ECHS – Parent Polyclinic and procedure for Referral to other hospitals
ECHS – Parent Polyclinic and Referral Procedure for Outstation Patients – Issue of Drugs and Consumables to Outstation ECHS Members
1. The concept of Parent Polyclinic for ESM has been introduced, so as to collate a database and cater to a known ESM load at all the ECHS Polyclinics. This will ensure better and more efficient OPD facilitates. Full range of medical facilities can be availed at the parent polyclinic. The parent polyclinic for an ECHS member was initially decided based on the residential address including the district and state. However consequent upon implementation, it was found that due to the uneven spread of resident ESM population some of the members have had to register at parent polyclinics which are at a greater distance to the stipulation of district/state etc.
2. ESM at the time of applying for ECHS membership can choose the parent polyclinic which is geographically closest of the district of residence. As far as the existing members are concerned, irrespective of the parent Polyclinic mentioned on the Smart Card, they can go to the Polyclinic geographically closest to the residence and register there as the parent polyclinic.
3. To change the address/polyclinic dependency, the ESM (but for those residing in NCR) will have to submit the following to Stn HQs nearest to the new address:-
(a) An application on plain paper giving reasons for change.
(b) A fresh application form with relevant columns filled and super scribed ‘CHANGE OF ADDRESS’ on top.
(c) Affidavit as per format endorsed on Rs.10 non judicial stamp paper duly notarized
(d) Enclose the old cards duly cut into 2 pieces.
(e) Deposit Cash/DD @ Rs. 90/- per card requested.
4. Station HQs will scrutinize the form and give a photo receipt to the member which will be valid for 60 days. Subsequently, SITL(Vendor) will carry out necessary amendments to the records and issue fresh cards within the laid down period.
5. The Polyclinics in Delhi & NCR have been designated as Parent Polyclinics depending upon the geographical boundaries. The geographical boundaries for the same are as follows:-
(a) Base Hospital Polyclinic
(i) All areas west of River Yamuna upto Raj Ghat
(ii) All areas north of road joining Dayal Chowk to Raj Ghat(Along-Link Road, Desh Bandhu Gupta Road, Ajmeri Gate, Jawahar Lal Nehru Marg, Delhi Gate and joining Raj Ghat).
(iii) All areas North & West of Ridge Road up to Dhaula Kuan and NH 8 upto Delhi – Haryana border towards Gurgaon.
(iv) In addition all outstation patients referred to Delhi will first be attended to at this Polyclinic.
(b) Lodhi Road Polyclinic
(i) All areas East of Yamuna upto and along UP Border upto trijunction of Delhi-Haryana-UP border.
(ii) All areas South and East of Raj Ghat along the Jawahar Lal Nehru Marg, Desh Bandhu Gupta Road upto Dayal Chowk and along Ridge Road upto Dhaula Kuan, thereafter along NH8 upto Haryana-Delhi border towards Gurgaon
(iii) The Southern limit is the Delhi-Haryana Border in the South West and trijunction of Delhi-Haryana UP Border in South East.
(c) NOIDA – All areas East of UP-Delhi Border and South of NH24 (Hapur Bypass) upto Haryana –UP Border in the South West including Greater NOIDA.
(d) Gurgaon– All areas South and West of Delhi – Haryana Border on NH-8 towards Gurgaon. The entire district of Gurgaon is included.
(e) Faridabad– All areas South of Delhi Haryana Border and West of Haryana UP Border.
(f) Hindon – All areas East and North of the UP-Delhi Border and out of Delhi upto NH-24(Hapur Bypass). These areas fall in the Ghaziabad District.
6. Whenever an ECHS member actually shifts between Delhi, NOIDA, Greater NOIDA, Gurgaon, Faridabad and Ghaziabad, the following procedure will be followed for change of Polyclinic dependency in NCR of Delhi:-
(a) The member to submit the following documents:-
(i) Application on plain paper addressed to Regional Director ECHS, Delhi Cantt, explaining reasons for change of address.
(ii) Fill up a fresh application form with all details including old registration number and photographs of self and dependants. Incase change of any dependants is involved Affidavit, given in the application form will also be filled.
(iii) Affidavit on Non Judicial Stamp paper of Rs.10/-(Rupees ten only) for change of address is to be submitted.
(iv) Submit proof of residence i.e. Telephone/Electricity Bill/Ration Card.
(v) Submit a certificate from Resident Welfare Association/Municipal Corporation/ Committee that the ECHS member is actually residing at the new address.
(vi) Return all Cards
(vii) Pay @ Rs.90/- per card for new cards
(viii) Super-scribe application form with ‘CHANGE OF ADDRESS APPLICATION’.
(ix) Obtain receipt from Regional Centre.
(b) The master smart card and all ‘add on cards’ will be submitted and address changed on all. However, if a dependent is working/studying outside the NCR, that particular ‘add on card’ will not be changed.
7. ECHS members visiting Polyclinic other than their Parent Polyclinic are referred to as Out station ECHS members. They will continue to be eligible for all ECHS facilities.
8. The procedure for utilizing ECHS facilities at Polyclinics other than parent polyclinics will be as follows:-
(a) Member will be handled in OPD and given medicine for 07 days at a time.
