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Government of West Bengal Department of Health  Family Welfare Conten Government of West Bengal Department of Health  Family Welfare Conten

Government of West Bengal Department of Health Family Welfare Conten - PDF document

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Government of West Bengal Department of Health Family Welfare Conten - PPT Presentation

1 Background Information 2 Policy Context 3 Objective of the proposed initiative 4 Partnership model investment and ownership 5 Selection of private partners 6 Investment Pattern 7 Policy on u ID: 941861

district private scan health private district health scan hospital partner government family bengal west welfare dhfws services patients department

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Government of West Bengal Department of Health & Family Welfare Contents 1 Background Information 2 Policy Context 3 Objective of the proposed initiative 4 Partnership model, investment and ownership 5 Selection of private partners 6 Investment Pattern 7 Policy on user charges 8 Collection of user charges and 9 Policy on free services 10 Duration of services 11 Role and responsibilities of each partner 12 Monitoring Mechanism Annexure I – III Annexure II - The Grounds for Termination of Agreement Annexure III - Format of Possession Certificate Annexure IV - Format for advertisement in Newspaper(s). Government of West Bengal Department of Health & Family Welfare Abbreviations BPL Below Poverty Line DoHFW Department of Health and Family Welfare GoWB Government of West Bengal NOC No Objection Certificate OPD Out Patients Department PPP Public Private Partnership QCBS Quality and Cost Based Selection DHFWS District Health and Family Welfare Samiti SOP Standard Operating Procedure CMOH Chief Medical Officer of Health RKS Rogi Kalyan Samiti MIS Management Information System Government of West Bengal Department of Health & Family Welfare a) In the wake of increasing demand and expectations from a vast section of people for improved health care services, the Department of Health and Family Welfare (DoHFW), Government of West Bengal (GoWB) has taken several initiatives under Public Private Partnerships (PPP) to strengthen the health and medical care

services in the State. The purpose of these initiatives is to provide quality health care services at affordable cost as well as to improve the health status of the poor and vulnerable population in the State. b) One such initiative, that the department had already identified for implementation was establishment of C.T.Scan Facilities in the Medical Colleges under PPP. The objective of this initiative was to ensure greater access of the people to quality investigation facilities at affordable cost with a safety net for patients indigent in nature. Accordingly, Government Order was issued and administrative approval of the Governor was accorded in August, 2001 for establishment of C.T.Scan facilities by private agencies under joint venture project in 7(seven) Medical Colleges of the State. Encouraged by the positive response of the scheme, DoHFW has now decided to scale up the scheme and roll out the same across all the District Hospitals in the State. The department has itself established another 2(two) C.T.Scan units in two other Medical College Hospitals. All are running very satisfactorily.c) Currently, the State has 15 District Hospitals (list provided as Annexure I). All these Hospitals cater to the needs of a large population of the State with multi-specialty services. These Hospitals, put together, have an average bed capacity of 467 per hospital with a bed occupancy rate of 91.9 %. The average monthly admissions in each Hospital are around and OPD attendances are close to

20000 per month. Patients seeking treatment in these hospitals do have greater needs for higher investigation facilities, which include the he DoHFW has installed C T Scan Units in the District Hospitals of Malda, South 24-Parganas and in the North Bengal Medical College and Hospital which covers Darjeeling District. Considering the need, DoHFW has now decided for installation of one C.T.Scan Unit in each of those 12(twelve) uncovered District Hospitals by private d) PPP is a successful mechanism for providing quality healthcare services at relatively low cost to increased number of people coming to receive health services. 2. Policy Context a) The Policy for Public Private Partnerships in the Health Sector issued by DoHFW in January 2006 outlines various ways in which the diverse segments of the private sector can be engaged with the Government for expeditious achievements of desired health outcomes. b) The document for the policy for PPP also outlines specific areas for PPP in West Bengal at the Tertiary and Secondary Health Care Level and this includes partnerships with private agencies to set up and operate C.T.Scan services. c) The PPP policy document issued by DoHFW is in conformity with the National Policy Framework of Public Private Partnerships as mentioned in the National Health Policy 2002, Health on the March 2005-06 Government of West Bengal Department of Health & Family Welfare which states ‘’ In principle, this policy welcomes the participation of the private se

