基层中医药服务能力建设解决方案

　　Solutions to the Capacity Building of Grass-roots TCM Services

　　Notice on the implementation plan of the project of enhancing the service capacity of Chinese medicine at the grass-roots level is issued to the departments of health, Chinese medicine, human resources and social security, food and Drug Administration of provinces, autonomous regions and municipalities directly under the Central Government, the Health Bureau of Xinjiang Production and Construction Corps, the Social Security Bureau of human resources and the food and drug administration.

　　In order to conscientiously organize and implement the project of enhancing the service capacity of grass-roots Chinese medicine, the State Administration of Traditional Chinese Medicine and other five departments have jointly formulated the Project of Implementing the Project of Implementing the Improvement of Service Capacity of Grass-roots Chinese Medicine (No. 31 of Chinese Medical Administration [2012]), the State Administration of Traditional Chinese Medicine, the Ministry of Health, the Ministry of Human Resources and Social Security, and the State Food and Drug Administration. The implementation plan of the project of improving service capability is now issued to you. Please follow it.

　　State Administration of Traditional Chinese Medicine, Ministry of Health, Ministry of Human Resources and Social Security, State Food and Drug Administration

　　28 September 2012

　　In order to conscientiously organize and implement the upgrading project of grass-roots TCM service capability (hereinafter referred to as the upgrading project), according to the Opinions of the State Administration of Traditional Chinese Medicine, the Ministry of Health, the Ministry of Human Resources and Social Security, the State Food and Drug Administration and the Ministry of Health of the General Logistics on Implementing the upgrading project of grass-roots TCM service capability (China Medical Administration [2012] 31) (hereinafter referred to as "Opinions"). To formulate the implementation plan.

　　I. Working objectives

　　(1) Overall objectives

　　By 2015, the grass-roots Chinese medicine (Ethnic Medicine, the same below) service network with community health service centers, Township hospitals, community health service stations, village clinics as the main body, traditional Chinese medicine hospitals (Ethnic Medicine Hospital, Integrated Chinese and Western Medicine Hospital, the same below) as the leading and supporting organizations and social capital as the supplement has been basically established, and the facilities and facilities of traditional Chinese medicine service are basically complete. The staffing is more reasonable, the quality is further improved, and the ability is further improved. It basically meets the needs of urban and rural residents for medical and health services of traditional Chinese medicine. It makes it more convenient, more effective and cheaper for urban and rural residents to see traditional Chinese medicine. Through traditional Chinese medicine, health care can be prevented from getting sick, less getting sick and delaying getting sick.

　　(2) Annual targets

　　1. By the end of 2013, more than 85% of community health service centers, more than 70% of township hospitals, more than 60% of community health service stations and more than 60% of village clinics can provide TCM services.

　　2. By the end of 2014, more than 90% of community health service centers, 80% of township health centers, 65% of community health service stations and 62.5% of village health centers can provide traditional Chinese medicine services.

　　3. By the end of 2015, more than 95% of community health service centers, more than 90% of township hospitals, more than 70% of community health service stations and more than 65% of village clinics can provide traditional Chinese medicine services.

　　4. The service volume of TCM in primary medical and health institutions in counties (cities and districts) has increased annually, and has increased significantly during the 12th Five-Year Plan period.

　　(3) Local objectives

　　1. Provinces (districts and municipalities) should further refine and refine local work objectives around the overall objectives and annual objectives, formulate implementation plans, and implement them after consultation with the State Administration of Traditional Chinese Medicine, the Ministry of Health, the Ministry of Human Resources and Social Security and the State Food and Drug Administration.

　　2. The annual target of each city (prefecture) shall be agreed by each province (district, city) and each city (prefecture).

　　3. The annual target of each county (city, district) shall be agreed by each city (prefecture) and each county (city, district).

　　II. Major Tasks

　　(1) Promoting the implementation of various policies of traditional Chinese medicine at the grass-roots level

　　1. Give full play to the advantages and functions of traditional Chinese medicine in improving the national health insurance system.

　　(1) All Shenhe counties should increase the reimbursement ratio of traditional Chinese medicine in the new rural cooperative medical system;

　　(2) All Shenhe counties include non-drug diagnostic and therapeutic techniques such as acupuncture and moxibustion and therapeutic massage into the reimbursement scope of the new rural cooperative medical system, and guide the application of appropriate techniques of traditional Chinese medicine;

　　(3) When formulating the reimbursement catalogue of the provincial New Rural Cooperative Medical System (NRCMS), all provinces (districts and municipalities) include qualified medical institutions'traditional Chinese medicine preparations in the catalogue.

