CS directs for night inspections to curb unnecessary referrals to tertiary care hospitals

Srinagar, Nov 15: In an effort to put an end to unnecessary referrals and decongest the tertiary care hospitals, the Health Department Kashmir has ordered conduct of night rounds in rural hospitals to avoid unnecessary referrals to tertiary care hospitals which have become a routine in valley.
The order by the health department has been issued on the directions of Chief Secretary, J&K Government, Dr Arun Kumar Mehta to decongest the tertiary care institutions.
“In light of the directions given by the Chief Secretary, UT J&K, it is impressed upon all the Chief Medical Officers/Medical Superintendents of Kashmir division to take night rounds of all the hospitals falling under their jurisdiction,” said order of DHSK.
The officers have been instructed to check that unnecessary referrals are not forwarded to tertiary care hospitals, to avoid the rush of patients in these hospitals.
The health department has also issued strict instructions to the officers to submit the list of patients being referred to tertiary care hospitals on fortnightly basis with complete details of the patients and the reasons for referral.
The tertiary care hospitals in Srinagar, which serve as main referral units, continue to remain overburdened despite the claims of upgradation in rural healthcare. The hospitals remain flooded with people and there is huge stress on government hospitals.
Health officials said, more than 40,000 patients are referred from district and other rural health facilities to tertiary care hospitals in Srinagar, adding burden on these facilities.
The majority of referral cases are managed at Sher-e-Kashmir Institute of Medical Sciences (SKIMS), Soura followed by Shri Maharaja Hari Singh (SMHS) Hospital, Lal Ded Hospital, Bone and Joint Hospital, New Children Hospital and Chest Diseases Hospital.
Doctors at SKIMS Soura said that referral cases like life-saving treatments, especially for trauma and severe medical emergencies, are being delayed due to the referral process.
Four years back the Health and Medical Education Department had issued Standard Operating Protocol (SoP) for instituting answerability in healthcare institutes in case of referrals but these are not followed in hospitals and there is no end to unnecessary referrals.
In Jan 2021, J&K government publicised Standard Operating Procedures (SoPs) for instituting answerability in healthcare institutes in case of referrals.
As per the SoP, prepared by GMC Srinagar, a doctor who decides to send a patient to a higher institute had to ensure that the patient reaches the hospital safely.
In such a case the doctor had to follow an inventory before deciding that a case could not be handled at the level where the referral was taking place.
The SOPs were then issued after a roadside delivery case of a Kupwara woman in Srinagar to regulate patient referrals and burden on tertiary care institutions.