Different Services to All Patients attending at District Hospitals
GOVERNMENT OF WEST BENGAL
DIRECTORATE OF HEALTH SERVICES
HOSPITAL ADMINISTRATION BRANCH
SWASTHVA BHAWAN, GN-29, SECTOR-V, SALT LAKE, KOLKATA – 700091
File No. HFW-40099/58/2022-HA/192 Dated. 30.12.2022
CIRCULAR
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:
- “Essential” – Mandatory service to be done at all district hospitals.
- “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 |
| 1 | Electrocardiography (ECG) |
| 2 | Thrombolytic therapy |
| 3 | Echocardiography |
| 4 | DC Cardioversion |
| 5 | Nitro-glycerine (NTG)/ Lidocaine infusion |
| 6 | Injection (I/M, subcutaneous & l/V) |
| 7 | Nebulisation |
| 8 | Enema |
| 9 | Cast application |
| 10 | NG tube Insertion |
| 11 | Immunization |
| 12 | Suture removal |
| 13 | Skin scraping for fungus/ AFB |
| 14 | Dressing |
| 15 | Sitz bath |
| 16 | Catheterization/ Suprapubic Catheterisation |
| 17 | Bowel Wash |
| 18 | Blood Transfusion |
| 19 | CVP line insertion |
| 20 | Thoracocentesis |
| 21 | Abdomen Paracentesis |
| 22 | PICC (Perpherally Inserted Central Catheter) line insertion |
| 23 | Lumbar Puncture |
| 24 | ET intubation |
| 25 | Stomach wash |
| 26 | Venous cutdown |
| 27 | Resuscitation and Ventilation |
| 28 | Intra lessional injection |
| 29 | Chemical Cautery |
| 30 | Skin Biopsy |
| 31 | Punch Biopsy |
| 32 | Pleural Aspiration |
| 33 | Lumbar Puncture |
| 34 | Abdominal Tapping |
| 35 | Liver biopsy |
| 36 | Liver aspiration |
| 37 | Fibreoptic endoscopy |
| 38 | Haemodialysis |
| 39 | Bone Marrow Biopsy |
| 40 | FNAC |
| 41 | Cytological examination of body fluids |
| 42 | Chemotherapy |
| 43 | Dialysis |
| 44 | Peritoneal hemodialysis/ Sustained Low Efficiency Daily Dialysis (SLEDD) |
| 45 | Peripheral Joint Injections |
| Sl No. | Name of service (Essential) Category: PMR |
| 46 | Computerized Tractions (lumbar & Cervical) |
| 47 | Short Wave Diathermy |
| 48 | Electrical Stimulator with Tens |
| 49 | Electrical Stimulator |
| 50 | Ultra Sonic Therapy |
| 51 | Paraffin Wax Bath |
| 52 | Infra Red Therapy |
| 53 | Shoulder Wheel |
| 54 | Exercycle |
| 55 | Shoulder Pulley |
| 56 | Post Polio Exercise |
| 57 | Obesity Exercises |
| 58 | Breathing Exercises & Postural Drainage |
| Sl No. | Name of service (Essential) Category: ENT |
| 59 | Packing (anterior & posterior nasal) |
| 60 | I & D Septal Abscess (unilateral & Bilateral) |
| 61 | Sub Mucosal Resection (smr) |
| 62 | Septoplasty |
| 63 | Fracture reduction nose |
| 64 | Fracture reduction nose with septal correction |
| 65 | Rhinoplasty |
| 66 | Septoplasty With Reduction Of Turbinate (sub-mucosal Diathermy (smd)) |
| 67 | Adenoidectomy |
| 68 | Tonsillectomy |
| 69 | Adenoidectomy + Tonsillectomy |
| 70 | Frenuloplasty (Tongue tie excision) |
| 71 | Direct laryngoscopy |
| 72 | Hypopharyngoscopy |
| 73 | Direct laryngoscopy & biopsy |
| 74 | Preauricular sinus excision |
| 75 | Foreign Body Removal (Ear and Nose) |
| 76 | Stitching of cut lacerated wounds (CLW’s) |
| 77 | Dressings |
| 78 | Syringing of ear |
| 79 | Chemical cauterisation (Nose & Ear) |