　　(4) All provinces (districts and municipalities) have included qualified medical institutions, such as traditional Chinese medicine preparations, acupuncture and moxibustion, therapeutic massage and other traditional Chinese medicine non-drug diagnosis and treatment technologies into the reimbursement scope of basic medical insurance;

　　(5) Provinces (districts, municipalities) and co-ordinated areas should comprehensively carry out total payment control, adapt to the establishment of graded medical system, improve differential payment policies, further tilt the proportion of payment to the grass-roots level, and encourage urban and rural residents to use traditional Chinese medicine services at the grass-roots level.

　　2. To embody the characteristics of traditional Chinese medicine in consolidating and improving the system of essential drugs.

　　(1) All counties (cities and districts) shall, in accordance with the requirements of the essential drug system, equip all grass-roots medical and health institutions with the necessary pieces of traditional Chinese medicine and the varieties of Chinese patent medicines;

　　(2) The administration of essential medicines in all counties (cities and districts) shall be carried out in accordance with the relevant policies and regulations of the relevant departments of the State Council on the pricing, procurement, distribution, use and payment of basic medical insurance of traditional Chinese medicines.

　　(3) Encourage provincial units to carry out comprehensive evaluation of clinical use of Chinese patent medicines and Chinese herbal decoction pieces, and encourage the use and promotion of traditional Chinese medicine prescriptions with regional characteristics of simplicity, convenience, testing and cheapness.

　　3. The content of traditional Chinese medicine is taken as an important part in the performance appraisal and evaluation of primary medical and health institutions.

　　(1) In the performance appraisal of community health service institutions in all counties (cities and districts), TCM service should be listed as a first-class index, and the proportion of TCM content score should not be less than 10%.

　　(2) In the performance appraisal of township hospitals, all counties (cities and districts) regard "the proportion of outpatient clinics of traditional Chinese medicine in total outpatient clinics" as an important appraisal index; in the appraisal of township hospitals, the construction of traditional Chinese medicine departments and the provision of traditional Chinese medicine services are listed as important indicators, and the content score of traditional Chinese medicine should account for a certain proportion.

　　(2) Strengthen the construction of grass-roots TCM service network

　　More than 1.95% of the community health service centers set up TCM and TCM clinics and equipped with TCM diagnostic and therapeutic equipment in accordance with the Regulations on the Management of Community Health Service Institutions and the Basic Standards of Community Health Service Centers issued jointly by the Ministry of Health and the State Administration of Traditional Chinese Medicine.

　　More than 2.90% of township health centers set up TCM departments and TCM dispensaries, equipped with TCM diagnostic and therapeutic equipment, in accordance with the "Rules for the Management of Township Health Centres" issued jointly by the Ministry of Health and other five departments, and the "Basic Standards of TCM in Township Health Centres" issued jointly by the Ministry of Health and the State Administration of Traditional Chinese Medicine.

　　More than 3.70% of community health service stations and 65% of village clinics are equipped with appropriate TCM diagnostic and therapeutic equipment.

　　4. Strengthen the leading construction of county-level TCM hospitals.

　　(1) All provinces (districts and municipalities) have carried out the construction of basic conditions, key specialties and informationization of county-level TCM hospitals. 70% of county-level TCM hospitals have reached the level of second-level and first-class TCM hospitals, and each county-level TCM hospital has at least four provincial (including provincial) or higher TCM specialties.

　　(2) All provinces (districts and municipalities) have strengthened the construction of TCM pharmacies in general hospitals of counties (cities and districts) where TCM hospitals have not yet been established, and all of them have met the Basic Standards for Clinical Departments of TCM in General Hospitals and Basic Standards for Hospital TCM pharmacies.

　　(3) Strengthen the training of grass-roots TCM talents and team building

　　More than 1.95% of community health service centers and more than 90% of township health centers accounted for more than 20% of the total number of doctors in this institution.

　　More than 2.70% of the community health service stations are equipped with at least one TCM physician or clinical physician who can provide TCM services.

　　More than 3.65% of village clinics are equipped with at least one rural doctor who mainly serves traditional Chinese medicine or one rural doctor who can work in Zhonghui West.

　　4. At least one or more municipalities in all provinces (districts and municipalities) shall carry out the management of rural doctors according to the relevant requirements of Rural Doctors Employment Regulations and Opinions.