ctor in Public Private Partnerships in all areas of health activities - primary, secondary or tertiary” 3. Objective of the proposed initiative The objective is to ensure round the clock availability of C.T.Scan facilities in all the District Hospitals in the State of West Bengal. a) The partnership model will be governed by a legal instrument, i.e. a contract, signed between the selected private partner and the Chief Medical Officer of Health and Secretary of the District Health and Family Welfare Samiti (DHFWS) relating to the concerned District Hospital. b) The initial duration of the contract will be for a period of five years. There will be an annual review of performance. The renewal of the contract at the end of five years will be subject to satisfactory consecutive annual review reports during the initial contract period. c) The contract can be terminated on any one or more of the grounds mentioned in Annexure IId) Under the agreement, DHFWS will provide rent-free ready-to-use space within the District Hospital as per Norms of the Clinical Establishment Rules as amended up to 2003 or thereafter for establishment of C.T.Sce) The CMOH concerned in consultation with the Superintendent of the District Hospital shall identify the required space for establishing the facilities. f) A Possession Certificate in plain paper (Annexure III) shall be issued while handing over the above mentioned space duly signed by the private partner shall be kept in the record of the District

Hospital along with the agreement and a copy of these documents shall also be kept in the record of the DoHFW at the State level. g) The private partner will be allowed to undertake minor repair works at their own cost with the concurrence of Rogi Kalyan Samiti (RKS) who shall be approached through the Superintendent of the District Hospital. h) The private partner, at its own cost, would install furniture, C.T.Scan machine and all related and necessary equipment for operationalization of the services. DoHFW will determine the specification of the plant and machinery and modalities of operation. i) Ownership status for all movable assets created from investments made by the private j) DHFWS will provide free supply of water (including water tax) for use by the private partner. k) DHFWS will allow use of electricity for which private partner will pay consumption charges as per prevailing rules of energy supplier. The private partner will apply for the installation of separate electric meter in its name along with a No Objection Certificate (NOC) from the Superintendent of the District Hospital and the installation charges for such a connection (security deposit etc) will be borne by the private partner. The private partner will make Government of West Bengal Department of Health & Family Welfare payments for energy consumed for the C.T.Scan unit directly to energy supplier as per their rules. l) The private partner will be responsible for maintenance and security for the space

provided to them for C.T.Scan services. The premises will be in physical lock and key of the private m) Usage right of the private partner for space and facilities provided by DHFWS is governed by agreement between DHFWS and the private partner. a) The District Health and Family Welfare Samiti (DHFWS) concerned will invite bidders to quote their expression of interests as well as submit necessary technical information as would be required to be furnished and select the private agency who qualifies on technical and cost ground, based on an evaluation system that will be a Quality and Cost Based Selection (QCBS). b) Expression of Interest (EOI) will be invited for each District Hospital as detailed in Annexure-Iand an organization may apply for more than one District Hospital and may be considered for selection in more than one District Hospital if it qualifies in the evaluation system as described in para 5(a) above. 6. Policy on user charges a) The District Health and Family Welfare Samiti (DHFWS) concerned will fix the user charges taking into account the best offer received from the bidders. b) User charges as referred under 6(a) will be applicable only for patients referred by the Superintendent/authorized person(s) of the District Hospital. c) The cost of contrast media, where required, will be borne by the patient. However, use of contrast media should be kept minimum without compromising on the quality. d) The District Health and Family Welfare Samiti (DHFWS) may review the

user charges as and when required. e) The private partner will be able to levy and collect prices at prevailing market rates from patients referred by private practitioners/private institution(s). However, these rates need to be displayed prominently with prior intimation to the Chief Medical Officer of Health concerned and the Superintendent of the District Hospital. The private partner will not be allowed to change these rates without prior permission of the Chief Medical Officer of Health of the District f) The private partner will be required to pay a service charge @ 25% of the revenue earned per patient for all cases referred by private practitioners/institution(s) as per provision of para 6(e). The said amount for each month shall be paid within fifth working day of the next calendar month in the account of DHFWS of the concerned District. Government of West Bengal Department of Health & Family Welfare 7. Collection of user charges and utilization of revenue sharinga) Collection of user charges will be done directly by the private partner as per rates approved by DHFWS. The private partner will issue necessary money receipt to the patients for user charges. b) The private partner will utilize the user charges for operation of C.T.Scan, salary payments, electric and other business expenses. c) The referral cases from the private doctors/institutions be dealt with as per provisions prescribed in para 6(e) prepage. 8. Policy on free services a) The policy on free services w

