized technical matters for provincial and centrally-administered municipal hospitals.

b) Provincial level: Including provincial general hospitals, specialized hospitals, regional general hospitals, Maternal and Child Health Care Centers - Family Planning, hospitals of various sectors located within provinces and centrally-administered municipalities (hereinafter referred to as provincial-level healthcare facilities) must allocate personnel to manage the guidance line work (for those that have established a guidance line department, they need to continue consolidating and perfecting it), responsible for guiding specialized technical matters for district, city, town, and provincial hospitals.

c) District level: Including district, city, town, and provincial hospitals (hereinafter referred to as district-level healthcare facilities) must allocate personnel to manage the guidance line work, directly responsible for guiding specialized technical matters for community health centers and commune health stations.

2. Implementing the guidance line work effectively

a) Establishing a guidance line plan: Each level must develop a specific guidance line plan with objectives, contents, and implementation timelines annually, approved by the competent authority.

Central level: Central-level healthcare facilities must survey specific needs from lower levels, develop a guidance line plan, report to the Ministry of Health (Treatment Department) before August 15th each year for consolidation and submission to the Minister for approval of the overall guidance line plan, avoiding overlap between healthcare facilities.

Provincial level: Provincial-level healthcare facilities, based on local medical examination and treatment needs, select priority issues to request support from upper levels for developing specialized technical expertise. They must develop a guidance line plan, report to the Health Department for approval by the Provincial People's Committee. After approval, the plan must be submitted to the Ministry of Health (Treatment Department) before August 31st each year for coordination and direction.

District level: District-level healthcare facilities must develop a guidance line plan, report to the competent authority for approval and coordinate its implementation.

b) Training activities: Hospitals and institutes with hospital beds under the Ministry of Health need to collaborate with universities and colleges of medicine and pharmacy under the Ministry in organizing training and refresher courses to update knowledge and skills, particularly practical skills in specialized technical areas, to enhance the professional competence of hospital staff. Upper-level healthcare facilities should provide clear and specific guidance to lower-level facilities in training and technology transfer activities. Annually, lower-level healthcare facilities must have plans to ensure that staff receive regular training in practical skills and updated knowledge at upper-level healthcare facilities or educational institutions.

c) Technology transfer activities: Based on standardized guidelines for specialized technical matters issued by the Ministry of Health, upper-level healthcare facilities must transfer specialized technical matters to lower-level healthcare facilities. Transferred technologies must be suitable for the needs and equipment conditions of lower-level facilities to ensure effective and sustainable implementation. In 2005-2006, provincial-level healthcare facilities should prioritize implementing advanced resuscitation techniques, endoscopy techniques, essential obstetric care, newborn care, and rational drug use.

d) Strengthening human resources for grassroots healthcare: Guidance line work must focus on the community, continuing to promote the campaign "Strengthening Medical Staff at Grassroots Levels." Upper-level healthcare facilities should send personnel to reinforce lower-level facilities to transfer science and technology, ensuring the sustainability of technology transfer results, improving the quality of medical examination and treatment, and enhancing public health care.

đ) Information activities: Applying information technology in hospital management and professional operations, ensuring smooth and timely information exchange among levels and hospitals. Upper levels should regularly share experiences with lower levels, while lower levels should regularly report and reflect difficulties to upper levels as stipulated.

e) Scientific research activities: Upper-level hospitals should assist lower-level hospitals in conducting scientific research projects, promoting the research capabilities of lower-level hospitals.

3. Guidance line funding

Medical examination and treatment facilities must prepare a budget estimate for the leadership guidance work according to the plan to report to the competent financial authority for approval when allocating the assigned state budget. When lower-level staff go up to higher levels for training, the lower level must pay for the training costs in accordance with the general regulations of the State. The costs for staff implementing the leadership guidance work shall be borne by the directing unit in accordance with the regulations, avoiding inconvenience to the lower level.

4. Inspection, evaluation, and reporting work

a) Inspection of leadership guidance work: Each level shall organize regular inspections and evaluations of the implementation of leadership guidance work. Timely commendation and rewards shall be given to units and individuals who perform well in leadership guidance work.

b) Reporting on the results of leadership guidance work: Departments of Health of provinces and centrally-administered cities shall aggregate the results of leadership guidance work of subordinate medical examination and treatment facilities and report to the Ministry of Health (Treatment Department); central-level medical examination and treatment facilities shall report to the Ministry of Health (Treatment Department) before December 15 each year.

5. Responsibilities of agencies and units

a) Ministry of Health: Departments and Bureaus under the Ministry of Health shall be responsible for guiding and directing medical examination and treatment facilities to effectively implement leadership guidance work. The Treatment Department shall be responsible for consolidating leadership guidance work and reporting to the Minister.

b) Departments of Health of provinces and centrally-administered cities shall be responsible for guiding and directing subordinate medical examination and treatment facilities under their management to effectively implement leadership guidance work, and reporting to the People's Committee of the province and the Ministry of Health in accordance with the regulations.

Upon receipt of this Directive, the Ministry requests the Comrades Heads of Departments, Bureau Chiefs, Chief Inspectors of the Ministry of Health, Directors of hospitals and institutes with hospital beds directly under the Ministry, Directors of sectoral hospitals, Directors of provincial Departments of Health, Principals of universities and colleges of medicine and pharmacy directly under the Ministry, and Heads of health sectors to strictly organize and implement it. In case of difficulties during implementation, units and localities are requested to reflect them to the Ministry of Health (Treatment Department) for study and resolution.