Different Services to All Patients attending at District Hospitals


File No. HFW-40099/58/2022-HA/192 Dated. 30.12.2022


State government is committed to provide different services (procedure and diagnostic) to all patients attending at District Hospitals of the State. To implement this commitment, different services have been categorized as “Essential” and “Desirable” at District Hospital of State depending upon the feasibility, necessity and availability of resources where the service category is defined as follows:

  1. “Essential” – Mandatory service to be done at all district hospitals.
  2. “Desirable” – Expected service to be provided at specific district hospitals depending upon availability of expert HR and availability of necessary equipment.

The category wise services are hereby enclosed in Annexure-I.

All concerned are hereby informed.

Enclosure: As stated.

Director of Health Services
West Bengal

No. HFW-40099 dated 30.12.2022, Source

Annexure – I

Sl No.Name of service (Essential) Category: Procedure & Diagnostic
1Electrocardiography (ECG)
2Thrombolytic therapy
4DC Cardioversion
5Nitro-glycerine (NTG)/ Lidocaine infusion
6Injection (I/M, subcutaneous & l/V)
9Cast application
10NG tube Insertion
12Suture removal
13Skin scraping for fungus/ AFB
15Sitz bath
16Catheterization/ Suprapubic Catheterisation
17Bowel Wash
18Blood Transfusion
19CVP line insertion
21Abdomen Paracentesis
22PICC (Perpherally Inserted Central Catheter) line insertion
23Lumbar Puncture
24ET intubation
25Stomach wash
26Venous cutdown
27Resuscitation and Ventilation
28Intra lessional injection
29Chemical Cautery
30Skin Biopsy
31Punch Biopsy
32Pleural Aspiration
33Lumbar Puncture
34Abdominal Tapping
35Liver biopsy
36Liver aspiration
37Fibreoptic endoscopy
39Bone Marrow Biopsy
41Cytological examination of body fluids
44Peritoneal hemodialysis/ Sustained Low Efficiency Daily Dialysis (SLEDD)
45Peripheral Joint Injections
Sl No.Name of service (Essential) Category: PMR
46Computerized Tractions (lumbar & Cervical)
47Short Wave Diathermy
48Electrical Stimulator with Tens
49Electrical Stimulator
50Ultra Sonic Therapy
51Paraffin Wax Bath
52Infra Red Therapy
53Shoulder Wheel
55Shoulder Pulley
56Post Polio Exercise
57Obesity Exercises
58Breathing Exercises & Postural Drainage
Sl No.Name of service (Essential) Category: ENT
59Packing (anterior & posterior nasal)
60I & D Septal Abscess (unilateral & Bilateral)
61Sub Mucosal Resection (smr)
63Fracture reduction nose
64Fracture reduction nose with septal correction
66Septoplasty With Reduction Of Turbinate (sub-mucosal Diathermy (smd))
69Adenoidectomy + Tonsillectomy
70Frenuloplasty (Tongue tie excision)
71Direct laryngoscopy
73Direct laryngoscopy & biopsy
74Preauricular sinus excision
75Foreign Body Removal (Ear and Nose)
76Stitching of cut lacerated wounds (CLW’s)
78Syringing of ear
79Chemical cauterisation (Nose & Ear)
80Eustachian tube function test
81Vestibular function test/ Caloric test
82Audiogram (Pure tone and Impedance)
83Therapeutic removal of granulations (Nasal, aural, oropharynx)
84Punch Biopsy (Oral Cavity & oropharynx)
85Cauterization (Oral, oropharynx, aural & nasal)
86Mastoid abscess I & D
89Examination under microscope
93Hearing aid analysis and selection
94Tonsillectomy, Mastoidectomy, Stapedotomy (D)
Sl No.Name of service (Essential) Category: Ophthalmology
95Refraction (using Snellen’s Chart)
96Refraction (using auto refractometer)
97Syringing and probine
98Foreign body removal (Conjunctival)
99Foreign body removal (Corneal)
100Suture removal
101Sub-conjunctival injection
102Retrobulbar injection (Alcohol etc.)
104Biometry/ keratometry
105Automated perimetry
106Pterygium excision
107Syringing & probing
108Perforating corneo-scieral injury repair
109Glaucoma surgery (e.g. Trabeculectomy)
110Wart excision
111Stve/chalazion surgery
112Cauterization (thermal)