ill be applicable only to Below Poverty Level (BPL) category of patients identified through BPL cards. However, if BPL cards have not been issued by the competent authority, certificate from M.P/ M.L.A/Municipal Commissioner/Sabhadhipati of the Zilla Parishad and Sabhapati of the Blb) The Superintendent of the District Hospital will authorize free services of these BPL patients based on production of BPL cards or certificates mentioned in 8(a) above. c) The private partner will vestigations free of cost to a minimumof 10% of total cases referred from District Hospitals. Only the BPL patients will get this privilege of free investigation. d) Unutilized percentage/cases of free entitlement in a month will be carried forward to the next month and so on. The private partner will ensure that the machine willat least 95% of the time with the provision of maximum 5% of time to be spared for maintenance activities. (i) The private partner, at its own cost, would install C.T.Scan machine, furniture and all related and necessary equipment for operationalization of the services. The Department of Health and Family Welfare (DoHFW) will determine the specification of the plant and machinery and modalities of operation. (ii) The private partner will apply for the installation of separate electric meter in its name and the installation charges for such a connection (security deposit etc) will be borne by the private partner. The private partner will make payments for energy consumed

for the C.T.Scan facility directly to energy supplier as per their rules. responsible for maintenance and security for the space provided to them for C.T.Scan services. The premises will be und Government of West Bengal Department of Health & Family Welfare (IV) The private partner will abide by the policy regarding user charges and free services as described in paragraphs 7 and 9. (V) The private partner will be responsible for hiring qualified technical personnel as per requirement. The private partner will ensure that the Radiologists deployed by them possess recognized post graduate qualification in Radiology (VI) All the operational cost relating to the functioning of the C.T.Scan services including the cost of deployment of personnel (both technical and non-technical) will have to be borne by the private The private partner will obtain necessary permissions and licenses and comply with all statutory requirements for running the operations and produce relevant documents during inspection by statutory authorities. responsible to set up systems for their own operations in respect of inventory management, customer servicing, financial accounting, record-keeping and MIS. (IX) The private partner will coordinate with Superintendent of the District Hospital in regard to operational activities relating to patient servicing on day-to-day basis. In the absence of Superintendent, such coordination will be required to be done with the person authorized by the Superintendent. (X) The pr

ivate partner will required to submit monthly reports in the prescribed format(s) to the Superintendent of the District Hospital with copies endorsed to the CMOH and the DoHFW at (XI) The private partner will also arrange to collect in the prescribed format, the patient satisfaction report, on which remedial actions would to be taken for patient/customer satisfaction through a review mechanism by the DHFWS. The private partner will ensure that the entire system commissioned by it shall be accessible for teaching and training purposes for undergraduates and postgraduates students, if it is required, at any point of time, at predesigned schedule. The private partner will ensure that the machine will be operational at least for 95% of the time with provision of maximum of 5% of time to be spared for maintenance activities. (XIV) The private partner will not undertake any technical addition or alteration without prior permission of DoHFW. The private partner will make timely payment of the service charges to DHFWS as described under Section 6(f). ly Welfare Samiti (DHFWS) DHFWS concerned will invite bidders to quote their expression of interests and select a private partner as mentioned in paragraph 5. A draft standard format for advertisements in Newspaper(s) is enclosed (Annexure-IV Government of West Bengal Department of Health & Family Welfare DHFWS will fix the user charges for the C.T.Scan services as described in Paragraph 6. DHFWS will make provision for physical infrastructur

e for the C.T.Scan Center with rent-free space within the District Hospital premises as per agreed time schedule. (IV) DHFWS will make provision for free water supply. (V) DHFWS will provide necessary NOC to the private partner for installation of separate electric meter and provide necessary help to the private partner for early installation of electricity meter. (VI) DHFWS will extend all support to the private partner and provide necessary help and protection in case of any pressure created by any individual or group on the private partner. The Superintendent of the District Hospital on behalf of DHFWS shall monitor the day-to-day operational activities of the C.T.Scan center DHFWS will review the rates of the user charges as and when required C) Department of Health and Family Welfare (DoHFW), GoWB (I) The DoHFW will determine the specification of the plant and machinery and modalities of The DoHFW will develop Standard Operating Procedures (SOPs) and management system as well as quality assurance system to be followed by the C.T.Scan Center under PPP. a) The Superintendent of the District Hospital on behalf of its DHFWS shall monitor the day-to-day operational activities of the C.T.Scan center. The CMOH concerned will also visit the C.T. Scan center at least once in a month. b) A committee authorized by DHFWS, preferably the R.K.S, will undertake the overall monitoring of the C.T.Scan center. c) The private partner will be required to submit monthly reports in prescribe

