Circular No. 21/2019/TT-BYT guides the pilot implementation of family medicine activities.

CIRCULAR

Guidelines for the pilot implementation of family medicine activities

On the basis of Law on Medical Examination and Treatment November 23, 2009;

Decree No. 109/2016/NĐ-CP dated July 1, 2016 of the Government stipulating the issuance of practice certificates for practitioners and permits for medical examination and treatment facilities;

Decree No. 155/2018/NĐ-CP dated November 12, 2018 of the Government amending and supplementing certain provisions related to investment conditions within the scope of management of the Ministry of Health;

Decree No. 75/2017/ND-CP dated June 20, 2017 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;

At the proposal of the Director of the Department of Medical Examination and Treatment;

The Minister of Health issues this Circular guiding the pilot implementation of family medicine activities.

Article 1. Scope of Regulation

Article 1. This Circular guides the pilot implementation of:

a) The position, functions, and tasks of the following family medicine facilities:

- Commune health stations, district health stations, town health stations; infirmaries; health stations of agencies, units, organizations (hereinafter referred to as health stations);

- Private multi-specialty clinics, private specialty clinics;

- Multi-specialty clinics, regional multi-specialty clinics, specialty clinics under district health centers, military-civilian clinics;

- Outpatient departments of district hospitals, district health centers, or university-affiliated hospitals.

b) The tasks of family doctors;

c) Professional qualifications, training certificates in family medicine.

Article 2. Position, functions, and tasks of family medicine facilities

Article 2. Position, functions:

Family medicine facilities are the first point of contact for initial health care, management, counseling, disease prevention, health promotion, emergency care, multi-specialty medical examination, and treatment according to the principles of family medicine for individuals and households.

a) Community health management:

2. Tasks:

- Establish individual health records according to Decision No. 831/QĐ-BYT dated March 11, 2017 of the Minister of Health promulgating the model of individual health records for primary healthcare;

- Manage and provide health care according to the principles of family medicine for individuals and households as assigned by the Department of Health of provinces and centrally-administered cities (hereinafter referred to as the Department of Health).

b) Health promotion and disease prevention counseling:

- Provide counseling on nutrition, physical activity, tobacco control, alcohol control, and other risk factors affecting health, as well as counseling on medical examination and treatment for individuals, households, and communities;

- Communicate and educate about health, enhancing public awareness of proactive and active disease prevention and preventing risk factors that affect health;

- Guide environmental hygiene and food safety;

- Participate in monitoring, early detection, and prevention of diseases in the community;

- Vaccination;

- Prevention of non-communicable diseases: cancer, cardiovascular diseases, hypertension, diabetes, chronic obstructive pulmonary disease, and asthma.

c) Implement community health care programs, community-based rehabilitation, palliative care, end-of-life care; population health programs, maternal and child health care, elderly health care, family planning, integration of traditional medicine with modern medicine.

d) Medical examination and treatment:

- First aid, emergency care;

- Screening and early detection of diseases, especially epidemics;

- Chronic diseases, non-communicable diseases;

- Home-based care, medical examination, and treatment for patients according to the list specified in the Appendix attached to this Circular;

- Perform technical services in:

+ Basic health service packages as stipulated in the Circular of the Minister of Health;

+ Technical lists of level 3 and level 4 as stipulated in the Circular of the Minister of Health on specialized technical division and technical lists;

+ Other specialized techniques at higher levels when meeting the required conditions.

The maximum scope of professional activities of family medicine facilities and family doctors includes the services and techniques specified herein. Based on the actual conditions of infrastructure, equipment, and human resources (practice certificates, professional qualifications, training certificates in family medicine of practitioners) of each family medicine facility, the Ministry of Health and the Department of Health will determine the appropriate scope of professional activities and technical lists for each family medicine facility, and the scope of professional activities of family doctors within their jurisdiction.

e) Transfer patients to higher-level facilities according to professional requirements; accept patients who have been stabilized from higher-level facilities for continued treatment as stipulated in Circular No. 14/2014/TT-BYT dated April 14, 2014 of the Minister of Health on the transfer between medical examination and treatment facilities;

f) Participate in scientific research, training, and technology transfer in family medicine; serve as practical training bases for family medicine specialties according to the law.

g) Perform other tasks as prescribed by competent authorities.