113Conjunctival resuturing
114Corneal scraping
115Lid abscess Incision & drainage (l&D)
116Uncomplicated lid tear
117Indirect ophthalmoscopy
119Examination under General Anaesthesia
122Air Injection & Resuturing
123Enucleation without implant
124Cataract extraction with IOL (including Phacoemulsification)
125Small lid tumour excision
126Conjunctival Cyst
Sl No.Name of service (Essential) Category: Paediatric Medicine
129Immunization (As per National Immunization Schedule)
130Vit K for premature babies
131Neonatal resuscitation
133Umbilical Vein/ Artery Catheterization
135ET & TT Intubation
136Lumbar Puncture
137Venous Cut Down
139Ng Tube Insertion
Sl No.Name of service (Essential) Category: Gynae & Obst.
141Female Sterilization (mini Laparotomy & Laparoscopic Ligation]
142Antenatal check-up
143Intranatal check-up
144Postnatal checkups
145Antenatal corticosteroid to mother in case of pre term babies
146Normal vaginal delivery
147Assisted breech delivery
148Forceps delivery
149Cervical/ Perineal tear repair
150Caesarean section
151Ectopic pregnancy surgery (unruptured/ ruptured)
152Examination Under Anaesthesia (EUA)
153Dilatation & Curettage (D&C)
154MTP (Medical Method & Surgical Methods
155IUD services (insertion & removal)
156Contraceptives including emergency contraceptives
157Fine Needle Aspiration Cytology (FNAC)
159Cervical VIA Staining
160Cervical Biopsy
161Endometrial Aspiration and Biopsy
162Cervical Cautery (Electro/ Cryo Cautery)
163Bartholin Cyst Excision
164Emergency exploratory laparotomy
166Sling operation
168Haematocolpos Drainage Colpotomy
169Ovarian Cystectomy/ oophorectomy
170Vaginal hysterectomy
171Abdominal hysterectomy
Sl No.Name of service (Essential) Category: Ortho Surgery
173Femoral neck nailing with or without plating replacement prosthesis/ Upper femoral osteotomy
174Innominate osteotomy/ open reduction of hip dislocation
175DHS/ Richard screw plate
176Synovial or bone biopsy from Hip
177Girdle stone Arthroplasty
178Open Reduction Internal fixation (ORIF) of femur, Tibia, Humerus, Radius, Ulna, Sternum
179Open reduction and Internal fixation bimalleolar fracture
180Fracture dislocation of ankle
181Montaggia fracture dislocation
182Fracture medial/ lateral condyle of humerus
183Olecranon fracture
184Repair of Fracture Patella, Calcaleus, Talus
185Single forearm bone fracture
186External fixation – Pelvis, femur, tibia, humerus, forearm
187External fixation of hand & foot bones; Tarsals, metatarsals, Phalanges, Carpals, Metacarpals
188Excision head fibula
189Excision Lower end of ulna
190Drainage of fracture
191Interlocking nailing of long bones
192Debridement & secondary closure
193Percutaneous fixation (small and long bones)
194Closed Fixation of hand/ foot bone, Shoulder dislocation, knee dislocation, Acromioclavicular or Sternoclavicular Joint, Clavicle, Ankle Bimalleolar
195Open reduction
196Ankle trimalleolar Open reduction,
197Wrist dislocation on intercarpal joints, MP & IP Joints
198Fasciotomy leg/ forearm
199High Tibial Osteotomy
200Arthrodesis (shoulder, elbow, wrist, hip, knee, ankle)
201Triple arthrodesis, Arthrodesis – MP & IP Joints
202Excision of exostosis-long bones, (single/ double)
203Curettage/ bone grafting of bone tumour of femur/ tibia, Flumerus & forearm
204Surgery tumours of small bone, hand and foot
205Debridement & primary closure of compounds fracture of tibia, Femur forearm without fixation
206Debridement of hand/ foot
207Debridement primary closure of compound fractures of tibia.
208Debridement & primary closure of compounds fracture of tibia, Femur, forearm forearm with fixation
209Tendon surgery soft tissue release in club foot
210Internal fixation of small bone (single, two, more than two)
211Tendon surgery (repair and lengthening)
212Surgery of chronic osteomyelitis (Saucerization, sequestrectomy of femur, humerus, tibia) Fibula radius ulna (Clavicle) and wrist, Ankle, hand foot