d format(s) to Superintendent of the District Hospital with copies endorsed to the CMOH and the DoHFW at Government of West Bengal Department of Health & Family Welfare 1. M.J.N. (District) Hospital, Coochbehar P.O. & Dist: Coochbehar 2. District Hospital, Jalpaiguri Hospital Para Road, P.O. & Dist: Jalpaiguri 3. Darjeeling District Hospital Darjeeling, Dist: Darjeeling 4. District Hospital Dakshin Dinajpur Balurghat, Dist: Dakshin Dinajpur 5. District Hospital, Raiganj Raiganj, Dist: Uttar Dinajpur 6. District Hospital, Malda P.O. & Dist: Malda 7. Murshidabad District Hospital Baharampore, Dist: Murshidabad 8. Nadia District Hospital Krishnanagar, Dist: Nadia 9. District Hospital, Barasat Barasat, Dist: 24 Pgns (N) 10. M.R. Bangur Hospital [District Hospital for 24 Pgns (S)] Tollygunj, Kolkata 700033 11. Haora District Hospital Haora, Dist: Haora 12. Hooghly District Hospital Chunchura, Dist: Hooghly 13. Suri Sadar Hospital 14. Deben Mahato (Sadar) Hospital P.O. & Dist: Purulia 15. District Hospital, Tamluk Dist: Purba Medinipore One C T Scan Unit has been installed by DoHFW in North Bengal Medical College and Hospital] [One C T Scan Unit has been installed by DoHFW] [One C T Scan Unit has been installed by DoHFW] Government of West Bengal Department of Health & Family Welfare Failure to deliver reports in time as per terms by more than three consecutive occasions Failure to follow Standard Operating Procedures () for performing the tests

Overcharging the pre agreed rates Inaccuracy of reports detected in three occasions at least in a quarter Non-compliance to contractual terms and conditions Non-compliance of statutory requirements Criminal Indictment Insolvency Government of West Bengal Department of Health & Family Welfare Whereas it has been decided by the Government vide Order No. ______________ dated _________ that C.T.Scan facilities would be set up in the District Hospital of ---------------------- district under Public Private Partnerships by---------------------------------- of-------------------------------------------------------------------- (Private Partner) to provide C.T.Scan Services in accordance with the Agreement executed on --------------------------- between the aforesaid Private Partner and the Chief Medical Officer of Health and the Secretary, District Health & Family Welfare Samiti (DHFWS) of the District; Whereas in terms of the aforesaid Government Order and the Agreement executed, the District Health & Family Welfare Samiti is required to provide adequate rent free space in the above mentioned -------------------------------District Hospital of------------------------------district to the above private partner to set up the C.T.Scan facilities; Whereas the cover space in total area of ---------------square feet as indicated in the enclosed site map, within the premises of ------------District Hospital has been identified as the project site in respect of the C.T.Scan

Centre referred to above. Now in keeping with the decision of the Government and the Agreement aforesaid, the right of occupancy of the space, details of which are indicated in the site map is hereby handed over to ----------------------------(Private Partner) on the following terms and conditions: The ownership of the project site remains with the Government of West Bengal and the private partner shall have only occupancy right to the project site for running C.T.Scan services till such date as per the agreement executed between Chief Medical Officer of Health & Secretary, DHFWS and the Private Partner shall. No encumbrance of any nature shall be created in the project site. The occupant shall not do anything, which would be prejudicial to the soundness and safety of the property or reduce the value thereof. The occupant shall not sell, transfer or rent out this project site or its part for any purpose whatsoever and the entire site will be used exclusively for C.T.Scan services by the Private Partner of the agreement with the Chief Medical Officer of Health & Secretary of DHFW concerned. The occupant shall in respect to the said project site be subject to the provisions of the said agreement and shall comply strictly with the covenants, conditions and restrictions set forth in the agreement with Chief Medical Officer of Health & Secretary of DHFW. The occupant shall vacate the project site in the event of the termination of the agreement or at the end of 5(FIVE) years whiche

ver is earlier. (Signature) Chief Medical Officer of Health and Secretary, District Health & Family Welfare Samiti District:_________________ (Contd.. to next page) Date : Place : Government of West Bengal Department of Health & Family Welfare Received the possession of the above mentioned project site on this day of-----------------------------and solemnly declare that I shall abide by all the terms and conditions of the agreement as well as the terms mentioned in this certificate. (Signature of Private Partner) Name of the Private Partner: Name of the Organization: Address Date : Place : Government of West Bengal Department of Health & Family Welfare Annexure-IV Format for Advertisement Applications are invited from interested private organizationsagencies/individuals for procurement and installation of one new Spiral C T Scan machine at the _____________________ District Hospital at _____________________(Name of District Town). The capital cost including cost of installation of machines and maintenance cost thereof should be borne by the private organizations/agencies/individuals. The District Health & Family Welfare Samiti (DHFWS) on behalf of the State Government would provide land and structures (if available) and other infrastructural facilities for this purpose on the following terms and conditions : (i) The tot

