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Duty Hours of Medical Officers, Staffs providing Patient Care Service

Published in Health.

Government of West Bengal
Department of Health & Family Welfare
GA Branch
Swasthya Bhawan, GN-29, Sector-V,
Salt Lake City, Kolkata-700091

No. HF/O/GA/1936/W-153/11 Date: 26.07.2011

MEMORANDUM

The improvement of service delivery at different Govt Hospitals is a high priority item on the agenda of the state government. The Hon’ble Chief Minister strongly emphasized this aspect in her meeting with different health care providers on June 13th in the Town Hall. Accordingly, after careful consideration the undersigned is directed by order of the Governor to say that the Governor, has been pleased to formulate the following ‘Standard Operating Procedure’ delineating the scheduled hours of public services and duties of employees at the District/ Sub-Divisional/ State General/ Decentralized/ Specialized Hospitals under the control of the state government, as per the Schedules A & B to this order.

2. The list of all the patient care services available at the hospital and their frequency/timings as per ‘Schedule A’ will be displayed as a part of Citizens’ Charter in prominent place(s) within the hospital premises. Any changes/modification will be promptly incorporated to avoid public harassment. Availability of any upgraded service not mentioned in ‘Schedule A’ will be incorporated as soon as possible. The list will also be available on the website of the department.

3. The Governor is pleased to authorize the Superintendent to prepare a duty roster including shift duties, on-call period and day-off for medical officers, specialists, and other staff to run round the clock services in a manner as mentioned in ‘Schedule B’

(a) In the interest of public service, all the out-patient departments, in-patient departments, clinics, units including the P.P. Unit and the Blood Bank under the administrative control of a particular Superintendent, will be considered as a single unit and the employees attached with such units can be allocated duties anywhere as deemed fit by the Superintendent.

(b) Such duty rosters will be prepared, if required, in consultation with the concerned employees. The roster will clearly mention the shift duties and on-call period for each specified day in the week applicable to each individual employee. While preparing the duty roster, the Superintendent will take into consideration the total shift duty hours of an employee which should not be less than 40 hours per week.

(c) Frequent changes in the duty roster are not desirable. Besides displaying those duty rosters in the office notice board, the availability of doctors will be displayed as a part of Citizens’ Charter mentioned above.

(d) The outpatient based services mentioned in ‘Schedule A’ will remain closed on Sundays and holidays notified by the department for this specific purpose from time to time.

4. (a) The Governor is further pleased to authorize the Superintendent of the different hospitals to adjust the hours of duty of Medical Officers of their institutions on specified days in the week or by rotation to run the indoor and other services on Sundays/notified holidays. On such holidays the indoor, emergency and other services will be provided through local arrangements in consultation with medical officers/specialists and other staff.

(b) Notwithstanding the fixation of the hours of duty as above, the services of the medical officers/specialists and other staff may be utilized at any time beyond the scheduled hours in any manner as may be required by the Superintendent in terms of Rule 15 of W.B.S.R. Part I. without claim for additional remuneration vide rule 15 of the West Bengal Service Rules, Part-I. Relevant extracts are enclosed.

5. The Governor is pleased to authorize the Chief Medical Officer of Health/Jt.DHS(Admn) as controlling officer of the Superintendents to ensure the proper implementation of this guideline

6. Any form of non-compliance will be strictly dealt with for the interest of the public service.

7. This order being issued in supersession of all previous orders issued in this regard, will take immediate effect and will remain valid till further orders.

8. All concerned are being informed.

Sd/- Principal Secretary to the
Government of West Bengal.

ANNEXURE to GO No HF/O/GA/1936/W-153/11 Dated 26.07.2011

Schedule A: Hours for patient care services

1. Working Days and holidays

Some of the service will be available throughout the year on a 24 x 7 basis and some of the service will be available only on working days as enumerated below. Unless mentioned otherwise the ‘Working days’ for patient care service of the hospital will be considered as all weekdays from Monday to Saturdays including Gazetted holidays except Sundays and those holidays as may be notified by the Department for this specific purpose from time to time.

