Clinical establishments act and Standard for Ayurvedic Clinics

The clinical establishments act was adopted in year 2012, still so many states are to implement this act. This act is equally applicable for all system of medicine including Ayurveda. Here are the standards for ayurveda clinics and hospital. Present presentation explain the standards for ayurvedic clinics and dispensaries only

1. The Clinical Establishments (Registration and Regulation) ACT, 2010 Minimum Standards for AYURVEDA CLNICS Dr. Surendra Chaudhary [email protected]

2. These Standards are for Ayurveda Clinics,Dispensaries and Therapy centres only. Standards for Hospital & Teaching institutes with In-patients hospitals are different -My views- Recommendations of he draft committee on standards for Ayurveda clinics and hospitals are not explanatory in nature and so many points are not covered.

3. The Clinical Establishments (Registration and Regulation) ACT, 2010 The Act is for the Registration and Regulation of the clinical Establishments in the country and for matters connected therewith Act passed by Parliament in August 2010 and notified on 1 st March, 2012. National Council under the Act notified on 19 th March, 2012 and Central Rules notified on 23rd May, 2012 Model State Rules have been circulated to the States/UT’s. Ministry has requested the Chief Ministers to adopt and implement the Act. Highest priority of Govt. for implementation and monitored by the PMO.

4. Definition of Clinical Establishment (i) a hospital, maternity home, nursing home, dispensary, clinic, sanatorium or an institution by whatever name called that offers services, facilities requiring diagnosis, treatment or care for illness, injury, deformity, abnormality or pregnancy in any recognized system of medicine established and administered or maintained by any person or body of persons, whether incorporated or not; or (ii) a place established as an independent entity or part of an establishment referred to in sub-clause (i), in connection with the diagnosis or treatment of diseases where pathological, bacteriological, genetic, radiological, chemical, biological investigations or other diagnostic or investigative services with the aid of laboratory or other medical equipment, are usually carried on, established and administered or maintained by any person or body of persons, whether incorporated or not,

5. Coverage All clinical establishments - including diagnostic centres and single doctor clinics, Including ALLOPATHY AYUSH  Ayurveda YOGA Unani Siddha  Sowa-Rigpa   Homoeopathy  Naturopathy (Exception: establishments of the Armed Forces)          

6. Objectives of the Act To establish digital registry of Clinical Establishments at National, State and District level. To prevent quackery by unqualified practitioners by introducing registration system, which is mandatory. To prescribe minimum standards of facilities and services for all categories of health care establishments (except teaching hospitals, health care) and ensure compliance of other conditions for registration like standards treatment protocols, display of range of rates to be charged, maintenance of records.

7. Objectives of the Act The minimum requirements of personnel as may be prescribed; Provisions for maintenance of records and reporting as may be prescribed; The clinical establishment shall undertake to provide within the staff and facilities available such medical examination and treatment as may be required to stabilize the emergency medical condition of any individual who comes or is brought to such clinical establishment.

8. Registration under Clinical establishments act (Data accessed on 4-8-2016) State Total Registration Ayurvedic Registration Andaman&Nicobar 311 22 Bihar 1 1-Homeo Chandigarh UT 310 24 Dadra&Nagar Haveli 42 13 Daman & Diu UT 147 25 Himachal 5186 1839 Jharkhand 3096 111 Rajasthan 88 17 U.P. 5 - Total 9186 2052

9. Type of Ayurvedic Establishments Clinic Dispensary Therapy Centre Hospitals Minimum 10 Beds 11 to 25 Beds 26 to 50 Beds 51-100 Beds More Than 100 Beds

10. CATEGORIES OF CLINICAL ESTABLISHMENTS-AYURVEDA Ausadh Chikitsa, Shalya Chikitsa, Shodhan Chikitsa, Rasayana, Pathya Vyavastha As categorised by Central Government * *section 13(1) under the Clinical Establishments (Registration and Regulation) Act, 2010 reads; “Clinical Establishment of different systems shall be classified into such categories as may be prescribed by the Central Government from time to time”.