al cost of installation of the C T Scan machines and ongoing costs of maintenance, operational expenditure including cost of manpower electricity, purchase of spare parts, cost of repair and/or replacing parts, components of the said equipments shall be borne by the applicant. (ii) Free land and building (if available) necessary for the purpose will be provided by the District Health & Family Welfare Samiti (DHFWS) on behalf of the State Government (iii) Power supply to be provided by the applicant. (iv) Specifications of the plant and machinery will be determined by the Government (v) No technical additions and alterations will be done without permission of the Government (vi) Technical and non-technical personnel will be provided by the applicant and the Government/ DHFWS will not bear the responsibility for such engagements. (vii) The Government hospitals will refer cases which are to be scanned at the rates to be finalized during execution of agreement. (viii) The number of cases to be scanned free of cost will the agreement and it should not be less than 10% of the total cases scanned. (ix) The rates to be charged for patients not referred by the hospital(s) shall be determined by the Government. A share of 25% of the revenue thus earned per patient may be claimed by the Government. (x) The unit shall abide by all the rules and regulations of the hospital campus. (xi) It shall be subject to inspection by the Government Government of West Bengal Department of Health & Family We

lfare (xii) The space provided for the installation shall not be used for any other purpose other than diagnostic scanning of patients. (xiii) Performance and functioning of the equipment would be subject to inspection of designated officials from the Department concerned. (xiv) Termination clause of agreement will be finalized on mutual discussions. Private organizations, agencies and individuals having sound financial base and proven record interested in this project are requested to submit their applications to the Chief Medical Officer of Health and the Secretary, DHFWS of District within ____________ 200 _ by 4.00 p.m. of the day. Chief Medical Officer of Health and Secretary, District Health & Family Welfare Samiti of ______________ District S c h e m e for Establishing C.T.Scan Facilities underPublic Private Partnerships the District Hospitals January, 2008 Government of West Bengal Annexure III Patient’s Satisfaction Report Name of Patient ………………………………………….. Age ……(years) Sex ……… Name of referring Hospital : (i) Whether satisfied with the servi Government of West Bengal ii) …………………………………………………………………………………………………… iii) …………………………………………………………………………………………………… (iv) Any other feedback: Declaration: I hereby declare that the information provided above is true and complete and is fully verifiable whenever needed. Copies to be sent to : 1) Superintendent of the District Hospital 2) Chief Medical Officer of Heath 3) Department of Health and Family Welfare,

PPP Branch, Swasthya Bhavan, Wing-B, 4GN-29, Sector-V, Bidhannagar, Kolkata-700091 (Fax: 2357-0955; Email: alokghosh4@hotmail.com) hould be sent to all concerned by working day of the next month] Government of West Bengal Revenue collection for the month: (I) Revenue from District Hospital patients: Rs -------------------------- Revenue from private patients: Rs -------------------------- Revenue from others (specify) Rs -------------------------- Total Revenue Rs --------------------------- (IV) Amount of Service charges (25% of revenue of private cases) for the month: (V) Date of payment to DHFWS : Other information (I) Number of absences of employees or / and leave taken during the month ………………… Number of test reports that were not delivered to the patients on time …………………….. Reason for the same and action(s) taken……………………………………………………… (IV) Working order of equipment: : (V) % of time used for maintenance: (VI) Equipment under repair, if any -----………………………………………………………………………………………………………… ………………………………………………………………………………………………………… (i) Number of complaints received in the suggestion box/directly in the patients’ satisfaction reports (ii) Nature of complaints received (iii) Major actions taken regarding the complaints received i) …………………………………………………………………………………………………… Government of West Bengal MONTHLY REPORT Report for the Month of ---------------, 200---. Dat

