Dehradun, July 22: Acting on the directions of Chief Minister Pushkar Singh Dhami, the Uttarakhand government has adopted a stringent approach to curb unnecessary referrals of patients from government hospitals. In a significant move to streamline the referral process and ensure timely treatment at local levels, the Health Department has issued a detailed Standard Operating Procedure (SOP) to make the system transparent, accountable, and strictly based on medical grounds.
Health Secretary Dr. R. Rajesh Kumar stated that no patient will henceforth be referred from district or sub-district hospitals to higher medical institutions without valid medical justification. “In line with the Chief Minister’s vision, we are committed to ensuring that patients receive primary treatment and expert consultation at the district level itself,” he added.
Key Highlights of the SOP:
Referral Only in Absence of Specialist:
Referrals will be permitted only when the relevant specialist is unavailable at the hospital.
Decision by Senior Doctor On-Duty:
The authority to refer a patient will rest with the senior-most doctor present. Referrals made via telephone or email will not be considered valid.
Emergency Exemptions:
In urgent cases, decisions may be made via WhatsApp or phone, but proper documentation must follow immediately.
Mandatory Documentation:
Each referral must include specific and verifiable reasons—such as lack of expertise or unavailability of required resources—clearly recorded in the referral form.
Accountability of CMO/CMS:
In cases of unjustified referrals, the concerned Chief Medical Officer (CMO) or Chief Medical Superintendent (CMS) will be held responsible.
Guidelines for Ambulance Services:
To enhance transparency in patient transfers, new norms have also been introduced for the use of ambulance services:
Use of 108 Ambulance:
These ambulances will strictly be used for Inter-Facility Transfers (IFT) only.
Departmental Ambulance Review:
The operational fitness of all departmental ambulances will be assessed. Older vehicles, found unfit for patient transport, will be re-designated as hearse vans.
District-Level Situation & Measures:
As of now, Uttarakhand has 272 “108” ambulances, 244 departmental ambulances, and just 10 hearse vans across the state. Alarmingly, districts like Almora, Bageshwar, Champawat, Pauri, and Nainital lack even a single hearse van. The Health Department has instructed CMOs of these districts to make immediate alternative arrangements.
Focus on Transparency and Patient Welfare:
“This is more than a procedural reform. It is a critical step to safeguard patient welfare and to reinforce accountability in government healthcare,” said Dr. Kumar. He emphasized that every referral must be justified, documented, and audited regularly to ensure compliance.
The Health Department has issued strict instructions to all Medical Officers In-Charge (MOICs) and CMOs to implement the SOP in letter and spirit, with proper documentation of each referral case.