| 80 | Eustachian tube function test |
| 81 | Vestibular function test/ Caloric test |
| 82 | Audiogram (Pure tone and Impedance) |
| 83 | Therapeutic removal of granulations (Nasal, aural, oropharynx) |
| 84 | Punch Biopsy (Oral Cavity & oropharynx) |
| 85 | Cauterization (Oral, oropharynx, aural & nasal) |
| 86 | Mastoid abscess I & D |
| 87 | Mastoidectomy |
| 88 | Stapedotomy |
| 89 | Examination under microscope |
| 90 | Myringotomy |
| 91 | Myringoplasty |
| 92 | Tympanoplasty |
| 93 | Hearing aid analysis and selection |
| 94 | Tonsillectomy, Mastoidectomy, Stapedotomy (D) |
| Sl No. | Name of service (Essential) Category: Ophthalmology |
| 95 | Refraction (using Snellen’s Chart) |
| 96 | Refraction (using auto refractometer) |
| 97 | Syringing and probine |
| 98 | Foreign body removal (Conjunctival) |
| 99 | Foreign body removal (Corneal) |
| 100 | Suture removal |
| 101 | Sub-conjunctival injection |
| 102 | Retrobulbar injection (Alcohol etc.) |
| 103 | Tonometry |
| 104 | Biometry/ keratometry |
| 105 | Automated perimetry |
| 106 | Pterygium excision |
| 107 | Syringing & probing |
| 108 | Perforating corneo-scieral injury repair |
| 109 | Glaucoma surgery (e.g. Trabeculectomy) |
| 110 | Wart excision |
| 111 | Stve/chalazion surgery |
| 112 | Cauterization (thermal) |
| 113 | Conjunctival resuturing |
| 114 | Corneal scraping |
| 115 | Lid abscess Incision & drainage (l&D) |
| 116 | Uncomplicated lid tear |
| 117 | Indirect ophthalmoscopy |
| 118 | Retinoscopy |
| 119 | Examination under General Anaesthesia |
| 120 | Canthotomy |
| 121 | Paracentesis |
| 122 | Air Injection & Resuturing |
| 123 | Enucleation without implant |
| 124 | Cataract extraction with IOL (including Phacoemulsification) |
| 125 | Small lid tumour excision |
| 126 | Conjunctival Cyst |
| 127 | Capsulotomy |
| 128 | Evisceration |
| Sl No. | Name of service (Essential) Category: Paediatric Medicine |
| 129 | Immunization (As per National Immunization Schedule) |
| 130 | Vit K for premature babies |
| 131 | Neonatal resuscitation |
| 133 | Umbilical Vein/ Artery Catheterization |
| 134 | Phototherapy |
| 135 | ET & TT Intubation |
| 136 | Lumbar Puncture |
| 137 | Venous Cut Down |
| 138 | Venipuncture |
| 139 | Ng Tube Insertion |
| Sl No. | Name of service (Essential) Category: Gynae & Obst. |
| 140 | Colposcopy |
| 141 | Female Sterilization (mini Laparotomy & Laparoscopic Ligation] |
| 142 | Antenatal check-up |
| 143 | Intranatal check-up |
| 144 | Postnatal checkups |
| 145 | Antenatal corticosteroid to mother in case of pre term babies |
| 146 | Normal vaginal delivery |
| 147 | Assisted breech delivery |
| 148 | Forceps delivery |
| 149 | Cervical/ Perineal tear repair |
| 150 | Caesarean section |
| 151 | Ectopic pregnancy surgery (unruptured/ ruptured) |
| 152 | Examination Under Anaesthesia (EUA) |
| 153 | Dilatation & Curettage (D&C) |
| 154 | MTP (Medical Method & Surgical Methods |
| 155 | IUD services (insertion & removal) |
| 156 | Contraceptives including emergency contraceptives |
| 157 | Fine Needle Aspiration Cytology (FNAC) |
| 159 | Cervical VIA Staining |
| 160 | Cervical Biopsy |