e of Submission…………… Name of the C.T.Scan Centre under PPP ----------------------------------------------------------------- Name of District Hospital ----------------------------------------, District ---------------------------- ________________________________________________________________________ Total number of patients served by the C.T.Scan Centre for the month a) District Hospital patients b) Private (Pvt) patients from outside c) Others (specify) d) Grand Total (a+b+c) ---------------------- Tests Performance Details for the month :Tests District Tests* (c) (number of tests) Total Number of cases where contrast media were used C.T.scan - Brain C.T.Scan- C.T.scan- C.T.Scan - etc. Total (i)Free cases shall be at least 10% of the total number of cases referred by Government Hospital(s). (ii) One Brain Scan will be treated as one unit. (iii) Whole Body (Parts) Scan will be equivalent to 2 units Government of West Bengal Annexure-I Money Receipt Name of the centre Receipt Number. Da

te. Advance - Description of item - Code - Rate - Quantity - Amount Net Payable Amount in Rs Paid in full by cash Rupees (in words) Government of West Bengal 16. Payment of service charges (a) The PSP will be required to pay a service charge of 25% of the revenue earned per patient for all cases referred by private practitioners/institutions to the District Health & Family Welfare Samiti (DHFWS) account concerned. (b) The said amount for each month shall be paid as per terms of agreement and within the fifth working day of the next calendar month in the account of DHFWS of the concerned District Hospital. 17. Monthly Reports a) The PSP will submit Monthly Reports in prescribed format to the Superintendent of the District Hospital and copy of the report should also be submitted to the CMOH and the concerned official at the Department of Health & Family Welfare, Government of West Bengal at Swasthya Bhavan, Kolkata. b) The report for a calendar month should be submitted by the 7 working day of the next calendar month. c) The PSP will also submit any other document as and when asked for by appropriate authority in a timely manner. a) The Superintendent of the District Hospital on behalf of RKS shall monitor the day-to-day operational activities of the C.T.Scan centre. The CMOH will also inspect the centre at l

east once in a month. b) A Committee authorized by DHFWS, preferably RKS, will undertake the overall monitoring of the C.T.Scan centre c) The private partner will be required to submit monthly reports in prescribed formats to the Superintendent of the District Hospital with copies endorsed to the CMOH and the DoHFW d) The Superintendent of the District Hospital may scrutinize the Patient’s Satisfaction Report as and when necessary. Government of West Bengal a) The suggestion box must be displayed prominently in the C.T. Scan centre so as to be visible to the customers. b) The box needs to be opened daily to collect feedback from the customers. c) Action should be taken within 24 hours of receipt of feedback and intimated to the customer. d) Suggestions received from the patient’s Satisfaction Reports should be acted upon within 24-hours also. a) The PSP must ensure that all documents, registers and accounts are maintained properly. These records would be subject to inspection by the designated officials of the department. b) All records need to be computerized and stored. Records need to be maintained relating to following areas (I) Patient’s Investigation Reports should be stored in CDs. Patient’s date of booking, date of investigation, services provided, date of delivery of reports should be noted in CDs. Details of free cases provided should be recorded also (IV) Details of cases referred from hospital and private cases referred by private doctors/institutions should be recor

ded separately. (V) Records relating to maintenance of the machine be noted (VI) Records relating to deployment of staff and their daily attendance record be Records on inventory of items should be made All relevant financial records including the details of 25 % of the service charges to be paid to RKS from the revenue earned per patient for all cases referred by private practitioners/institutions should be clearly maintained (IX) Patient’s Satisfaction Reports of each month should be preserved for inspection by the Superintendent concerned if required. Only these reports of the previous month are to be preserved. Government of West Bengal III. Code of conduct for the official/staff of the C.T.Scan centre for handling a) Should listen to the customer/patient attentively. b) Should be well behaved. c) Should be sympathetic. d) Should talk to the customers in soft tone and refrain from using objectionable language. e) Should record all details as per requirement. f) Should give correct information regarding user charges. g) Should explain to the patients or their family members all the required instructions to be followed by the patient for the investigation. Written instructions, where applicable, should be handed over to the patient or their family members in appropriate format. h) Should handle all those patients or their family members with politeness who might get impatient in case of prolonged waiting. i) Should give priority for all emergency cases. a) Rates must be