213Amputation (thigh or arm, leg or forearm, feet or hand, digits)
214Disarticulation of hip or shoulder (disarticulation of knee elbow/ wrist/ ankle; fore-quarter or hind-quarter)
215POP Application (Hip spica, Shoulder spica POP Jacket; A-K/A-E POP; B-K/B-E POP)
216Corrective osteotomy of long bones
217Excision arthroplasty of elbow & other major joints
218Excision arthroplasty of small joints
219Surgery of hallus valgus
220Bone surgery (Needle biopsy, axial skelton, non-axial)
221Removal of nail AO plates
222Removal forearm nail, Screw
223Fracture lower end of radius,
224Fracture medial malleolus
225Skeletal traction femur, Tibia, Calcaneus, Elbow, Bone grafting (small grafting and long bone)
226Soft tissue biopsy
227Skin graft (small, medium and large)
229Olecranon fixation
230Open ligament repair of elbow, Ankle & wrist
231Arthrotomy of hip/ shoulder/ elbow
232Carpal tunnel release
233Dupuytren’s contracture release
234Closed nailing of long bones
235Removal of external fixation
236Removal of implant
237Excision of soft tissue tumour muscle group
Sl No.Name of service (Essential) Category: Gen. Surgery
238Minor surgery
239I & D abscess
240Gland biopsy
241Small soft tissue tumour (Benign)
242Exploratory laparotomy
244Prepuceal dilatation & Meatotomy
245Reduction of Paraphimosis
246Torsion of testis
247Umbilical hernia/ epigastric hernia repair
248Inguinal herniotomy (unilateral & bilateral)
249Deep abscess
251Fissurotomy or fistulectomy
256Suprapubic cystostomy
257Diagnostic laparoscopy
258Non-Scalpel Vasectomy (NSV)
260Superficial & total parotidectomy
261Intra-oral removal of submandibular duct calculus,
262Abscess drainage (including breast & perianal),
263Wound debridement
264Excision branchial cyst or Fistula or Sinus
265Excision of lingual thyroid,
266Hemithyroidectomy (Sub-total thyroidectomy/ lobectomy)
267Cysts and benign tumour of the palate
268Excision submucous cysts
269Fibroadenoma/ Lump Excision
270Simple mastectomy
271Modified radical mastectomy (multi-disciplinary approach)
272Sectoral mastectomy/ microdochectomy/ lumpectomy
273Wedge biopsy
274Mammary fistula excision
275Inguinal hernia repair
276Inguinal hernia repair with mesh
277Femoral hernia repair
278Epigastric/ ventral hernia repair
279Recurrent Inguinal hernia repair
280Ventral hernia repair with mesh
281Operation of strangulated ventral, Inguinal or Incisional hernia
282Recurrent Incisional hernia repair
283Diaphragmatic hernia repair
284Exploratory laparotomy,
285Gastrostomy or Jejunostomy
286Simple closure of perforated ulcer
287Ramstedt’s Operation
289Vagotomy & drainage procedure
290Adhesionolysis or division of bands
291Mesenteric cyst
292Retroperitoneal tumour excision
293Burst abdomen repair
295Drainage of Pseudo pancreatic cyst (Cystogastrectomy)
296Retroperitoneal drainage of Abscess
297Emergency appendicectomy
298Appendicular abscess drainage
299Interval appendicectomy
300Resection and anastomosis
301Intussusception, Intestinal fistula repair
302Multiple resection and anastomosis
303Intestinal perforation repair
304Open Drainage of liver abscess
305Drainage of Subdiaphragmatic Abscess/ Peri gastric abscess
306Hydatid cyst excision (abdominal)
307Cholecystectomy (Open and laparoscopic)
308Choledocholithotomy & choledochoduodenostomy
309Right hemicolectomy
310Sigmoid & descending colectomy
312Sphincterotomy and fissurectomy
313Tube caecostomy
314Closure of loop colostomy
315Rectal prolapse repair
316Anal sphincter repair
317Thiersch’s operation
318Imperforate anus with low opening repair
319Pilonidal sinus repair
320Fistula in ano (low level) repair
321Fistula in ano (high level) with Stenosis repair
323Perianal abscess drainage
324Ischiorectal abscess
325Ileostomy or colostomy
326Sigmoid myotomy
328Partial amputation of penis
329Total amputation of penis
330Orchidectomy (unilateral & bilateral)