| 161 | Endometrial Aspiration and Biopsy |
| 162 | Cervical Cautery (Electro/ Cryo Cautery) |
| 163 | Bartholin Cyst Excision |
| 164 | Emergency exploratory laparotomy |
| 165 | Hysterotomy |
| 166 | Sling operation |
| 167 | Tuboplasty |
| 168 | Haematocolpos Drainage Colpotomy |
| 169 | Ovarian Cystectomy/ oophorectomy |
| 170 | Vaginal hysterectomy |
| 171 | Abdominal hysterectomy |
| 172 | Salpingo-oophorectomy |
| Sl No. | Name of service (Essential) Category: Ortho Surgery |
| 173 | Femoral neck nailing with or without plating replacement prosthesis/ Upper femoral osteotomy |
| 174 | Innominate osteotomy/ open reduction of hip dislocation |
| 175 | DHS/ Richard screw plate |
| 176 | Synovial or bone biopsy from Hip |
| 177 | Girdle stone Arthroplasty |
| 178 | Open Reduction Internal fixation (ORIF) of femur, Tibia, Humerus, Radius, Ulna, Sternum |
| 179 | Open reduction and Internal fixation bimalleolar fracture |
| 180 | Fracture dislocation of ankle |
| 181 | Montaggia fracture dislocation |
| 182 | Fracture medial/ lateral condyle of humerus |
| 183 | Olecranon fracture |
| 184 | Repair of Fracture Patella, Calcaleus, Talus |
| 185 | Single forearm bone fracture |
| 186 | External fixation – Pelvis, femur, tibia, humerus, forearm |
| 187 | External fixation of hand & foot bones; Tarsals, metatarsals, Phalanges, Carpals, Metacarpals |
| 188 | Excision head fibula |
| 189 | Excision Lower end of ulna |
| 190 | Drainage of fracture |
| 191 | Interlocking nailing of long bones |
| 192 | Debridement & secondary closure |
| 193 | Percutaneous fixation (small and long bones) |
| 194 | Closed Fixation of hand/ foot bone, Shoulder dislocation, knee dislocation, Acromioclavicular or Sternoclavicular Joint, Clavicle, Ankle Bimalleolar |
| 195 | Open reduction |
| 196 | Ankle trimalleolar Open reduction, |
| 197 | Wrist dislocation on intercarpal joints, MP & IP Joints |
| 198 | Fasciotomy leg/ forearm |
| 199 | High Tibial Osteotomy |
| 200 | Arthrodesis (shoulder, elbow, wrist, hip, knee, ankle) |
| 201 | Triple arthrodesis, Arthrodesis – MP & IP Joints |
| 202 | Excision of exostosis-long bones, (single/ double) |
| 203 | Curettage/ bone grafting of bone tumour of femur/ tibia, Flumerus & forearm |
| 204 | Surgery tumours of small bone, hand and foot |
| 205 | Debridement & primary closure of compounds fracture of tibia, Femur forearm without fixation |
| 206 | Debridement of hand/ foot |
| 207 | Debridement primary closure of compound fractures of tibia. |
| 208 | Debridement & primary closure of compounds fracture of tibia, Femur, forearm forearm with fixation |
| 209 | Tendon surgery soft tissue release in club foot |
| 210 | Internal fixation of small bone (single, two, more than two) |
| 211 | Tendon surgery (repair and lengthening) |
| 212 | Surgery of chronic osteomyelitis (Saucerization, sequestrectomy of femur, humerus, tibia) Fibula radius ulna (Clavicle) and wrist, Ankle, hand foot |
| 213 | Amputation (thigh or arm, leg or forearm, feet or hand, digits) |
| 214 | Disarticulation of hip or shoulder (disarticulation of knee elbow/ wrist/ ankle; fore-quarter or hind-quarter) |
