J&K’s Tele-ICU proposal for rural GMCs stalled

Srinagar, Feb 25: The proposal for setting up Tele Intensive Care Units (ICUs) in peripheral hospitals/medical colleges of Jammu and Kashmir remains stalled, while avoidable referrals to tertiary care hospitals continue to be a longstanding issue.
In August last year, Mission Director, National Health Mission issued a communiqué to the principals of seven new medical colleges—GMC Baramulla, Anantnag, Handwara, Kathua, Doda, Udhampur, and Rajouri—regarding the establishment of Tele ICUs.
The model for setting up of Tele ICUs/e- ICU services was an innovative practice to be put in place especially given harsh geo-climatic conditions of Jammu & Kashmir which contribute to frequent breakdowns in road train and air connectivity.
However, a comprehensive tour was conducted by the State Team of National Health Mission, J&K along with the concerned committee members constituted in August 2024 to take the physical stock of the institution for setting up of Tele-ICUs.
The committee recommended addressing infrastructure and equipment gaps in institutions after following Indian Society of Critical Care Management and NQAS, ICU guidelines and a detailed report was to be submitted to initiate Tele-ICU services on time.
However, very few new medical colleges set up intensive care units while rest of the institutions are yet to start the same which is pushing patients in the rural areas.
Notably, GMC Baramulla has constructed an ICU, both maternal and child, but it hasn’t been made functional as the health department is yet to recruit manpower for the same.
“The ICU is still locked. This is also a reason why patients including high-risk pregnancies from north Kashmir are referred to Srinagar hospitals for treatment. This facility must be made available as patients often need ICU post-surgery,” said an official at the hospital.
He said that pregnant women who suffer excessive bleeding during surgeries are referred as such cases aren’t attempted at maternity department at GMC Baramulla putting them at high risk. “A fully equipped ICU is the need of the hour to handle life-threatening emergencies.”
“Both the 10-bed maternal and 10-bed child ICU is ready but we have no staff. We would have made it functional but we don’t have manpower. This is the inefficiency of the medical college and they are sleeping over the issue,” said an employee.
As per Indian Public Health Standards (IPHS)-2022 norms, 8-10 percent of total hospital beds should be ICU beds for providing critical care services.
In absence of this, avoidable referrals from remote areas of J&K to tertiary care hospitals remain a longstanding issue causing severe difficulties for families of patients in need of ICU services.
Similarly, an official said GMC Handwara has proposed establishing an ICU to the Health Department, which forwarded it to NHM for feasibility assessment. Once reviewed, it will be taken up with the central agency and is currently under process.
“There is still a dearth of space and shortage of staff like specialist doctors and nurses which is also a reason why the Tele-ICU was not made functional,” said a doctor at Handwara.
The situation is no different at GMC Doda, GMC Rajouri and patients continue to be referred to tertiary care hospitals.
However, GMC Anantnag has developed an ICU which has improved cardiac and surgical services. GMC Anantnag is the only peripheral medical college in India and among the seven new medical colleges in J&K that has installed cath lab service.
Under the PM Ayushman Bharat Health Infrastructure Mission, the Tele ICUs were supposed to be based on a spoke and hub model as peripheral medical colleges would be linked with the central medical colleges and SKIMS Soura.
“Doctors should be assigned on a rotational basis, as many have remained in old GMCs for years. There is a need for a policy to address the issue and reduce referrals,” the doctor said.
However, a senior official of the Health and Medical Education Department stated that running ICUs requires anaesthetists and other logistics. “We are planning a major intervention soon. Tele-ICUs will be set up only once there are ICUs,” the official said.