2. Enrolment/Registration for Patient:

a) OPD patients’ registration (both new & old) will remain open from 8.30AM to 2.00 PM on each working day.
b) IPD Patient registration for admission will remain open round the clock.
c) Emergency Patients’ registration will remain open round the clock.
d) Collection of User charges (cash collection counters) will remain open round the clock.

3. Consultation/Therapy clinics for outpatients:

a) All clinics will remain open from 9AM to 2 PM or till the last registered outpatient is served whichever is later.
b) General OPD will remain open on all working days including AYUSH clinic, if any from 9 AM to 2.00 PM or the last patient is served whichever is later.
c) Specialist OPD and clinics like Chest, Dental, STD, and Physiotherapy etc. will remain open for those fixed days per week as declared by the Superintendent.

4. Emergency services for outpatients:

It will remain open round the clock in three shifts i.e. Morning from 8AM to 2 PM; Evening from 2PM to 8 PM and Night shift from 8PM to 8AM throughout the year.

5. Services by P.P. Unit

The P.P. Unit will remain open from 9 AM to 4 PM on all working days. Specific services for out-patient/in-patient like ANC, PNC, Immunization, Family Planning will be available as declared by the Superintendent.

6. Services for inpatients:

a) Normal as well as emergency services for inpatient will remain open round the clock in same three shifts throughout the year
b) Labour room will remain open round the clock in same three shifts throughout the year

7. OT Services

a) Selective OT services will remain open on all working days throughout the year,
b) Casualty OT services beyond normal hours will remain open as declared by the Superintendent subject to the availability of manpower.

8. Diagnostic Services:

a) All Diagnostic Services (Laboratory, Imaging & Others) like Biochemistry, Pathology, X-Ray, ECG, USG etc. for in-patients and out-patients will remain open from 8AM to 2 PM on each working day.
b) Diagnostic Services during Evening Shift from 2PM to 8 PM on working days will be available either by on-duty staff (preferable) or as ‘on-call service’ as declared by the Superintendent subject to the availability of manpower.
c) Emergency Diagnostic Services during (i) Night shift from 8PM to 8 AM on working days, and (ii) throughout the day on Sunday/holiday will be available as ‘on-call service’ as declared by the Superintendent subject to the availability of manpower.

9. Dispensing Service:

a) The drug dispensing counter at the main pharmacy will remain open during Morning shift from 8.30AM to 2.30 PM on all working days or till the last registered out-patient is served whichever is later.
b) The drug dispensing counter in the Emergency Room will remain open round the clock in same three shifts throughout the year.

10. Post-Mortem Examination:

Until further orders the post-mortem examination related services will continue as per the existing guideline.

11. Other services:

Other services like diet, security, scavenging etc. will be made available as per the existing guidelines.

12. Visiting Hours:

During visiting hours the relatives/friends of the patient, the patient party, will have the opportunity to meet the patient admitted. There will be two visiting hours, Morning from 11 AM to 12 AM and Afternoon from 4 PM to 6 PM. Entry/Exit of Patient party into the restricted area will be regulated as per existing guideline.

13. Discharge Time:

Other than the transfer of patient for emergency referral or ‘Discharge against Medical Advice’ (Discharge on Request Bond) the admitted patient will normally be discharged before 1 PM.

14. Doctor-Patient Party Meet:

Patient Party will have the opportunity to meet with the concerned Doctor at scheduled hour during morning/evening as declared by the Superintendent.

15.Blood Banking:

a) Blood bank will remain open from 9 AM to 4 PM on all weekdays and from 9 AM to 2 PM on Saturdays.
b) Blood banking services during remaining period i.e. (i) from 4 PM to 9 AM on all weekdays; (ii) from 2 PM to 9 AM on Saturdays and (iii) throughout the day on Sunday/holiday will be available as ‘on-call service’ as declared by the Superintendent subject to the availability of manpower.