| 215 | POP Application (Hip spica, Shoulder spica POP Jacket; A-K/A-E POP; B-K/B-E POP) |
| 216 | Corrective osteotomy of long bones |
| 217 | Excision arthroplasty of elbow & other major joints |
| 218 | Excision arthroplasty of small joints |
| 219 | Surgery of hallus valgus |
| 220 | Bone surgery (Needle biopsy, axial skelton, non-axial) |
| 221 | Removal of nail AO plates |
| 222 | Removal forearm nail, Screw |
| 223 | Fracture lower end of radius, |
| 224 | Fracture medial malleolus |
| 225 | Skeletal traction femur, Tibia, Calcaneus, Elbow, Bone grafting (small grafting and long bone) |
| 226 | Soft tissue biopsy |
| 227 | Skin graft (small, medium and large) |
| 228 | Patellectomy |
| 229 | Olecranon fixation |
| 230 | Open ligament repair of elbow, Ankle & wrist |
| 231 | Arthrotomy of hip/ shoulder/ elbow |
| 232 | Carpal tunnel release |
| 233 | Dupuytren’s contracture release |
| 234 | Closed nailing of long bones |
| 235 | Removal of external fixation |
| 236 | Removal of implant |
| 237 | Excision of soft tissue tumour muscle group |
| Sl No. | Name of service (Essential) Category: Gen. Surgery |
| 238 | Minor surgery |
| 239 | I & D abscess |
| 240 | Gland biopsy |
| 241 | Small soft tissue tumour (Benign) |
| 242 | Exploratory laparotomy |
| 243 | Colostomy |
| 244 | Prepuceal dilatation & Meatotomy |
| 245 | Reduction of Paraphimosis |
| 246 | Torsion of testis |
| 247 | Umbilical hernia/ epigastric hernia repair |
| 248 | Inguinal herniotomy (unilateral & bilateral) |
| 249 | Deep abscess |
| 250 | Appendicectomy |
| 251 | Fissurotomy or fistulectomy |
| 252 | Haemorrhoidectomy |
| 253 | Circumcision |
| 254 | Hydrocelectomy |
| 255 | Herniorrhaphy |
| 256 | Suprapubic cystostomy |
| 257 | Diagnostic laparoscopy |
| 258 | Non-Scalpel Vasectomy (NSV) |
| 259 | FNAC |
| 260 | Superficial & total parotidectomy |
| 261 | Intra-oral removal of submandibular duct calculus, |
| 262 | Abscess drainage (including breast & perianal), |
| 263 | Wound debridement |
| 264 | Excision branchial cyst or Fistula or Sinus |
| 265 | Excision of lingual thyroid, |
| 266 | Hemithyroidectomy (Sub-total thyroidectomy/ lobectomy) |
| 267 | Cysts and benign tumour of the palate |
| 268 | Excision submucous cysts |
| 269 | Fibroadenoma/ Lump Excision |
| 270 | Simple mastectomy |
| 271 | Modified radical mastectomy (multi-disciplinary approach) |
| 272 | Sectoral mastectomy/ microdochectomy/ lumpectomy |
| 273 | Wedge biopsy |
| 274 | Mammary fistula excision |
| 275 | Inguinal hernia repair |
| 276 | Inguinal hernia repair with mesh |
| 277 | Femoral hernia repair |
| 278 | Epigastric/ ventral hernia repair |
| 279 | Recurrent Inguinal hernia repair |
| 280 | Ventral hernia repair with mesh |
| 281 | Operation of strangulated ventral, Inguinal or Incisional hernia |
| 282 | Recurrent Incisional hernia repair |
| 283 | Diaphragmatic hernia repair |
| 284 | Exploratory laparotomy, |
| 285 | Gastrostomy or Jejunostomy |
| 286 | Simple closure of perforated ulcer |
| 287 | Ramstedt’s Operation |
| 288 | Gastro-Jejunostomy |
| 289 | Vagotomy & drainage procedure |
