MoHP issues National Patient Referral guidelines

KATHMANDU: The Ministry of Health and Population (MoHP) has released a National Patient Referral Directive to streamline the referral process in healthcare facilities.

The directive mandates that patients requiring specialized treatment beyond the capacity of the initial healthcare institution must be promptly referred to appropriate facilities for further care.

The guidelines emphasize that institutions must utilize available resources and services before referring patients elsewhere. If treatment cannot be provided due to a lack of infrastructure, equipment, or specialist services, the facility should ensure coordination with a higher-level hospital or a nearby institution capable of providing the required care.

For emergency and admitted patients, the directive assigns primary responsibility to the initial healthcare institution until the referred patient is admitted to another hospital. It stresses the need for seamless coordination to avoid gaps in patient care during the transition.

The directive prohibits healthcare facilities from referring patients to other institutions if the required services are available within their capacity. Referrals should only be made to the nearest, most appropriate higher-level hospital when services are unavailable.

Ministry spokesperson Dr. Prakash Budhathoki stated that while existing referral standards for different types of patients were in place, this directive serves as a unified framework for the overall hospital referral system.

The guidelines also make it mandatory for primary healthcare institutions to contact the receiving hospital beforehand to confirm the availability of beds, treatment facilities, and necessary services, ensuring effective coordination.

Each hospital and healthcare level—including local, provincial, and national—must establish a dedicated referral unit as mandated by the directive. This initiative aims to ensure that patient information is effectively shared, eliminating redundant testing and facilitating seamless continuation of care.

The directive seeks to alleviate the burden on government hospitals by enforcing referral decisions based on necessity. Patients are granted the right to access information about their treatment destinations, while hospitals are urged to minimize unnecessary referrals wherever possible.

Dr. Budhathoki added that referral units at local, provincial, and federal levels would guide healthcare facilities on maintaining service quality and managing patient referrals effectively.

The Department of Health Services’ Curative Services Division will oversee the implementation and management of the referral program.

At the provincial level, coordination will be handled by the Provincial Health Directorate under the respective health ministries, while local-level coordination will be managed by health departments or relevant branches.

The directive represents a significant step toward enhancing patient care, ensuring systematic referrals, and improving the overall efficiency of healthcare delivery in Nepal.