MEDICAL CLINICS

The Hong Kong Medical Association receives a letter from Department of Health dated 21 December 2016, in which we were consulted on the draft standards for medical clinics.

The Government proposes to regulate all medical clinics in Hong Kong, save for those exempted. The Government intends to exempt small medical practices.

EXEMPTION: https://youtu.be/pl8dHH9DDsc

To qualify as a small medical practice, a clinic must fulfill the following criteria:
1. The clinic will have 3 doctors or less,
2. Each doctor must be a director of the clinic,
3. All doctors regularly see patients in the clinic, and
4. No high-risk procedure will be performed in the clinic

A small medical practice can be exempted if no doctor in the clinic regularly sees patient in more than 2 small medical practices.

REGULATION: https://youtu.be/PfbrKcNwm0Q

The Government has proposed "Standards for Medical clinics". A copy of the "Standards" can be downloaded from this website (click here).
There are 5 areas in the proposed regulation:
1. Management / Governance
2. Physical Conditions
3. Service Delivery and Care Process
4. Infection Control
5. Risk Management and Contingencies

The core person of Management / Governance is the "Person-in-charge" (the Government proposes to rename him as Chief Medical Executive). The Chief Medical Executive must either be a registered medical practitioner or a registered dental practitioner. He will be responsible for all policies related to medical services. He will be responsible for overseeing the training of staff, and ensure that all doctors working in the clinic are up to professional standard.

Physical Conditions refer to the physical structure of the clinic, including layout, fixture, furniture and equipment. It also includes functional aspects like ventilation, lighting, signage and sanitation. It is in this area that usage, storage, maintenance of equipment is spelt out. Basically, the above items must comply with existing standards.

Service Delivery and Care Process encompasses a number of items, including patient's rights, medical record, drug management, handling of specimens, charge transparency etc. Each regulated clinic is required to have in place a complaint handling policy for patients.

Infection Control requires policies in place for the prevention and prompt reporting of infection incidence. Adequate PPEs have to be stocked and available to staff and patients. Medical equipment designed for reuse must be disinfected or sterilized in accordance with accepted standards. Medical equipment designed for single use must not be reused. Clinical / chemical wastes are to be disposed of in accordance with the guideline laid out by the Environmental Protection Department. Radioactive waste are handled in accordance with the law.

Risk Management and Contingency refer to events including resuscitation. As such, adequate equipment must be stocked and made readily available to staff, and staff must be familiar with the usage of such equipment. Staff training and drilling are required to maximize patient safety in case of emergencies. Interestingly, fire drill is part of the requirement.

DAY PROCEDURE CENTRES

REGULATION: https://www.facebook.com/151407245292728/videos/263506470749471/
GUIDELINE: Core Standards for Day Procedure Centres