Circular 21/2019/TT-BYT guiding the pilot of family medicine activities issued by the Minister of Health

CIRCULAR

GUIDELINES FOR PILOT FAMILY MEDICINE PRACTICES

Pursuant to the Law on Medical Examination and Treatment dated November 23, 2009;

Pursuant to Decree No. 109/2016/ND-CP dated July 01, 2016 of the Government on issuance of operating license for practioners and operation license for medical examination and treatment facilities;

Pursuant to Decree No. 155/2018/ND-CP dated November 12, 2018 of the Government on amendments to a number of provisions relating the business investment conditions under state management of the Ministry of Health;

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

At the request of the Director General of the Vietnam Administration of Medical Services;

The Minister of Health promulgates Circular providing guidelines on pilot family medicine practices.

Article 1. Scope

1. This Circular provides guidelines for the pilot implementation of:

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

- The medical stations of communes, wards, towns; the infirmaries; the medical stations of agencies, units and organizations (hereinafter referred to as “the medical station”);

- The general clinics, the private specialist clinics;

- The general clinics, the general clinics of the divisions, the specialist clinics affiliated to the medical centers of the districts, wards, military clinics;

- The outpatient departments in the disctrict-level, ward-level hospitals or district-level, ward-level medical centers or hopistals of the medical universities.

b) The tasks of the family medicine practitioners;

c) Specialized degrees and certificates relating training in family medicine.

2. The provisions that are not specified in this Circular shall follow those set forth under the Law on Medical Examination and Treatment and elaborating documents.

Article 2. Positions, functions and tasks of general practice facilities

1. Positions and functions:

The family medicine facilities shall be the first to accept, manage, take care of health initially, consult, prevent diseases, improve health, perform emergency treatment, examine and treat general diseases following the family medicine principles applicable for households and persons.

2. Tasks:

a) Community health management:

- Prepare the personal health records as set forth under Decision No. 831/QD-BYT dated March 11, 2017 of the Minister of Health on the issuance of personal health management form serving initial health care;

- Manage and conduct health care following the family medicine principles for persons and households as assigned by the Health Deparments of provinces and central-affiliated cities (hereinafter referred to as “the Health Departments”).

b) Health improvement and disease prevention advice:

- Give advice on nutrition, health activities, prevention of cigarette, alcoholic beverages harmful effects and other risks to health; give advice on disease examination and treatment to persons, households and community;

- Publicize, educate the people on health, raise their awareness of active and effective disease prevention, prevention of health risks;

- Provide guidelines on environmental hygiene and food safety;

- Participate in monitor, early detection and prevetion of disease in the community;

- Vaccinate;

- Prevent non-communicable diseases: cancer,cardiovascular diseases, hypertension, diabetes mellitus, chronic obstructive pulmonary diseases and bronchial asthma.

c) Implementation of programs and activities relating community health care, community-based functional restoration, palliative care, end-of-live care; the programs relating health-population target, maternal child and elders health, population – birth control, combination of traditional medicine and modern medicine.

d) Medical examination and treatment:

- Perform first aid and provide emergency medical services;

- Conduct screening, early detection of illnesses, particularly the contagious dieases;

- Chronic diseases, non-communicable diseases;

- Take care, examine and treat diseases at home for patients mentioned in the list under the Annex issued together with this Circular;

- Provide technical services in:

+ The basic medical service packs under Circulars of the Minister of Health;

+ The technical lists of level 3, level 4 under Circulars of the Minister of Health on classifying specialized levels, technical list;

+ Other specialized techniques, in higher levels once satisfactory to the regulations.

