In order to implement the Circular of the General Office of the State Council on the Issue of the Reform Plan for the Distribution of Financial Power and Expenditure Responsibility between the Central and Local Government in the Field of Medical and Health (No. 67 issued by the State Office, hereinafter referred to as the Programme), and to do a good job in basic public health services in 2019, the relevant matters are hereby notified as follows:
I. Defining the Task and Objectives of Work
(1) The original contents of basic public health services. In accordance with the overall and regional performance objectives of the central transfer of local special transfer payments for basic public health services in 2019 and the National Basic Public Health Service Standards (Third Edition), all localities should continue to implement the establishment of residentshealth records, health education, vaccination, child health management and pregnant and lying-in women. Health management, elderly health management, hypertension and type 2 diabetes mellitus and other chronic diseases, severe mental disorders, tuberculosis patients, traditional Chinese medicine health management, infectious diseases and public health emergencies reporting and handling, health supervision and co-management of 12 categories of projects. In the process of developing childrens health management, we should implement the Notice of the General Office of the State Health Commission on Eye Health Care and Eye Inspection for Children Aged 0-6 (Maternal and Child Hair, State Health Office, No. 9, 2019), standardize the work of eye health care and eyesight inspection for children aged 0-6, and strengthen the screening and health guidance for childrens obesity. Actively carry out prevention and control of childhood obesity. We should do a good job in basic public health services for the poor and promote the equalization of basic public health services.
(2) New contents of basic public health services. According to the requirements of the Program, from 2019, the contents of maternal and child health, elderly health services, medical and nursing integration, health emergency, pre-pregnancy examination, etc. in the original major public health services and family planning projects, will be included in basic public health services. For the new contents of basic public health services, three key tasks, including endemic disease prevention and control, occupational disease prevention and control, major diseases and hazard factors monitoring, are listed separately according to the project, with clear funds and tasks; other diseases prevention and control, maternal and child health services, elderly health and medical care services, food safety assurance and health supervision. Supervisory management, health emergency team building, population monitoring and family planning services, health literacy promotion and other work (see annex for details). The National Health Commission provides work norms and performance evaluation indicators, which are implemented by provinces in accordance with local conditions. In the implementation, project linkages should be made to ensure the continuity of related work.
In 2019, the per capita subsidy standard for basic public health services was 69 yuan, and the additional 5 yuan was spent entirely on villages and communities, so that grassroots people must benefit. Local governments should actively implement local financial powers and expenditure responsibilities in accordance with the requirements of the Program, and strictly comply with the requirements of the Circular of the State Administration of Traditional Chinese Medicine of the State Medical Security Bureau of the State Health and Health Commission of the Ministry of Finance on the Management Measures of Five Subsidies for Printing and Issuing Basic Public Health Services (Finance Society  113). Insurance project funds are in place on time and in full, and shall not be crowded out or misappropriated. On the premise of ensuring that the basic national standards are in place, we can reasonably increase the content of security or improve the standard of security. The additional expenditure should be borne by local governments, and the funds of national projects should not be crowded out.
3. Strengthen the management of vaccination units in grass-roots institutions
The grass-roots health and health administrative departments at all levels should cooperate with relevant departments to strengthen the construction of vaccination information and promote the traceability management of the whole process of vaccine production, circulation and use. We should guide the daily management of vaccination units established in community health service centers and township health centers and the risk prevention and emergency disposal of vaccination work. Strengthen the main responsibility, strictly implement the Regulations on the Administration of Vaccine Circulation and Vaccination and other laws and regulations and work norms. Optimize and refine the process of vaccination, on the basis of implementing three checks and seven pairs, add one validation link, and ask the vaccinator or guardian to verify the type and effective period of vaccination before vaccination, so as to ensure that the vaccination is correct. Strengthen the training of medical personnel and improve the skills and level of standardized vaccination.
IV. Actively and steadily promote the opening of electronic health records to individuals
We should optimize the channels and forms of interaction of electronic health records for individuals, adhere to the principle of safety and convenience, and create conditions for the masses to use electronic health records. Further clarify the contents of electronic health records open to individuals. The basic personal information, health examination information, health management records of key groups and other medical and health service records in electronic health records should be opened to individuals according to law on the basis of informed consent of themselves or their guardians. We should give full play to the advantages of Internet +, integrate the local actual situation, integrate the functions of appointment registration, online health assessment, online examination results and medication guidance, so as to improve the utilization rate of electronic health records by the masses. Rationally quantify the workload of online services provided by primary health care institutions and medical staff relying on electronic health records, and give play to the incentive role of performance evaluation. In promoting the work, all localities should implement the National Standards and Norms for Informatization Construction of Grass-roots Medical and Health Institutions (National Health Planning Letter No. 87) and the requirements of national network security laws, regulations and hierarchical protection system, implement the responsibility of safety management, properly handle the opening of electronic health records to individuals and guarantee the number of citizens. The relationship between human information security.
