The hospitals under the supervision of the National Health Commission are known as the "national team" and are the leading geese of public hospitals in the country, playing an exemplary and leading role. In the context of the expansion of public hospitals across the country, ensuring the regional balance of medical resources and the balance of medical service quality has become the key.
How to build the branch area of the hospital under the management of the commission? A few days ago, the National Health Commission issued the "Measures for the Construction and Management of Branch Hospitals under the National Health Commission (Trial)".
The Measures require that the construction of sub-hospital districts of subordinate (managed) hospitals should conform to the regional medical and health service system planning and the planning of the establishment of medical institutions, give priority to the construction of branch districts in areas with relatively weak medical resources, give full play to the driving role of radiation, improve the homogenization level and coverage of medical services, and achieve the expansion and balanced layout of high-quality medical resources.
The Measures specify that by the end of 2025, except for national medical centers, national regional medical centers, and project units undertaking tasks such as the relief of Beijing's medical and health non-capital functions, hospitals under the commission (management) shall not build branch hospitals across provinces; It is strictly forbidden to build (office) without approval and build (office) while approving it, and resolutely avoid disorderly expansion.
The Measures point out that commissioned (managed) hospitals with poor infrastructure conditions and tight business premises in the original campus are encouraged to relieve some of the medical beds in the original campus through the construction of branch campuses, and reasonably plan and set up the scale of beds in each campus. The construction of subordinate (managed) hospital branch areas should combine its own advantages, take the principle of making up for shortcomings and optimizing layout, focus on strengthening the construction of specialties such as tumors, cardiovascular and cerebrovascular, respiratory, intensive medicine, obstetrics and gynecology, children, psychiatry, rehabilitation, etc., adhere to the integration of medical and prevention, and move the threshold forward. At the same time, the function of combining emergency and emergency is strengthened, and expandable space is appropriately reserved to ensure rapid conversion and activation when major epidemics occur, and improve the emergency handling capacity of major public health emergencies.
The Measures propose that the construction of subordinate (managed) hospital branch districts should adhere to the public welfare nature of public hospitals, improve the corresponding institutions, personnel, technology, information, finance and other management systems, and further optimize and increase the proportion of hospital personnel expenditure and the proportion of fixed salary of personnel. Establish a management system that adapts to the multi-campus of public hospitals, implement a unified quality management and performance evaluation system, improve service quality and efficiency, and provide homogeneous medical services. Where a commissioned (managed) hospital plans to build a new campus, it shall meet the requirements for the establishment of sub-districts in the "Guidelines for the Planning of the Establishment of Medical Institutions". In principle, the hospital that intends to open a branch area should have no long-term debt. The National Medical Center, the National Regional Medical Center, and the hospitals undertaking the task of decentralizing non-capital functions of Beijing's medical and health care may determine the size of the beds in the branch area according to the actual situation.
The Measures emphasize that if existing hospitals and facilities are accepted as branch districts by means of mergers and acquisitions, and the proposed hospitals and facilities involve legal disputes, unclear property rights relationships, and serious disruption of medical order in the past three years, the National Health Commission will suspend or refuse to handle the procedures for approval of the branch campus. Except for projects such as national medical centers and regional medical centers, other hospitals that cooperate with affiliated (managed) hospitals shall not be named in the form of "such and such hospital + identification name + campus/branch district/hospital". Hospitals with cooperative projects that have been listed to the outside world should take into account their own conditions and do a good job of cleaning up and delisting in a timely manner.
When referring to the construction approval procedure, the Measures point out that if a commissioned (managed) hospital accepts an existing hospital or facility construction branch through mergers and acquisitions, etc., it is required to submit the following declaration materials:
(1) Request for documents;
(2) The opinions of the provincial-level health administrative department and the higher-level management department of the hospital or facility to be accepted;
(3) Medium- and long-term career development plans;
(4) The minutes of the collective research and decision-making meeting of the hospital's leadership group and the minutes of discussion and voting at the staff representative assembly;
(5) The basic information of hospitals (including branch areas) that have been opened, mainly including hospital beds, buildings, personnel and composition, medical services, characteristic specialties, teaching and scientific research, etc. Economic conditions audited by accounting firms, etc.;
(6) The basic situation of the existing hospital or facility to be accepted, mainly including the necessity and feasibility of the establishment of the hospital area, the location, scale, assets, sources and composition of medical and health technical personnel, and the comparative analysis of the economic situation of the hospital before and after the construction of the branch campus;
(7) Feasibility analysis of the receiving plan, asset transfer plan and personnel acceptance plan;
(8) Relevant contract documents to be signed;
(9) Other materials that need to be provided in accordance with laws and regulations.
Appendix 1: List of 44 affiliated hospitals
Attachment 2: Measures for the Construction and Management of Branch Districts of Hospitals under the National Health Commission (Trial)
Chapter I General Provisions
Article 1: These Measures are formulated in accordance with the Law of the People's Republic of China on Basic Medical Care and Health Promotion, the Guiding Principles for the Planning of the Establishment of Medical Institutions (2021-2025), the Notice on Regulating the Management of Public Hospital Branch Districts, and other relevant provisions, in order to standardize the construction of branch hospitals under the commission (management), promote the expansion of high-quality medical resources and balanced regional layout, improve the emergency response capacity of major regional public health incidents, and promote the high-quality development of hospitals.