The maximum specialized operation range of the family medicine facilities and practitioners includes the services and techniques under this Point. Based on the actual facilities, equipment and personnel conditions (operating license, specialized certificates, famility medicine qualitification of the pratitioners) of each family medicine facility, the Ministry of Health, the Health Deparment shall determine the specialized operation range, the list of techniques suitable for each family medicine facility, the specialized operation range of the family medicine practitioners under their management.

dd) Transfer of the patients to the higher levels according to the appropriate sector; accept the patients receiving steady treatment from the higher levels to continue the treatment as set forth under Circular No. 14/2014/TT-BYT dated April 14, 2014 of the Minister of Health on change of medical examination and treatment facility levels;

e) Participation in scientific research, training, technical conversion relating family medicine; acting as the practicing facilities in family medicine training as per law.

g) Implementation of other tasks specified by the competent authorities.

Article 3. Tasks of family medicine practitioners

The family medicine practitioners shall implement tasks set forth under Clause 2 Article 2 of this Circular as assigned by the specialist in charge of the family medicine facilities.

Article 4. Specialized degrees and certificates relating training in family medicine

1. Persons issued with the disease examination and prevention operating license who already performs disease examination and prevention relating family medicine before the effective date of this Circular shall continue to operate and shall have the responsibilities to participate in the re-training courses, continuous training courses to update on the family medicine knowledge for at least 03 months.

2. The general practitioners, the spealized clinical practitioners issued with the disease examination and prevention operating license before and after the effective date of this circular shall exam and treat diseases relating the family medicine once any of the requirements are met:

a) Possessing any of the following degrees: resident physician, first degree, second degree physician, masters or doctors in family medicine;

b) Possessing the certificates relating the receipt of family medicine training and education for at least 03 months;

c) Possessing the confirmation relating participating in courses whose contents are specifiedi n the certificate, degrees or training, education courses relating family medicine for a minimum of 03 months.

3. Preventive practitioners issued with the disease examination, prevention operating license before and after the effective date of this Circular possessing the certificate for participation in the family medicine training, education for at least 03 months shall be able to examine and treat diseases relating family medicine at the medical stations of communes (level 4).

Article 5. Entry into force

1. This Circular comes into force from October 15, 2019.

2. Circular No. 16/2014/TT-BYT dated May 22, 2014 of the Minister of Health on pilot family medicine practitioners and family medicine clinics expires from the effective date of this Circular.

Article 6. Terms of reference

If the legislative documents extracted in this Circular are approved for amendments or superseded by other legislative document, the new documents will apply.

Article 7. Transition clauses

The medical examination and treatment facilities issued with the disease examination, prevention operation license relating the family medicine before the effective date of this Circular shall continue their operations relating family medicine but must update to satisfy the family medicine training and education applicable to the practitioners as specified in Article 4 of this Circular within 24 months from the effective date thereof.

Article 8. Responsibility for implementation

1. The Vietnam Administration of Medical Services shall act as the contact point to guide, implement and inspect the implementation of this Circular on a national scale.

2. The Administration of Science Technology and Training shall act as the contact point to guide, inspect the training facilities regarding the training and issuance of degres, specialized certificates relating the family medicine as set forth under this Circular.

3. The the Department of Planning—Finance shall cooperate with the Vietnam Administration of Medical Services to develop, amend, provide guidelines for the regulations on disease examination and treatment prices within the operation range of the family medicine facilities and practitioners.

4. The Health Departments of provinces and central-affiliated cities shall have the responsibilities to:

a) implement, inspect the implementation of this Circular within their competence and report to the Ministry of Health on a yearly basis about the implementation of this Circular;

b) based on the disease examination and treatment need of the people, the quantity and specialized competence of the local family medicine facilities for disease examination and treatment, assign and adjust the amount of personal health records appropriately on a yearly basis.

5. Chief of the Ministry Office, Ministry Inspectorates, Directors General of Departments, General Departments affiliated to the Ministry of Health, Directors of Health Department, heads of health sector and other relevant agencies, organizations, units and persons shall have the responsibilities for the implementation of this Circular.

Difficulties that arise during the implementation of this Circular should be reported to the Ministry of Health (Vietnam Administration of Medical Services) for consideration and solution./.

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