5. Promoting the Integration of Medical and Prevention through Breakthroughs in Chronic Diseases such as Hypertension and Diabetes
In 2019, we will continue to explore the integration service mode of primary medical care and prevention through the management of chronic diseases such as hypertension and diabetes, and promote the separation of upper and lower levels. Shanxi, Liaoning, Guangdong, Chongqing, Guizhou, Yunnan, Shaanxi and other seven provinces should play a pilot role in the integration of primary hypertension prevention and treatment, change the mode of service provision, give full play to the advantages of family doctorsteam, clarify the leading role of team doctors in the integration management of medical prevention and treatment, and promote the establishment of grass-roots institutions and higher medical institutions. The two-way cooperation and referral mechanism will actively play the technical guidance role of CDC institutions. Other provinces should continue to explore the integration of medical treatment and prevention of primary hypertension in accordance with the pilot requirements of these seven provinces.
In 2019, the management of medical integration of primary diabetes prevention and treatment will be launched. The National Guidelines for the Prevention and Control of Primary Diabetes (2018) issued by the Chinese Medical Association will be used as a technical guide for the development of medical integration of primary diabetes prevention and treatment, and the training of teachers and primary medical personnel will be organized. The National Health Commission will select some prefectures with good informationization foundation and strong grass-roots medical service capability to carry out pilot projects. Provinces wishing to submit declaration materials by the end of September 2019 are invited to do so. The State Health Commission entrusted the National Cardiovascular Disease Center and the Chinese Medical Association to establish the quality control and monitoring systems for hypertension and diabetes respectively. All regions should make good links between the regional health information system and the quality control and monitoring systems for hypertension and diabetes, and promote the data sharing of the medical and preventive integration management of hypertension and diabetes.
6. Innovation of performance evaluation methods
It is indeed necessary to implement the Opinions of the CPC Central Committee and the State Council on the Comprehensive Implementation of Budget Performance Management, strengthen project performance evaluation, give full play to the role of information technology in performance evaluation, reduce on-site evaluation, and improve the efficiency and quality of performance evaluation. It is necessary to organize personnel to check on-site. County (city, district) should implement the main responsibility of project performance evaluation, formulate performance indicators scientifically and rationally, and carry out comprehensive performance evaluation at least once a year for all medical and health institutions undertaking tasks in their jurisdiction. Strengthen the effect evaluation and cost-benefit analysis of the project, highlight residentsperception and sense of acquisition. Make good use of the results of performance evaluation, and link the evaluation results with allocation. To clarify the division of tasks at the village level and the basic public health service tasks undertaken at the village level, we should allocate funds in time according to the results of performance evaluation, effectively implement the subsidy funds, safeguard the legitimate rights and interests of rural doctors, and strictly prohibit the illegal withholding of the basic public health service subsidy of rural doctors. All localities should actively organize and carry out ten-year evaluation of projects, make full use of daily data information, pay attention to continuous and dynamic health management information mining, make full use of charts, data, typical cases and other forms, and focus on reflecting the effectiveness of projects in promoting the equalization of basic public health services in their jurisdictions since the implementation of the project, and objectively analyze them. The existing problems are pointed out and policy recommendations are put forward. The provincial project evaluation report should be submitted to the National Health Commission by the end of September.
VII. Effectively lighten the burden on the grass-roots level
Implementing the Notice on Solving Formalist Problems to Reduce Burden at the Grass-roots Level of the General Office of the Central Committee of the Communist Party of China, innovating working methods, strengthening the construction of basic public health service information system, and focusing on data sharing and business collaboration with medical and health institutions and maternal and child health information system. In accordance with the principle of one source, one source and multi-use, we should clear up the problems of the grass-roots organizations, such as numerous reports, multiple filling-in and too many filling-in frequencies, and strive to achieve one filling-in of similar information. Where electronic health records are perfect and can be opened to individuals, the corresponding paper files may be cancelled after evaluation by provincial health administrative departments. In 2019, the project progress data reported quarterly to the National Basic Public Health Service Project Management Information System (http://glpt.nbphsp.org.cn) will be changed to semi-annual reports. Strengthen the centralized management of report forms in grass-roots organizations. The new report forms should be issued after the examination and verification by the grass-roots health management departments at the next higher level. The repetitive issuance and filling-in should be eliminated, the work efficiency and quality should be improved, and the burden on grass-roots units should be effectively reduced.
8. Bringing into Full Play the Role of Disease Control and Other Specialized Public Health Institutions
9. Increase publicity
Continue to carry out project propaganda, focusing on improving project awareness and public perception. In 2019, the provinces will submit the basic information of basic public health service institutions (including institutional information, address, contact number, content of undertaking projects, etc.) to the national management information system of basic public health service projects. The National Health Commission will make the basic information available to the public in a unified way to facilitate public inquiry. County (city, district) and grass-roots medical and health institutions should place prominent posters on promotional posters produced by the State Health Commission or provincial health administrative departments; when using funds for basic public health services to carry out their work, prominent positions of promotional materials should be displayed in striking fonts to indicate basic public health services projects. u201d Public service advertisements for basic public health services produced by the State Health and Health Commission are widely broadcast. Encourage grass-roots medical and health institutions to classify and refine the service content, carry out personalized publicity, and regularly push health education information to residents of the jurisdiction if conditions permit.
Ministry of Finance, State Health Commission
State Administration of Traditional Chinese Medicine
30 August 2019
Source: Zhong Qiming_NF5619, Responsible Editor of the National Health Commission of the Peoples Republic of China