2019〕3号），建立严格规范的医疗卫生行业综合监管制度，经市人民政府同意， 9月30日，市人民政府办公室印发了《安顺市改革完善医疗卫生行业综合监管制度实施方案》 （安市办发〔 2019〕 8 号）（以下简称《实施方案》）。 In order to implement the "Implementation Opinions on the Reform and Improvement of the Comprehensive Supervision System of the Medical and Health Industry" issued by the General Office of the Provincial Government (Qianfu Office Development [ 2019] No. 3), the establishment of a strict and standardized comprehensive supervision system for the medical and health industry It was agreed that, on September 30, the Office of the Municipal People's Government issued the “Implementation Plan for the Comprehensive Improvement of the Medical and Health Industry Supervision System in Anshun City” (Anshibanfa [ 2019] No. 8 ) (hereinafter referred to as the “Implementation Plan”).
I. Background and Significance of Formulating the Implementation Plan
Since the 18th National Congress of the Communist Party of China, the city's medical and health resources and services have grown rapidly, new industries, new formats and new models of medical and health services have continuously emerged, technological means have continued to advance, and the medical and health industry supervision faces new opportunities and adjustments. Through the improvement of relevant systems, we will promote the transformation of supervision concepts, strengthen supervision synergy, innovate supervision methods, improve supervision effectiveness, and better protect the health rights of the people. Establishing a strict and standardized comprehensive supervision system for the medical and health industry is an important part of comprehensively establishing a basic medical and health system, and promoting the modernization of the medical and health governance system and governance capabilities.
2. The policy basis and drafting process of the Implementation Plan
(I) Policy basis
1. "Guiding Opinions of the General Office of the State Council on Reforming and Perfecting the Comprehensive Supervision System of the Medical Industry" (Guo Ban Fa  No. 63)
《省 人民政府办公 厅 关于改革完善医疗卫生行业综合监管制度的实施意见 》（ 黔府办发〔 2019〕3号 ） 2. " Implementation Opinions of the General Office of the Provincial People's Government on Reforming and Perfecting the Comprehensive Supervision and Control System for the Medical and Health Industry " ( Qianfu Office Development [ 2019] No. 3 )
(B) the drafting process
《省 人民政府办公 厅 关于改革完善医疗卫生行业综合监管制度的实施意见 》（ 黔府办发〔 2019〕3号 ），要求我局牵头制定《安顺市 改革完善医疗卫生行业综合监管制度的实施 方案》，我局安排法规监督科牵头草拟了《安顺市 人民政府办公 室 关于改革完善医疗卫生行业综合监管制度的实施 方案》，先后送各县（区）卫生健康局、市直各有关部门，市直医疗卫生单位和局机关有关科室广泛征求意见，并在市卫生健康局门户网站公开征求意见，将市委宣传部、人民银行安顺支行等单位反馈的意见补充到方案中，同时送局法律顾问进行法制审查，按照法律顾问的意见，完善方案后提交局党组会议审议。 On May 29, 2019, the Bureau received the " Implementation Opinions of the General Office of the Provincial People's Government on the Reform and Improvement of the Comprehensive Supervision and Control System of the Medical and Health Industry " ( Qianfu Office Development [ 2019] No. 3 ). Our Bureau has taken the lead in formulating the " Implementation Plan for the Reform and Improvement of the Comprehensive Supervision System of the Medical and Health Industry in Anshun City ". It was successively sent to the county (district) health and health bureaus, relevant municipal departments, municipal medical units and bureaus and relevant departments to solicit opinions widely, and publicly solicited opinions on the portal of the municipal health and health bureau. After the unit's feedback is added to the plan, it will be sent to the bureau's legal adviser for legal review, and according to the advice of the legal adviser, the scheme will be improved and submitted to the bureau's party group meeting for review. According to the requirements of legality review, it was sent to the Municipal Judicial Bureau for legality review, and it was revised and improved according to the review opinions of the Municipal Judicial Bureau. 9月4日，市卫生健康局召开征求意见会，再次征求市公安局、人社局等部门意见和建议，会上，市人社局、市审计局、市财政局、民政局、市住建局分别提了意见和建议，并根据征求到的意见和建议再次完善方案。 According to the arrangements of the Municipal Government Office, on September 4th, the Municipal Health and Health Bureau held a consultation session, and again sought the opinions and suggestions of the Municipal Public Security Bureau, the Human Resources and Social Security Bureau and other departments. At the meeting, the Municipal Human Resources and Social Affairs Bureau, the Municipal Audit Bureau, and the Municipal Finance Bureau , The Civil Affairs Bureau and the Municipal Housing and Construction Bureau respectively put forward their opinions and suggestions, and based on the opinions and suggestions solicited, they perfected the plan again.