The branch hospital area referred to in these Measures includes: a hospital under the commission (management) is established in the form of new construction, merger and acquisition, etc., outside the original campus (main campus), and operates and manages as a non-independent legal person, and its personnel, property, material and other assets are all owned by the main campus, and has a certain bed scale.
Primary medical service extension points, outpatient departments, health examination centers without beds, scientific research and teaching facilities, etc. set up by affiliated (managed) hospitals, as well as medical cooperation acts operated and managed in various forms such as medical alliances, trusteeship, cooperation, and counterpart support are not within the scope of branch districts of these Measures, and their management shall be carried out in accordance with relevant requirements.
Article 2: Hospitals under the commission (management) shall adhere to the people's health as the center, respect the law of hospital development and construction, strengthen the research and promotion of health promotion and preventive appropriate technologies, comprehensively consider the distribution of economic and social and medical resources in the region and the health needs of the masses, and scientifically and appropriately carry out the construction of branch hospitals in accordance with the principles of overall planning, integration of medical and prevention, integration of emergency and emergency, homogeneous development, radiation guidance, and adherence to the public welfare.
Article 3 The National Health Commission is the competent department for the construction and management of subordinate (managed) hospital branch districts, establishes a working mechanism for the construction and management of subordinate (managed) hospital branch districts within the commission, and strengthens the daily supervision of the construction of subordinate (managed) hospital branch districts.
Article 4 The entrusted (managed) hospital is the main body responsible for the construction and management of the branch district, and is responsible for the declaration and construction of the establishment of the branch district.
Chapter II: General Requirements
Article 5 The construction of sub-hospital districts of subordinate (managed) hospitals shall conform to the regional medical and health service system planning and the establishment planning of medical institutions, strictly implement the relevant requirements for hierarchical diagnosis and treatment, give priority to the construction of branch districts in areas with relatively weak medical resources, give full play to the driving role of radiation, improve the homogenization level and coverage of medical services, and realize the expansion and balanced layout of high-quality medical resources.
Encourage the entrusted (managed) hospitals with poor infrastructure conditions and tight business space in the original hospital area to relieve some of the medical beds in the original campus through the construction of branch campuses, rationally plan and set up the scale of beds in each hospital area, and further improve the medical service environment and the healthy working environment of employees.
Article 6 Affiliated (managed) hospitals shall include the construction of branch districts in the hospital career development plan and overall development construction plan, make overall planning with the original campus, achieve functional coordination, resource sharing, green wisdom and balanced development, make full use of technical means such as informatization, improve the level of integration and intensification between each hospital, and shall not dilute high-quality medical resources due to the construction of new campuses, affecting the overall service quality and operational efficiency of the hospital.
Article 7 The construction of subordinate (managed) hospital branch districts shall combine its own advantages, focus on key diseases and patients' medical needs, take the principle of making up for shortcomings and optimizing layout as the principle, focus on strengthening the construction of specialties such as tumors, cardiovascular and cerebrovascular, respiratory, intensive medicine, obstetrics and gynecology, children, psychiatry, rehabilitation, etc., adhere to the integration of medical and prevention, move the threshold forward, change from treatment as the center to people's health as the center, and actively adapt to the people's health needs.
Article 8: The construction of subordinate (managed) hospital branch districts shall strengthen the function of combining emergency and emergency, appropriately reserve expandable space, ensure rapid conversion and use when major epidemics occur, and increase emergency response capacity for major public health emergencies.
Article 9: Decision-making on the construction of subordinate (managed) hospital branch districts shall strictly implement the "three major ones" system, and adhere to lawful decision-making, scientific decision-making, democratic decision-making and collective decision-making. Follow the principle of reciprocity of responsibilities and rights, do a good job of preliminary demonstration work such as operation analysis, personnel reserves, asset ownership, debts, etc., and when necessary, carry out third-party assessments to ensure that the legitimate rights and interests of hospitals are safeguarded.
Chapter III: Construction Requirements
Article 10 In principle, by the end of 2025, except for the National Medical Center, the National Regional Medical Center and the project units undertaking tasks such as the relief of Beijing's medical and health non-capital functions, the entrusted (managed) hospitals shall not build branch districts across provinces.
Article 11: Where a commissioned (managed) hospital plans to build a new campus, it shall meet the requirements for the establishment of sub-districts in the "Guidelines for Planning the Establishment of Medical Institutions". In principle, the hospital that intends to open a branch area should have no long-term debt. National Medical Center, National Regional Medical Center and hospitals undertaking the task of decentralizing non-capital medical and health functions in Beijing may determine the size of beds in branch areas according to the actual situation.
Article 12: Where existing hospitals, facilities, etc. are accepted as branch districts by means such as mergers and acquisitions, and the proposed hospitals and facilities involve legal disputes, unclear property rights relationships, or serious disruption of medical order in the past three years, the National Health Commission will suspend or refuse to handle procedures such as approval by the branch district.