| 290 | Adhesionolysis or division of bands |
| 291 | Mesenteric cyst |
| 292 | Retroperitoneal tumour excision |
| 293 | Burst abdomen repair |
| 294 | Splenectomy |
| 295 | Drainage of Pseudo pancreatic cyst (Cystogastrectomy) |
| 296 | Retroperitoneal drainage of Abscess |
| 297 | Emergency appendicectomy |
| 298 | Appendicular abscess drainage |
| 299 | Interval appendicectomy |
| 300 | Resection and anastomosis |
| 301 | Intussusception, Intestinal fistula repair |
| 302 | Multiple resection and anastomosis |
| 303 | Intestinal perforation repair |
| 304 | Open Drainage of liver abscess |
| 305 | Drainage of Subdiaphragmatic Abscess/ Peri gastric abscess |
| 306 | Hydatid cyst excision (abdominal) |
| 307 | Cholecystectomy (Open and laparoscopic) |
| 308 | Choledocholithotomy & choledochoduodenostomy |
| 309 | Right hemicolectomy |
| 310 | Sigmoid & descending colectomy |
| 311 | Haemorrhoidectomy |
| 312 | Sphincterotomy and fissurectomy |
| 313 | Tube caecostomy |
| 314 | Closure of loop colostomy |
| 315 | Rectal prolapse repair |
| 316 | Anal sphincter repair |
| 317 | Thiersch’s operation |
| 318 | Imperforate anus with low opening repair |
| 319 | Pilonidal sinus repair |
| 320 | Fistula in ano (low level) repair |
| 321 | Fistula in ano (high level) with Stenosis repair |
| 322 | Colostomy |
| 323 | Perianal abscess drainage |
| 324 | Ischiorectal abscess |
| 325 | Ileostomy or colostomy |
| 326 | Sigmoid myotomy |
| 327 | Circumcision |
| 328 | Partial amputation of penis |
| 329 | Total amputation of penis |
| 330 | Orchidectomy (unilateral & bilateral) |
| 331 | Hydrocele (unilateral & bilateral) |
| 332 | Excision of multiple sebaceous cysts of scrotal skin |
| 333 | Reduction of paraphimosis |
| 334 | Other Surgical Procedures |
| 335 | Suturing of large laceration |
| 336 | Suturing of small wounds |
| 337 | Repair torn ear lobule |
| 338 | Small superficial tumour excision |
| 339 | Large superficial tumour excision |
| 340 | Incision and drainage of abscess |
| 341 | Lymph node biopsy |
| 342 | Excision biopsy of superficial lumps |
| 343 | Excision biopsy of large lumps |
| 344 | Infection haemorrhoids/ ganglion/ keloids |
| 345 | Removal of foreign body (superficial) |
| 346 | Removal of foreign body (deep) |
| 347 | Excision biopsy of ulcer |
| 348 | Excision of sebaceous cyst |
| 349 | Excision carbuncle |
| 350 | Excision multiple cysts |
| 351 | Excision soft tissue tumour muscle group |
| 352 | Muscle biopsy |
| 353 | Repair of Tongue tie |
| 354 | Debridement of wounds |
| 355 | Diabetic foot debridement/ management |
| 356 | In-growing toe nail removal |
| 357 | Burn dressing all grades |
| 358 | Ear lobules repair one side (bilateral) |
| 359 | Simple wound |
| 360 | Complicated wound |
| 361 | Simple Injury fingers |
| 362 | Multiple fingers injury |
| Sl No. | Name of service (Essential) Category: Dental Surgery |
| 363 | Dental abscess drainage/ dental cleaning/ gingivitis |
| 364 | Impaction of teeth |
| 365 | Scaling (crown and root) and polishing |
| 366 | Trauma including vehicular accident |
| 367 | Root canal treatment |
| 368 | Dental extractions |