Third, the characteristics of the "implementation plan"
2019〕3号文件的各项任务，确保全面贯彻落实省文件要求。 (1) Refined and perfected the various tasks of Qianfu Office in issuing [ 2019] No. 3 documents to ensure the full implementation of provincial document requirements.
(2) Refining and improving the working mechanism of medical supervision, mobilizing the daily supervision of medical and health services from inside and outside the system, especially from all sectors of society.
(3) Improve and improve the comprehensive supervision coordination mechanism and supervision mechanism, clarify the responsibilities of various departments at all levels, and strive to accelerate the improvement of a diversified comprehensive supervision system combining institutional autonomy, industry self-regulation, government supervision, and social supervision.
(4) Clarified various tasks, timelines for completion, as well as timetables and roadmaps, so as to achieve effective results.
Issues that the Implementation Plan focuses on
——构建政府主导、医疗卫生机构自我管理、行业自律和社会监督“四位一体”的综合监管体系。 (I) Who will supervise ? Construct a "four-in-one" comprehensive supervision system led by the government, self-management of medical and health institutions, industry self-regulation and social supervision.
——市、县（区）、乡（镇）三级医疗卫生机构。 (2) Who to supervise -city, county (district), township (town) level three medical and health institutions.
——通过构建综合监管体系，明确监管主体和责任；完善监管措施，加强全过程监管；创新监管机制，提升监管水平和效能；加强能力保障，提升综合监管效能等 4项工作重点23项具体措施开展全方位监管。 (3) What kind of supervision is used —by establishing a comprehensive supervision system to clarify supervision subjects and responsibilities; improving supervision measures and strengthening supervision throughout the process; innovating supervision mechanisms to improve supervision level and effectiveness; strengthening ability guarantees and improving comprehensive supervision effectiveness, etc. 4 We will carry out all-round supervision on 23 specific measures.
——建立综合监管结果协同运用机制。 (4) How to effectively use the results of supervision — Establish a mechanism for synergistic use of comprehensive results of supervision. Taking the supervision of medical supervision by the industry authorities, and the scores of bad practice behaviors of medical and health institutions and medical staff as important basis for the overall use of comprehensive results, verification with medical and health institutions, rating review, management of fixed-point agreement for medical insurance, key specialty setting, finance The investment, selection and selection of merit are linked to the employment of medical titles, promotion of jobs, evaluation of merit, and performance allocation, while seeking the opinions of the health supervision department.
——建立健全医疗卫生行业信用机制。 (5) How to jointly punish the targets of supervision -establish and improve the credit mechanism of the medical and health industry. Credit information such as administrative licenses, administrative penalties, and random inspection results in the medical and health industry will be included in the national credit information sharing platform and publicized according to law. Strict implementation of points management measures. Establish and improve the scoring system and blacklist system for bad practices of medical and health institutions and medical personnel, improve the database of credit records of the medical and health industry based on registration of practice access and records of bad practices, and strengthen the records, publicity and early warning of dishonesty.
V. Changes in the Implementation Plan
(1) Further emphasized the entire industry, all elements, the whole process, and all-round supervision of the medical and health industry, highlighting the deepening of the transfer of functions, methods, and styles, improving efficiency and efficiency, and changing the concept, system, and methods of supervision.
(2) From key supervision of public medical and health institutions to industry-wide supervision.
(3) From focusing on pre-examination approval to focusing on post-event and whole-process supervision.
(4) From single supervision to comprehensive collaborative supervision.
(5) Moving from the main use of administrative methods to the coordinated use of administrative, legal, economic, and information methods to further enhance supervision and capacity.
6. Basic principles and main objectives in the Implementation Plan
(I) Basic principles: Adhere to government-led, comprehensive coordination; supervision according to law, territorialized industry-wide management; co-governance of society, open work; reform and innovation, and improvement of efficiency.
2020年，建立完善职责明确、分工协作、透明有效的市、县（区）、乡（镇、街道）三级联动的综合监管工作制度，构建政府主导、医疗卫生机构自我管理、行业自律和社会监督“四位一体”的综合监管体系，形成专业高效、统一规范、文明公正的卫生健康执法监督队伍，实现医疗卫生行业综合监管法治化、规范化、常态化。 (II) Main objective: By 2020, establish and improve a comprehensive supervision work system with clear responsibilities, division of labor, cooperation, transparency and effectiveness at the city, county (district), township (town, and street) level, and build a government-led, medical and health institution The "four-in-one" comprehensive supervision system of self-management, industry self-discipline and social supervision forms a professional, efficient, unified, standardized, civilized and fair health and health law enforcement supervision team, and realizes the legalization, standardization and normalization of comprehensive supervision of the medical and health industry.