Perform other tasks as prescribed by the competent authority.

Article 3. Duties of family doctors

Family doctors shall perform the tasks specified in Clause 2, Article 2 of this Circular according to the assignment of the person in charge of the family medical facility.

Article 4. Professional Qualifications and Training Certificates for Family Medicine

1. Those who have been granted a practice certificate for diagnosis and treatment and have carried out activities in family medicine before the effective date of this Circular shall continue their activities and are responsible for retraining and continuous training to update knowledge on family medicine for a minimum of three months.

2. General practitioners and clinical specialists who have been granted a practice certificate for diagnosis and treatment before and after the effective date of this Circular may engage in family medicine diagnosis and treatment immediately upon meeting one of the following conditions:

a) Possessing one of the diplomas of internal medicine resident, specialist level I, specialist level II, master's degree, or doctoral degree in the specialty of family medicine;

b) Holding a certificate confirming completion of at least three months of training and upgrading in family medicine;

c) Holding a certificate confirming participation in individual courses with contents recorded in the confirmation letter or credits or training and upgrading programs in family medicine for a total duration of at least three months.

3. Preventive medicine doctors who have been granted a practice certificate for diagnosis and treatment before and after the effective date of this Circular, holding a certificate confirming completion of at least three months of training and upgrading in family medicine are eligible to participate in family medicine diagnosis and treatment at commune health stations, urban district health stations, and town health stations (level 4).

Article 5. Effective Date

1. This Circular takes effect from October 15, 2019.

2. Circular No. 16/2014/TT-BYT dated May 22, 2014, issued by the Minister of Health guiding the pilot implementation of family doctors and family doctor clinics, shall cease to be effective from the date this Circular takes effect.

Article 6. Reference Provisions

In cases where the referenced documents in this Circular are amended, supplemented, or replaced, they shall be implemented according to the amended, supplemented, or replaced documents.

Article 7. Transitional Provisions

Medical facilities that have been granted a permit for family medicine diagnosis and treatment activities before the effective date of this Circular shall continue their family medicine activities but must update to meet the training and upgrading requirements for practitioners stipulated in Article 4 of this Circular within a period of twenty-four months from the date this Circular takes effect.

Article 8. Responsibility for Implementation

1. The Department of Medical Examination and Treatment shall act as the lead in guiding, organizing the implementation, and inspecting the enforcement of this Circular nationwide.

2. The Department of Science, Technology, and Training shall act as the lead in guiding and inspecting educational institutions regarding the training and issuance of professional qualifications and certificates in family medicine as prescribed by this Circular.

3. The Department of Planning and Finance shall cooperate with the Department of Medical Examination and Treatment to establish, supplement, and guide the implementation of regulations on service fees for diagnosis and treatment activities within the scope of family doctors' and family doctor clinic's professional activities.

4. Provincial Departments of Health under centrally administered cities and provinces shall be responsible for:

a) Organizing the implementation and inspection of this Circular within their jurisdiction and annually reporting to the Ministry of Health on the implementation of this Circular;

b) Based on the demand for diagnosis and treatment of the population, the number and professional capacity of local family medicine diagnostic and treatment facilities, annually allocating and adjusting the number of personal health record management to suit the situation.

5. The Director of the Ministry's Office, the Inspector General, Heads of Departments, Directors of Bureaus, General Directors of Departments, Bureaus, and General Bureaus under the Ministry of Health, Directors of Provincial Departments of Health, Heads of Health Services, and other relevant agencies, organizations, units, and individuals shall be responsible for implementing this Circular.

During the implementation process, if there are any difficulties, agencies, organizations, and individuals should promptly report them to the Ministry of Health (Department of Medical Examination and Treatment) for research and resolution./.