Special Secretary to the
Government of West Bengal
H & F.W. Deptt

Schedule B: Hours of Duty for MO/Staff providing patient care services

1. Employees attached with clinical and Para-clinical services:

1.1. Unless mentioned otherwise, the shift mentioned in a 24 hours duty roster will be considered as: (a) Morning: 8 AM to 2 PM, (b) Evening: 2 PM to 8 PM and (c) Night: 8 PM to 8 AM and the medical officers, specialists, and other staff will attend their duties in any of those three shifts as per the duty roster.

1.2. All employees on shift duties will remain at their workstation or duty room during the entire period of the shift or till the work is finished. Splitting of duty hours by the employees amongst themselves will not be allowed. It should be especially impressed upon all the employees that they should not leave the workplace, particularly the OPD, till the last Patient has been served. Depending upon the patient load, more than one MO/Specialist will be available in each OPD clinic.

1.3. Every specialist should conduct specialty OPD consultation clinic at least 2 fixed days per week and every surgeon should conduct selective OT at least 2 fixed days per week. While preparing the duty roster, the specialist should be exempted from duties outside his/her specialty as far as possible. As a result of that it is expected that more number of specialist outdoor services and more number of selective OT would be available for the patient.

1.4. All employees of shift-duty are required to attend the workplace sufficient time before the actual work for the sake of ‘charge-handover’ so that no patient remained unattended any time. They will be required to record the time of their arrival and departure regularly in the ‘Attendance Register’ kept under the custody of Emergency Medical Officer. This ‘Attendance Registered’ will be verified by the Superintendent from time to time and at least one in a week.

1.5. Two ‘on-duty’ Emergency Medical Officers should be available at least in evening & night shift. When called upon, one on-duty EMO will attend all cases of inpatients where his intervention is required as first on-call. If required further, the concerned specialist on-call may be called upon to attend that particular case. Another on-duty EMO will attend allcases of out-patients presenting at Emergency Deptt. By this arrangement it is expected that any cases of emergency of in-patient or out-patient can be tackled without delay round the clock.

1.6. The Medical Officer/specialist having beds under his/her charge will have a fixed ‘Admission Day’ including Sunday by rotation which will be displayed in the Citizen Charter. Bed-in-charge will give rounds in the wards twice daily starting from 8 AM in the morning and at 6 PM in the evening. After completion of each round, s/he will meet the patient party at a place fixed by the Superintendent.

2. Employees attached with Blood Banks:

The Medical Officer and other staff of Blood bank will attend and remain at their workplace as per the duty roster. They will remain on-call as per the duty roster. They will also attend the Blood Donation Camp by rotation even on Sundays and Holidays if necessary.

3. Employees attached with post-mortem examination:

Until further orders the Medical Officer and other staff attached with post-mortem examination related services will continue to discharge their duties as per the existing guideline.

4. Employees detailed with administrative services in the Hospital:

4.1. The Officer and Staff who are not directly attached with the Services mentioned in Part A of the schedule will attend and remain at the office during office hours. The office of the hospital including store will remain open from 9 AM to 4 PM (1 P.M. to 2.00 P.M. tiffin break) on weekdays and from 9 AM to 2 PM on Saturdays.

4.2. The Officer and other staff on office duty will be required to record the time of their arrival and departure regularly in the Attendance Register kept under the custody of the Superintendent. Any officer/staff requiring to the leave his/her workstation for a short period on govt. duty will be required to record that period in the Short-leave Register kept under the custody of the Superintendent.

5. Employees engaged in any other duties:

For the interest of public service, employees are to discharge other duties from time to time which are not mentioned above like attending medical relief camps etc. Scheduled hours of those duties will be as per the direction given by the appropriate authority.

Special Secretary to the
Government of West Bengal
H & F.W. Deptt

No. HF/O/GA/1936/W-153/11 dated 26.07.2011, Source