(b) Referral to an empanelled facility will be authorized for an emergency/essential along with its related treatment.
(c) Medical equipment authorized for him use will only be sanctioned by parent polyclinics.
(d) The concept or the parent Polyclinic based on geographical locations in Delhi and NCR will remain in force.
9. Station HQs will receive the application form and provide “Receipt of Documents duly affixed photographs” which will be valid for 60 days and thereafter to be revalidated if ECHS Smart Cards are not received. ECHS member should personally collect the cards from Stn HQ after 60 days of submission of application.
10. Station HQ will place the demand to SITL through concerned Regional Centre ECHS for re-manufacturing of Smart Cards as per request of the member. SITL will issue fresh cards duly indicating new address and new parent polyclinic. SITL will also maintain details of old address and old parent polyclinic in their data base.
Issue of Drugs and Consumables to Outstation ECHS Members
11. ECHS Members/ Dependents suffering from chronic diseases requiring long term and continuous treatment need to visit their Parent Polyclinic at least once a month for review of medical condition/ collection of medicines. However, when they visit any outstation location, they are issued medicines from the nearest Polyclinic for only 07 (seven) days at a time, as
per present policy. This has caused considerable dissatisfaction amongst the ECHS members. The policy has now been reviewed and a revised procedure evolved as laid down in the succeeding paragraphs.
12. Acute/ Fresh Illness. There is no change in procedure in case of occurrence of an acute or fresh illness. ECHS beneficiaries can report to any/ nearest Polyclinic for immediate medical requirement. Medicines will be issued for duration as prescribed to treat the illness.
13. Chronic Illness/ Long Term Treatment Cases. There are certain chronic cases where life long treatment is necessary and medicines for the same are issued by the Parent Polyclinic, after monthly review for 90 days at a time. Such patients, when visiting some other station, can now be issued medicines from any specified ‘Outstation Polyclinic’ of choice (other than their Parent Polyclinic) for 30 days at a time. The procedure to be followed will be as under :-
(a) A ‘Temporary Attachment Certificate’ is to be obtained from the Parent Polyclinic before the patient moves to a new location temporarily. Perform a for the same is attached as per appendix ‘A’ to this letter.
(b) Part-A of Temporary Attachment Certificate (TAC) in original is to be deposited with Oi/c of Outstation Polyclinic from where subsequent issue of medicines is desired.
(c) Part-B of TAC is to be retained by the patient and endorsement is obtained on it during each time the medicines are issued to him by the Outstation Polyclinic.
(d) Part-B of TAC is to be deposited back with the Parent Polyclinic once the patient returns back to the place of his permanent residence for continuation of ongoing treatment.
(e) No medicines will be issued to the patient from the parent polyclinic for the duration for which TAC has been issued.
(f) TAC can not be issued for more than one Polyclinic for the same duration. Deposition of Part-B of one TAC is a mandatory prerequisite for recommencement of issue of medicines from Parent Polyclinic and for eligibility of issue of another TAC at a later date, if required.
(g) Once issued, a TAC will be valid for a maximum period of 06 (six) months only.
14. Action at Parent Polyclinic. Parent Polyclinic issuing the TAC has to ensure the following:-
(a) A ‘TAC issue Register’ is to be maintained as per format attached at appendix ‘B’ to this letter.
(b) Entries are to be made in this Register, both at the time of issue of the certificate and receipt/ submission of Part-B of TAC.
(c) Part-B of TAC is to be kept in file for records and audit.
(d) If Part-B of a Particular TAC is not received within the stipulated validity period of 06 (six) months, the Oi/c Polyclinic is required to confirm from the concerned outstation Polyclinic about the welfare/ status of the patient and amend his records if required, with necessary authentication.
(e) The phrase ‘TAC issued’ will be entered in MIS against the patient’s/ ESM’s name while updating OPD records.
(f) Further continuation of issue of medicines to a patient who has been issued with TAC will only commence after its Part-B has been duly submitted back in the Polyclinic.
15. TACs will be utilized only for issue of drugs and consumables. They will under no circumstances be utilized for issue of non expendable items.
16. ECHS patients will be provided treatment for all known diseases, including referral to empanelled hospitals, at any Polyclinic he reports. The purpose of TAC is to enable issue of drugs for longer duration to chronic patients. However, this does NOT debar a patient from availing of requisite treatment without a TAC.
17. When a patient seeks planned/specific treatment in a station other than the station of his Parent Polyclinic, a specific referral is to be generated by Parent Polyclinic to the ‘other’ station to enable further management. However, when an ECHS beneficiary falls sick or requires treatment while visiting some ‘other’ station, he is fully entitled to report to the nearest Polyclinic and avail of any treatment.
Referral Procedure for Outstation Patients
18. When an appropriate Service/Empanelled Hospital is not available in the station, polyclinics may refer patients to other town/stations. All referrals to Service Hospitals in ‘other’ stations can be made directly by Parent Polyclinic and patient need not report to that ‘other’ station ECHS polyclinic for the same. However, all referrals to empanelled facilities will be routed through the local ECHS Polyclinic of the station.