　　5. All provinces (districts and municipalities) carry out standardized training and post-transfer training for general practitioners of traditional Chinese medicine and assistant general practitioners of traditional Chinese medicine in economically underdeveloped rural areas. The proportion of general practitioners of traditional Chinese medicine accounted for more than 20% of primary general practitioners, and that of general practitioners of traditional Chinese medicine accounted for more than 50%.

　　6. Provinces (districts and municipalities) carry out the work of leading and Apprenticeship of grassroots veteran Chinese medicine experts, and train practical talents of Chinese medicine for grassroots level through the way of teacher-to-student.

　　7. All provinces (districts and municipalities) carry out education and continuing education of professional qualifications of traditional Chinese medicine for on-the-job Chinese medicine personnel at the grass-roots level, and carry out training of knowledge and skills of traditional Chinese medicine for clinicians and rural doctors.

　　(4) Strengthening the Construction of the Characteristic Advantages of Traditional Chinese Medicine in Primary Medical and Health Institutions

　　More than 1.95% of the community health service centers and all the central township hospitals have built integrated service areas of traditional Chinese medicine with centralized clinical departments, comprehensive use of various methods and means of traditional Chinese medicine, strong cultural atmosphere of traditional Chinese medicine and relatively independent.

　　2. All county-level hospitals of traditional Chinese medicine and large and medium-sized urban hospitals of traditional Chinese medicine have set up basic-level guidance departments, which provide basic-level medical and health institutions with professional guidance of traditional Chinese medicine in various forms, such as continuing education, itinerant medical treatment, rotational downward assignment and technical training.

　　3. All provinces (districts and municipalities) have carried out the pilot work of integrated management of TCM personnel in counties and villages, explored the vertical flow mechanism of TCM doctors in counties, townships and villages, and gradually established the mechanism of county-level TCM hospitals to assist township hospitals in building TCM departments from the perspectives of talents, technology and so on.

　　(5) Promoting appropriate techniques of traditional Chinese medicine for common diseases and frequently-occurring diseases at grass-roots level

　　1. All counties (cities and districts) have established a base for popularizing appropriate technology of TCM for common diseases and frequently-occurring diseases at the grass-roots level.

　　2. All counties (cities and districts) promote appropriate technologies of traditional Chinese medicine focusing on the Handbook of Appropriate Techniques of Traditional Chinese Medicine at the grassroots level and the Catalogue of Appropriate Techniques announced by the State Administration of Traditional Chinese Medicine. Among the grass-roots medical and health institutions that can provide TCM services, each community health service center and township health center can carry out at least 10 TCM appropriate technologies, and each community health service station and village clinic can carry out at least 4 TCM appropriate technologies.

　　(6) Promoting the development of preventive and health care services of traditional Chinese medicine in grass-roots medical and health institutions

　　1. All provinces (districts and municipalities) have strengthened the training of the theory and application methods of TCM physique identification in grass-roots medical and health institutions, and increased the proportion of TCM physique identification in residents'health records year by year.

　　2. All provinces (districts and municipalities) have promoted the development of health education of TCM in grass-roots medical and health institutions in accordance with the Basic Contents of Health Education of TCM. More than 40% of the contents of TCM should be included in printed materials of health education, types and quantities of audio-visual materials, updates of propaganda columns, lectures and consultation activities.

　　3. All provinces (districts and municipalities) have promoted grass-roots medical and health institutions to use TCM technology for health management of children, pregnant and lying-in women, elderly people, hypertension and type 2 diabetes mellitus in accordance with the requirements of the Technical Specification for TCM Health Management, so as to improve the rate of TCM health management of key groups and chronic patients year by year.

　　(7) Encouraging social forces to organize medical institutions of traditional Chinese medicine at the grass-roots level

　　1. All provinces (districts and municipalities) have formulated and implemented policies and measures to encourage qualified TCM professionals, especially veteran TCM doctors, to open TCM clinics or practice medicine individually at the grass-roots level.

　　2. All provinces (districts and municipalities) have formulated and implemented policies and measures to encourage qualified grass-roots drug chain enterprises to set up clinics in traditional Chinese medicine.

　　3. Provinces (districts and municipalities) have further implemented policies on price, taxation, fixed medical insurance sites, land, construction of key disciplines and evaluation of professional titles, giving priority support to non-profit medical institutions of traditional Chinese medicine run by various social capital.

　　(8) Strengthen the supervision and management of traditional Chinese medicine at grass-roots level according to law

　　1. Strengthen the supervision and management of traditional Chinese medicine, and all grass-roots medical and health institutions implement various standards and technical norms of traditional Chinese medicine industry.