charged as per the terms of agreement executed between the District Health & Family Welfare Samiti (DHFWS) of the district concerned and the Private Organization. b) All the rates as applicable must be displayed at a prominent place of the C.T. Scan centre. c) The cost of contrast media where required will be borne by the patients. However, the use of contrast media should be kept minimum without compromising the quality. d) Any clarification on the rates must be answered immediately. e) Free Services for BPL category of patients as per terms of agreement as set out in the scheme must be properly implemented and necessary records should be maintained. 13. Money Receipts against user charges a) Payments are to be accepted as per the terms set out in the agreement relating to the C.T. b) Money receipts (Annexure-I) for all payments must be issued immediately. Under no circumstances, payments should be accepted without giving a receipt for the same. c) In case of any situation where part payment has been made as advance, the receipt issued against such advance payment should be taken back before issuing the final receipt against full payment or a fresh receipt may be issued for payment of the rest amount Government of West Bengal c) Sufficient stock of contrast materials should be maintained by the PSP. Charges foges as prescribed. I. Timing of operation of the CentreThe centre must be operational during the time specified in the agreement and as prescribed under Paragraph 6 of th

is document. The services should be provided round the clock. The machine should be operational for 95% of the time at the minimum.II. Operating Procedures a) C.T.Scan investigation should be undertaken against advance booking excepting extreme emergencies like road accident requiring immediate scanning b) When the patients/customers report for advance booking, necessary details to be recorded in the advance booking slip, a copy of which should be handed over to the patient/customer. The slip should also indicate the time and date on which the patient would report at the centre for C.T.Scan investigation. Along with the advance booking slip, printed form containing instructions to be followed by the patient must be handed over after properly explaining the same to the patient/customer. The need for use of contrast media should also be properly explained. Any advance payment made by the party should be received against money receipt. When the patient produces the advance booking slip on the day as per appointed time, necessary invoice should be generated. c) All C.T.Scan investigations should be undertaken for each of the patients as per their booking serial in chargeable and free cases both. However, emergency cases should be given d) While accepting the booking, the PSP needs to ensure that necessary records are maintained regarding free cases as are applicable under the scheme. e) Reports for investigation should be handed over within 24 hours excepting extreme emergencies for wh

ich the findings should be informed at the earliest. f) Enough care should be taken to ensure that right reports are delivered to the right patients. g) All reports including the plates should be put inside envelops of proper size before delivering the same to the patient’s party. h) Money receipt as confirmation of having paid the full amount must be checked in respect of each patient before delivering the reports. i) An acknowledgement from the patients or their family members of having received the reports should be recorded in a register. Date, time and signature of the patients or their family members should be recorded in the register. j) The patient satisfaction report should be obtained from the patient or his family member in every case in the format prescribed in Annexure-IIIk) In case of any clarification sought for by any individual regarding any report, the person should be referred to the competent official of the concerned department of the hospital. Government of West Bengal a) Handling and maintenance of equipment are extremely important to ensure that the equipment can render long years of service. b) Operation and maintenance of equipment are to be done as per manufacturer’s directions. c) It is essential that the PSP comply with the requirement of having Annual Maintenance Contract (AMC) with the manufacturer. The AMC should be comprehensive d) The space of installation of the machine including the waiting room of the patients should be Air-conditio

ned. e) Regular cleaning of the room is extremely important to ensure that the room is dust-free. f) No modification of the machine or the arrangements for the unit shall be modified/changed without prior approval of the DoHFW and/or appropriate authority. 8. Deployment of personnel a) The PSP needs to hire qualified technical personnel as per requirement. b) The Radiologist deployed by the PSP must possess recognized post graduate degree/diploma in Radiology. c) The PSP will provide all the details of technical personnel to DoHFW for approval prior to actual deployment of those personnel. a) All written reports should be prepared in standard prescribed format(s). Prior to delivery of reports, enough care should be taken to ensure that the reports have been prepared error-free and signed by the competent authority. b) The PSP must provide C.T.Scan Plates along with the reports to all categories of patients in chargeable and free cases both. 10. Inventory of stocks a) An inventory monitoring register for stocks of items required for conducting the C.T.Scan services (films/consumables etc) should be maintained regularly. The register should be updated on a daily basis and stock status should be monitored at the end of each week for subsequent actions. The system of maintaining inventory of stocks needs to be computerized for better monitoring of stock status. b) An optimum inventory of stocks must be maintained and enough care should be taken to ensure that there is no stock out