331Hydrocele (unilateral & bilateral)
332Excision of multiple sebaceous cysts of scrotal skin
333Reduction of paraphimosis
334Other Surgical Procedures
335Suturing of large laceration
336Suturing of small wounds
337Repair torn ear lobule
338Small superficial tumour excision
339Large superficial tumour excision
340Incision and drainage of abscess
341Lymph node biopsy
342Excision biopsy of superficial lumps
343Excision biopsy of large lumps
344Infection haemorrhoids/ ganglion/ keloids
345Removal of foreign body (superficial)
346Removal of foreign body (deep)
347Excision biopsy of ulcer
348Excision of sebaceous cyst
349Excision carbuncle
350Excision multiple cysts
351Excision soft tissue tumour muscle group
352Muscle biopsy
353Repair of Tongue tie
354Debridement of wounds
355Diabetic foot debridement/ management
356In-growing toe nail removal
357Burn dressing all grades
358Ear lobules repair one side (bilateral)
359Simple wound
360Complicated wound
361Simple Injury fingers
362Multiple fingers injury
Sl No.Name of service (Essential) Category: Dental Surgery
363Dental abscess drainage/ dental cleaning/ gingivitis
364Impaction of teeth
365Scaling (crown and root) and polishing
366Trauma including vehicular accident
367Root canal treatment
368Dental extractions
369Intra Oral X-ray/ Intra Oral Peri-Apical radiograph (IOPA)
370Fracture wiring
Sl No.Name of service (Desirable) Category: Procedure & Diagnostic
1Pericardial tapping
2Pleural biopsy
3Pericardial tapping
4Exchange transfusion
6Arterial catheterization
7Bone marrow aspiration
8ICD insertion
9Trigger Finger Injections
Sl No.Name of service (Desirable) Category: PMR
10Ultraviolet therapy
11Electric vibrator
12Vibrator belt massage
13Mechanical tractions (lumber & cervical)
14Supinator Pronator Bar Exercises
15Gripper Exercises
16Vissco weight cuffs Exercises
17Walking bars Exercises
18Cerebral Palsy – Massage
Sl No.Name of service (Desirable) Category: ENT
19Nasal endoscopy & endoscopic sinus surgery
20Antral puncture (unilateral & bilateral)
21Inter nasal antrostomy (unilateral & bilateral)
22Trans antral procedures (Biopsy, excision of cyst and angiofibroma excision)
23Trans antral biopsy
24Bronchoscopic F B removal
25Brainstem auditory evoked response
Sl No.Name of service (Desirable) Category: Ophthalmology
26Enucleation with implant
27Corneal perforation/ lris prolapse surgery
28Anterior chamber wash
Sl No.Name of service (Desirable) Category: Gynaecology & Obst.
29Laparoscopy (diagnostic and therapeutic)
30Cervical PAP smear
31Vacuum assisted delivery
32Craniotomy-dead Foetus/ Hydrocephalus
Sl No.Name of service (Desirable) Category: Ortho Surgery
34Inter-condylar fracture of humerus and femur
35Knee synovectomy/ meniscectomy
36Synovectomy of major joint shoulder/ hip/ elbow
37Total Hip Replacement (D)
38Total Knee Replacement (D)
39Upper GI Endoscopy (Oesophagus, stomach, duodenum) (Diagnostic and Therapeutic)
40Big soft tissue tumour
41Branchial cyst/ fistula/ sinus
42Thyroglossal cyst and fistula
43Pyloric stenosis (Ramsted’s Operation)
45Hypospadias single stage (first stage)
46Orchidopexy (unilateral & bilateral)
47Rectal polyp removal
48Sacrococcygeal teratoma
49Intussusception (Simple Reduction)
50Volvulus of colon
51Orchidopexy (unilateral & bilateral)
52Congenital deformity repair (Extra digit, Syndactyly, Constriction rings)
53Reconstruction of hand (Tendon repair)
54Small wound skin graft
55Finger Injury with skin graft
56Polio Surgery
57Crush injury hand
58Full thickness graft
59Sigmoidoscopy and Colonoscopy
60Laparoscopy (diagnostic and therapeutic)
62Trocar cystostomy
Sl No.Name of service (Desirable) Category: Dental Surgery
63Periodontal surgeries
64Sub mucus fibrosis (SMF)
65Light Cure Crowning
66Subluxation and arthritis of Temporomandibular Joints
67Pre-cancerous lesions and Leukoplakias

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