　　2. Strengthen the management of the use of traditional Chinese medicine. All provinces (districts and municipalities) have trained and promoted the Guiding Principles of Clinical Application of Chinese Patent Medicine, the Guidelines for Clinical Application of Essential Drugs (Chinese Patent Medicine), and the Guidelines for Clinical Application of Traditional Chinese Medicine Injections to guide the rational use of Chinese Patent Medicine by grass-roots medical personnel. On the basis of standardized management, all provinces (districts and municipalities) have formulated and implemented policies and measures to allow rural TCM technicians to self-collect, self-cultivate and self-use folk traditional Chinese medicine.

　　3. To strengthen the quality supervision of traditional Chinese medicine, all provinces (districts and municipalities) strictly regulate the procurement procedures of Chinese medicine decoction pieces in grass-roots medical and health institutions. They should require grass-roots medical and health institutions to strictly examine the qualifications of enterprises engaged in the production and operation of Chinese medicine decoction pieces, and strictly prohibit the entry of fake and inferior Chinese medicine into grass-roots medical and health institutions and individual clinics.

　　(9) Promoting the activities of "Chinese Traditional Medicine Traveling into Countryside, Community and Family"

　　All provinces (districts and municipalities) have comprehensively carried out the activities of "Chinese traditional medicine travel into the countryside into the community and into the family", and carried out the popular propaganda activities of Chinese traditional medicine culture, which are popular with the masses, rich in content and diverse in form. The knowledge of Chinese traditional medicine culture has spread to more than 80% of administrative villages, 85% of communities and 80% of families throughout the country.

　　III. Key Projects

　　(1) Capacity-building Project of Appropriate Technical Services of Traditional Chinese Medicine at the Grass-roots Level

　　1. To build standardized comprehensive service areas of traditional Chinese medicine and standardized traditional Chinese Medicine pharmacies in community health service centers and township health centers.

　　2. To equip community health service stations and village clinics with appropriate TCM diagnostic and therapeutic equipment.

　　3. Depending on the existing resources of TCM, at least one provincial TCM appropriate technology promotion base has been built in each province (region, city), and one county (city, district) grass-roots level TCM suitable technology promotion base for common diseases and frequently-occurring diseases has been built.

　　4. To formulate catalogues of appropriate technologies for general medical treatment and preventive health care of TCM, catalogues of herbal pieces suitable for grass-roots units, and prescriptions of TCM that have been clinically verified and have reliable curative effects, for popularization and selection in various places.

　　(2) Standardization Construction Project of Grass-roots Medical and Health Institutions

　　In the standardization construction of village clinics, township hospitals and community health service institutions jointly implemented by the state and local governments, the function construction of traditional Chinese medicine should be strengthened so that basic medical and health institutions at the grass-roots level have the basic conditions for developing traditional Chinese medicine services. In the performance appraisal of the project, the compliance of TCM departments is regarded as one of the key indicators of the compliance of primary medical and health institutions.

　　(3) Training Program of Traditional Chinese Medicine Talents at Grass-roots Level

　　To train 15,000 backbone clinical technicians of TCM (including 500 ethnic doctors) for county-level medical institutions, to educate 50,000 eligible rural doctors and TCM personnel in township hospitals with professional college degree of TCM (including ethnic medicine), to train rural doctors with basic knowledge and skills of TCM (including ethnic medicine), and to train 30,000 grass-roots medical personnel for urban and rural areas. General practitioners of traditional Chinese medicine (TCM) have selected 8000 veteran TCM specialists at the grass-roots level to train a group of basic TCM talents for county, township, village and community health service institutions and a group of TCM preventive and health personnel.

　　(4) Standardization Construction Project of County-level Traditional Chinese Medicine Hospital

　　According to the "Standards for the Construction of Traditional Chinese Medicine Hospitals", the county-level Chinese Medicine Hospitals run by the government that did not meet the national standards were rebuilt, expanded and equipped with basic medical equipment, improved service conditions and improved service capacity, and strived to make the infrastructure conditions of most county-level Chinese Medicine Hospitals basically meet the national standards at the end of the "Twelfth Five-Year Plan".

　　(5) Key (Characteristic) Specialized Construction Projects of Traditional Chinese Medicine in Rural Medical Institutions

　　Strive to cultivate and build more than one key (characteristic) specialty of TCM for each county-level TCM hospital.