11. Mandatory Requirements Clinic Display the name of doctor with the degree. Registration number of the doctor Fee Timing of the clinic Experience of the doctor Dispensary- in addition to the clinic Dispensing counter with signage Name of the pharmacist with degree and experience Therapy centre- in addition to clinic & Dispensary Display of the therapy performed in the centre Fee structure for various procedures on daily as well as package system

12. Minimum Standards for Ayurvedic Establishments Specifications Clinic Dispensary Therapy Centre Space(Sq.Feet) 100 100 150 Human Resource
Doctor One One One Multi-purpose Worker One One One Pharmacist X One Pharmacist cum therapist

13. Minimum Standards for Ayurvedic Establishments Equipments Clinic Dispensary Therapy Centre Stethoscope 1 1 1 B.P. apparatus 1 1 1 Thermometer 1 1 1 Torch 1 1 1 Tongue depressor 1 1 1 X – Ray view box 1 1 1 Weighing machine 1 1 1 Hammer 1 1 1 Kharal 1 1 1 Other-as required Panchkarma equipments

14. Minimum Standards for Ayurvedic Establishments Equipments Clinic Dispensary Therapy Centre Doctor’s Table 1 1 1 Doctor’s Chair 1 1 1 Attendant Chair 2 2 2 Patient’s stool 1 1 1 Examination Table 1 1 1 Foot Step 1 1 1 Panchkarma Furniture X X As per requirement

15. Facilities@Clinic Essentials 1. Name of the physicians with qualification & Registration Number inside the clinics. 2. Biomedical waste management authorisation certificate. 3. Fire Extinguisher 4. Display of services provided. 5. Minimum physical, furniture and equipments 6. Hand washing facility, Drinking Water and some waiting space Optional Noise and Air Pollution authorization certificate. Electricity back up Toilet facility

16. Licenses Name of the act Authority Status Registration under shop and Establishment act Local authority-Municipal board etc If applicable Registration under clinical establishment act State government Applicable Clearance for radiation safety Imaging Not applicable Licenses for distribution of medicine Drugs authority Not applicable Biomedical waste collection agreement BWM agencies Applicable* Noise pollution control certificate Pollution control board Applicable if generator is there Generator Exhaust air quality -do- -do- *-Applicable if any process is being offered.There are certain other licenses which are applicable on Ayurveda clinics if being run by societies or charitable trusts

17. Template for Clinical establishment Rate/Charges Name & Address of establishment with e-mail Registration number-provisional/ permanent Type of establishment Facilities available Charges/ consultationFee OPD General OPD Specialty Investigation/Diagnostic-if any Therapeutic Charges Doctor consultation + any consumable expenditure + Medicine Charges(actual)+ any other Specialty- Doctors fee + Consumable( during punch karma , ksharsutra ) + Therapy charges + any other + Medicine

18. Clinical Records supposed to be kept OPD registration record Treatment record Medication Record Report of investigations Consent forms (All records are supposed to keep for three years)

19. Template for basic Processes-Registration Registration number, Name Age Gender Socioeconomic status Address with pin code Marital status Contact number/e-mail, Veg/Non-veg Date and time of visit, diagnosis Investigations if advised Name of the doctor ( Records can be kept electronically)

20. Assessment/ History taking Template Primary complaint of the patient Family History History of the primary complaint General Examination History of Medication Systemic Examination History of implants Physical Examination Past History Prakriti estimation History of Allergies Agni Pariksha Diet & Lifestyle History Pathya-Apathya Personal History Diagnosis-Provisional/Final Treatment Re-visit instructions Take note of any advise regarding home remedies, yogic advise,Anupan etc

21. Template For Medical Certificate (As per Uttar Pradesh Draft)

22. Template for Examination (As per Uttar Pradesh Draft)

23. For Suggestions, additions, omissions & comments [email protected]