Content framework of the Implementation Plan
The first part: the target task.
The second part: work focus.
(1) Establish a comprehensive supervision system, and clarify the supervision subjects and responsibilities;
(2) Improve comprehensive supervision measures and strengthen supervision throughout the process;
(3) Innovate the supervision mechanism and improve the supervision level and effectiveness;
(4) Strengthen the guarantee of capabilities and enhance the effectiveness of comprehensive supervision.
Part III: Implementation steps.
2019年11月底前）。 (I) System construction stage ( before the end of November 2019).
2019年11月至2020年6月）。 (2) Full implementation phase ( November 2019 to June 2020).
2020年7月—— ）。 (3) Consolidation and promotion phase ( July 2020-).
Part IV: Work requirements.
Eight, the key interpretation of the "implementation plan"
(1) Subjects and responsibilities of medical and health industry supervision
1. Strengthen party leadership. It is emphasized that the medical and health industry should further consolidate the main responsibility of governing the party and strengthen its main responsibility. First, it is necessary to better the direction of the reform and development of the cause, promote the deep integration of party building and business work, and integrate party leadership into all aspects of hospital internal management.
2. Government's leading responsibility. Strengthen the government's leading role in the construction of the rule of law, industry planning, standard formulation, industry access, and administrative law enforcement. Establish a comprehensive supervision and coordination mechanism led by the health administrative department and the participation of relevant departments, responsible for coordinating the supervision, guidance, coordination and investigation of major medical and health services in the administrative area.
3. Responsibility for self-management of medical and health institutions. Medical and health institutions assume the main responsibility for the institution's legal practice, standardized services, service quality and safety, and style construction, and emphasize that its main person in charge is the first person responsible.
4. Self-regulatory role of industry organizations. Play the role of industry organization in formulating industry management norms and technical standards, regulating professional practices and business management, maintaining industry reputation, and mediating and handling service disputes.
5. Social supervision. Medical and health institutions consciously accept the supervision of the people's congress deputies and members of the CPPCC and accept the supervision of the whole society from the masses, the media, professional institutions and intermediary organizations.
“一优化”、“六加强” (2) "One Optimization" and "Six Enhancements"
1. Optimize access to medical and health services. Accelerate the reform of the administrative examination and approval system in the medical and health field, formulate a list of administrative examination and approval matters, further optimize the admission and administrative licensing processes for medical and health institutions, employees, and medical technology, drugs, and medical devices, and implement electronic registration of medical institutions, physicians, and nurses , Develop comprehensive inter-departmental full-process approval procedures set up by social medical institutions.
2. Strengthen supervision of medical service quality and safety.
3. Strengthen the operation and supervision of medical and health institutions.
4. Strengthen supervision of public health services
5. Strengthen supervision of medical and health practitioners.
6. Strengthen the order supervision of the medical and health service industry.
7. Strengthen the supervision of the health industry.
(3) Mechanism innovation
1. Establish a working mechanism for medical supervision, requiring the county (district) health and health administrative departments and all medical institutions to be equipped with part-time medical supervisors, responsible for the supervision and inspection of the health and health industry's style within the scope of their respective departments (units). .
2. Improve and standardize administrative law enforcement mechanisms to ensure strict and standardized, fair and civilized law enforcement.
3. Fully implement the "double random and one open" spot check mechanism to increase spot checks on key institutions.
4. Establish and improve the credit mechanism of the medical and health industry, and the joint punishment system for medical institutions and medical personnel for violations of laws and regulations, and accelerate the implementation of “one violation and one limitation” in the industry.
5. Improve the information disclosure mechanism, and regularly disclose the practice qualifications, personnel information, service items, charging standards and related permits, inspections, assessments and administrative penalties of medical institutions at all levels in the city every year.
6. Establish a risk warning and assessment mechanism, and use modern information technology to improve the ability to detect problems and prevent and resolve major risks.
7. Form a grid-based management mechanism and establish an online and offline integrated supervision method.
8. Establish a coordinated application mechanism of comprehensive supervision results, the results of which will be linked to the verification of medical and health institutions, rating review, management of fixed-point agreement for medical insurance, key specialty setting, financial investment, and evaluation of first-rate and excellent results, as well as the results of medical service supervision for employees It is linked to the appointment of titles, promotion of posts, evaluation of the best, and performance distribution.
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