| 369 | Intra Oral X-ray/ Intra Oral Peri-Apical radiograph (IOPA) |
| 370 | Fracture wiring |
| Sl No. | Name of service (Desirable) Category: Procedure & Diagnostic |
| 1 | Pericardial tapping |
| 2 | Pleural biopsy |
| 3 | Pericardial tapping |
| 4 | Exchange transfusion |
| 6 | Arterial catheterization |
| 7 | Bone marrow aspiration |
| 8 | ICD insertion |
| 9 | Trigger Finger Injections |
| Sl No. | Name of service (Desirable) Category: PMR |
| 10 | Ultraviolet therapy |
| 11 | Electric vibrator |
| 12 | Vibrator belt massage |
| 13 | Mechanical tractions (lumber & cervical) |
| 14 | Supinator Pronator Bar Exercises |
| 15 | Gripper Exercises |
| 16 | Vissco weight cuffs Exercises |
| 17 | Walking bars Exercises |
| 18 | Cerebral Palsy – Massage |
| Sl No. | Name of service (Desirable) Category: ENT |
| 19 | Nasal endoscopy & endoscopic sinus surgery |
| 20 | Antral puncture (unilateral & bilateral) |
| 21 | Inter nasal antrostomy (unilateral & bilateral) |
| 22 | Trans antral procedures (Biopsy, excision of cyst and angiofibroma excision) |
| 23 | Trans antral biopsy |
| 24 | Bronchoscopic F B removal |
| 25 | Brainstem auditory evoked response |
| Sl No. | Name of service (Desirable) Category: Ophthalmology |
| 26 | Enucleation with implant |
| 27 | Corneal perforation/ lris prolapse surgery |
| 28 | Anterior chamber wash |
| Sl No. | Name of service (Desirable) Category: Gynaecology & Obst. |
| 29 | Laparoscopy (diagnostic and therapeutic) |
| 30 | Cervical PAP smear |
| 31 | Vacuum assisted delivery |
| 32 | Craniotomy-dead Foetus/ Hydrocephalus |
| 33 | Hysteroscopy |
| Sl No. | Name of service (Desirable) Category: Ortho Surgery |
| 34 | Inter-condylar fracture of humerus and femur |
| 35 | Knee synovectomy/ meniscectomy |
| 36 | Synovectomy of major joint shoulder/ hip/ elbow |
| 37 | Total Hip Replacement (D) |
| 38 | Total Knee Replacement (D) |
| 39 | Upper GI Endoscopy (Oesophagus, stomach, duodenum) (Diagnostic and Therapeutic) |
| 40 | Big soft tissue tumour |
| 41 | Branchial cyst/ fistula/ sinus |
| 42 | Thyroglossal cyst and fistula |
| 43 | Pyloric stenosis (Ramsted’s Operation) |
| 44 | Gastrostomy |
| 45 | Hypospadias single stage (first stage) |
| 46 | Orchidopexy (unilateral & bilateral) |
| 47 | Rectal polyp removal |
| 48 | Sacrococcygeal teratoma |
| 49 | Intussusception (Simple Reduction) |
| 50 | Volvulus of colon |
| 51 | Orchidopexy (unilateral & bilateral) |
| 52 | Congenital deformity repair (Extra digit, Syndactyly, Constriction rings) |
| 53 | Reconstruction of hand (Tendon repair) |
| 54 | Small wound skin graft |
| 55 | Finger Injury with skin graft |
| 56 | Polio Surgery |
| 57 | Crush injury hand |
| 58 | Full thickness graft |
| 59 | Sigmoidoscopy and Colonoscopy |
| 60 | Laparoscopy (diagnostic and therapeutic) |
| 61 | Meatotomy |
| 62 | Trocar cystostomy |
| Sl No. | Name of service (Desirable) Category: Dental Surgery |
| 63 | Periodontal surgeries |
| 64 | Sub mucus fibrosis (SMF) |
| 65 | Light Cure Crowning |
| 66 | Subluxation and arthritis of Temporomandibular Joints |
| 67 | Pre-cancerous lesions and Leukoplakias |