situation for any of the essential items at any point of time. Government of West Bengal (i) The general cleanliness of the premises including sanitary arrangements, furniture and equipment must be properly maintained along with 24 hours adequate potable water supply for the beneficiaries with an arrangement for safe and hygienic disposal of clinical waste products as per provisions laid down in the Bio-medical Waste (Management and Handling) Rules, 1998. (ii) The application for licence for establishment of the C.T.Scan Unit should accompany trade licence(s) of the Municipal Corporation/Municipal Authority concerned. A certificate from the Pollution Control Board will also have to be attached with the application. (iii) The persons employed to conduct the examinations of the clinical establishment must be properly qualified, trained and sufficient in number, as provided in these rules. (iv) An up-to-date register shall be maintained in which the name, present and permanent addresses and qualification of all the employees (both temporary and permanent) of the clinical establishment are to be noted. (v) Proper accounts shall be maintained of all receipts and expenditure. C.T. Scan - Brain C.T. Scan - Whole Body – Part (Thorax, Upper Abdomen, Lower Abdomen, Dorsal Spine, Lumber Spine, Cervical Spine etc) a) Rent-free space will be provided by the District Health & Family Welfare Samiti (DHFWS) through its Rogi Kalian Sam

iti (RKS) in each District Hospital for Installation of the C.T. Scan e Sector Partner (PSP). b) The Department of Health and Family Welfare (DoHFW) will approve the specification of the plant and machinery. c) The PSP shall to comply with the specifications of the DoHFW only a) The PSP will ensure that round the clock services are provided to the patients for C.T.Scan services b) The PSP will also ensure that the machine would be operational for 95% of the time at the minimum with provision of 5% time to be spared for maintenance activities at the maximum. may please be consulted for complete information. Government of West Bengal a) In the wake of increasing demand and expectations from a vast section of people for improved health care services, the Department of Health and Family Welfare (DoHFW), Government of West Bengal (GoWB) has taken several initiatives under Public Private Partnerships (PPP) to strengthen the health and medical care services in the state. The purpose of these initiatives is to provide quality health care services at affordable cost as well as to improve the health status of the poor and vulnerable population in the State. b) One such initiative, that the department already identified for implementation was establishment of C.T.Scan Facilities in the Medical Colleges under PPP. The objective of this initiative was to ensure greater access of the people to quality investigation facilities at affordable cost with a safety net for patients indigent in natur

e. Accordingly, 7(seven) C.T. Scan Units have been established under PPP. Those seven units are running very satisfactorily. Encouraged by the positive response of the scheme, DoHFW has now decided to scale up the scheme and roll out the same across 12(twelve) District Hospitals in the a) In line with the principles as set out in the scheme and to achieve the expected results, it is essential that the Center for C.T.Scan facilities must follow the requirements as specified in the Clinical Establishment Rules, maintain high quality of standards and adhere to the set procedures on the operational activities of the center. b) Standard Operating Procedure (SOP) will ensure consistency amongst all the personnel who are involved in the entire process of managing the Center for C.T.Scan facilities efficiently and effectively. c) The following sections present the important requirements under Clinical Establishment Rules as well as standards of quality and operational procedure to be followed by the centre to achieve the expected results. 3. Requirement under ‘The West Bengal Clinical Establishment a) The Private Sector Partner (PSP) of the centre for C.T.scan facilities to be established in the District Hospital under PPP shall be required to apply for registration and procure the licenses under ‘The West Bengal Clinical Establishment Rules, 2003’ from the Chief Medical Officer of Health (CMOH) of the concerned district for commencing the C.T.Scan services in the centre. b) Details of

requirement and procedure for procuring license are available in the ‘The West Bengal Clinical Establishment Rules, 2003’. c) Some of the relevant information pertaining to the above mentioned rules are provided hereunder. This information must be in the knowledge of the PSP of the C.T.Scan Centre for necessary and timely actions ‘The West Bengal Clinical Establishment Rules, 2003’ Government of West Bengal Abbreviations AMC Annual Maintenance Contract BPL Below Poverty Level DoHFW Department of Health and Family Welfare GoWB Government of West Bengal PPP Public Private Partnerships PSP Private Sector Partner DHFWS District Health and Family Welfare Samiti SOP Standard Operating Procedure CMOH Chief Medical Officer of Health RKS Rogi Kalyan Samiti Government of West Bengal Contents 1 Background Information 2 Standard Operating Procedure 3 Requirement under the West Bengal Clinical Establishment 4 Products / Services 5 Plant and Machinery 6 Duration of services 7 Handling and Maintenance of Equipment 8 Deployment of personnel 9 Reports 10 Inventory of stocks 11 Operating procedures for customer services 12 User Charges and Free services 13 Money Receipts for user charges 14 Suggestion Box 15 Maintenance of Records 16 Payment of service charges 17 Monthly Reports 18 Monitoring Mechanism Annexure I – III Annexure I - Format for Money receipt Annexure II - Format for Monthly Report Annexure III - Format for STANDARD OPERATING PROCED