Chapter IV: Construction Approval Procedures
Article 13 Where a commissioned (managed) hospital uses its own land or newly requisitioned land to build a new branch district, it shall be implemented in accordance with the relevant provisions of the National Health Commission's Capital Construction Management Measures; The construction of branch districts carrying the construction projects of national medical centers and national regional medical centers or included in the planning and construction projects related to the national medical and health service system shall be implemented in accordance with relevant management requirements.
Article 14 Where a commissioned (managed) hospital accepts an existing hospital or facility construction branch area through mergers and acquisitions, it shall submit the following declaration materials
(1) Request for documents;
(2) The opinions of the provincial-level health administrative department and the higher-level management department of the hospital or facility to be accepted;
(3) Medium- and long-term career development plans;
(4) The minutes of the collective research and decision-making meeting of the hospital's leadership group and the minutes of discussion and voting at the staff representative assembly;
(5) The basic information of hospitals (including branch areas) that have been opened, mainly including hospital beds, buildings, personnel and composition, medical services, characteristic specialties, teaching and scientific research, etc. Economic conditions audited by accounting firms, etc.;
(6) The basic situation of the existing hospital or facility to be accepted, mainly including the necessity and feasibility of the establishment of the hospital area, the location, scale, assets, sources and composition of medical and health technical personnel, and the comparative analysis of the economic situation of the hospital before and after the construction of the branch campus;
(7) Feasibility analysis of the receiving plan, asset transfer plan and personnel acceptance plan;
(8) Relevant contract documents to be signed;
(9) Other materials that need to be provided in accordance with laws and regulations.
Article 15 After the National Health Commission formally accepts the relevant application materials for the newly established branch area of the commissioned (managed) hospital, it shall issue a written notice of approval or disapproval after deliberation by the working mechanism for the construction and management of the branch district of the hospital under the commission (management) within the commission. It is strictly forbidden to build (office) without approval, and build (office) while approving it, and resolutely avoid disorderly expansion.
Article 16: Branch districts that have been approved by the National Health Commission for construction must not change the scale of establishment or other major matters without authorization. If it is really necessary to change due to development needs, an application for change and related documents shall be submitted to the National Health Commission, and adjustments can only be made after review and approval.
Article 17: The names of branch districts of subordinate (managed) hospitals shall comply with the relevant provisions on the naming of medical institutions. In principle, the registered name of the branch area is "hospital name + identification name + campus/branch area"; Among them, the identification name is a place name, a place name, a sequential name, or other name with an intrinsic logical relationship. Except for projects such as national medical centers and regional medical centers, other hospitals that cooperate with affiliated (managed) hospitals shall not be named in the form of "such and such hospital + identification name + campus/branch district/hospital". Hospitals with cooperative projects that have been listed to the outside world should take into account their own conditions and do a good job of cleaning up and delisting in a timely manner.
Chapter V: Construction Management
Article 18: The construction of subordinate (managed) hospital branch districts shall adhere to the public welfare nature of public hospitals, improve the corresponding institutions, personnel, technology, information, finance, and other management systems, and further optimize and increase the proportion of hospital personnel expenditure and the proportion of fixed salary of personnel. Establish a management system that adapts to the multi-campus of public hospitals, implement a unified quality management and performance evaluation system, improve service quality and efficiency, and provide homogeneous medical services.
Article 19: Where the transfer of assets is involved in the branch districts of subordinate (managed) hospitals, they shall comply with the relevant laws and regulations on the management of state-owned assets, and promptly handle the formalities for receiving state-owned assets.
Article 20 The construction of subordinate (managed) hospital branch districts shall integrate and rely on existing resources, further give play to the overall advantages, improve the hospital's ability to diagnose and treat difficult diseases, scientific research technology, and transformation of clinical achievements, strengthen the construction of high-level talent teams, and promote the sustainable development of multiple hospital areas.
Article 21 Where a subordinate (managed) hospital sets up a branch district by way of mergers and acquisitions, but there is a dispute during the acceptance process and it is really necessary to terminate, it shall promptly terminate the relevant contract or agreement in accordance with relevant laws and regulations, and publicly explain it on the official website within 20 working days from the date of termination. Where asset issues are involved, hospitals shall also conduct financial liquidation and asset inventory of branch districts in accordance with relevant national regulations, and report them to the National Health Commission for the record.
Chapter VI Supplementary Provisions
Article 22 From the implementation of these Measures, if a hospital under the commission (management) constructs a branch campus without the consent of the National Health Commission, once discovered, the National Health Commission will criticize it and order rectification; Directly responsible managers and other directly responsible personnel shall be investigated for responsibility in accordance with laws and regulations, depending on the seriousness of the circumstances.
Article 23: The National Health Commission is responsible for the interpretation of these Measures.
Article 24: These Measures shall take effect on the date of issuance. The National Health Office Planning Letter [2014] No. 1179 is abolished at the same time.
Source: National Health Commission, Health News