Circular 28/2023/TT-BYT scope of medical examination and treatment provision of health workers of units without medical establishments

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Circular No. 28/2023/TT-BYT dated December 29, 2023 of the Ministry of Health on the scope of medical examination and treatment provision, and professional contents of the training programs for health workers working in healthcare divisions of agencies, units or organizations without medical examination and treatment establishments
Issuing body: Ministry of HealthEffective date:
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Official number:28/2023/TT-BYTSigner:Nguyen Thi Lien Huong
Type:CircularExpiry date:Updating
Issuing date:29/12/2023Effect status:
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Fields:Medical - Health

SUMMARY

Contents of the training programs for health workers working

On December 29, 2023, the Ministry of Health issues Circular No. 28/2023/TT-BYT on the scope of medical examination and treatment provision, and professional contents of the training programs for health workers working in healthcare divisions of agencies, units or organizations without medical examination and treatment establishments. Bellows are a number of remarkable contents of this Circular:

1. The initial training period is 40 hours, including testing and evaluation time, focusing on training professional and practical skills. Professional update training shall be conducted every 5 years with a period at least equal to 50% of the initial training period, including testing and evaluation time;

2. Educational institutions in the health specialty, health establishments that have the function or are assigned the task of training medical human resources (hereinafter referred to as training establishments) shall develop, evaluate and promulgate training programs and materials suitable for each training subject; publicly announce information about the training courses on the their websites before organizing the training and granting certificates in accordance with applicable laws on education.

3. List of diseases examined for early detection, initial treatment and consultation at healthcare divisions of agencies, units and organizations. Including: Hypertensive diseases (I10-I15); Diabetes mellitus (E10-E14); Conjunctivitis (H10); Allergic rhinitis (J30.1 - J30.4); Acute nasopharyngitis (common cold) (J00); Acute sinusitis (J01); etc.

This Circular takes effect from January 01, 2024.
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THE MINISTRY OF HEALTH
____

No. 28/2023/TT-BYT

THE SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness

_______________________

Hanoi, December 29, 2023

CIRCULAR

On the scope of medical examination and treatment provision, and professional contents of the training programs for health workers working in healthcare divisions of agencies, units or organizations without medical examination and treatment establishments

_____________________

 

Pursuant to the Law on Medical Examination and Treatment No. 15/2023/QH15 dated January 1, 2023;

Pursuant to the Government’s Decree No. 95/2022/ND-CP dated November 15, 2022, defining the functions, tasks, powers and organizational structure of the Ministry of Health;

At the proposal of the Director of the Health Environment Management Agency;

The Minister of Health hereby promulgates the Circular on the scope of medical examination and treatment provision, and professional contents of the training programs for health workers working in healthcare divisions of agencies, units or organizations without medical examination and treatment establishments.

 

Article 1. Scope of regulation

This Circular guides the provisions of Point b Clause 2 Article 19 of the Law on Medical Examination and Treatment No. 15/2023/QH15 on the scope of medical examination and treatment provision, and professional contents of the training programs for health workers working in healthcare divisions of agencies, units or organizations without medical examination and treatment establishments.

Article 2. Interpretation of terms

1. Healthcare divisions of agencies, units and organizations include:

a) Healthcare divisions of state agencies and non-business units;

b) Healthcare divisions of production and business establishments;

c) Healthcare divisions of educational institutions;

d) Healthcare divisions of other units and organizations.

2. Health workers of agencies, units or organizations specified at Points a, b and d Clause 1 of this Article include:

a) Health workers of state agencies, non-business units and other organizations and units that meet the conditions specified in Appendices III and VIII to the Minister of Home Affairs’ Circular No. 12/2022/TT-BCT dated December 30, 2022, providing guidance on positions of leaders and managers being civil servants; shared professional expertise; support and service in administrative agencies, organizations and job positions of shared professional titles; support and service in public non-business units;

b) Health workers of production and business establishments who are those in charge of healthcare work, and meet the conditions specified in Clause 3 Article 37 of the Government’s Decree No. 39/2016/ND-CP dated May 15, 2016, detailing a number of articles of the Law on Occupational Safety and Health.

3. Health workers of educational institutions specified at Point c Clause 1 of this Article include:

a) People with medical qualifications who are in charge of healthcare work in school health work and meet the requirements specified in Clause 2 Article 8 of Joint Circular No. 13/2016/TTLT-BYT-BGDDT dated May 12, 2016, of the Minister of Health and the Minister of Education and Training, providing regulations on school healthcare (hereinafter after referred to as Joint Circular No. 13/2016/TTLT-BYT-BGDDT); Clause 2 Article 7 of Circular No. 33/2021/TT-BYT dated December 31, 2021, of the Minister of Health, on school healthcare in higher education institutions and vocational education institutions ( hereinafter referred to as Circular No. 33/2021/TT-BYT);

b) People with medical qualifications who fail to meet the requirements specified in Joint Circular No. 13/2016/TTLT-BYT-BGDDT, Circular No. 33/2021/TT-BYT, and people without medical qualifications who are assigned the school healthcare tasks.

Article 3. Scope of medical examination and treatment provision, and professional contents of the training programs for health workers working in healthcare divisions of agencies, units or organizations specified at Points a, b and d Clause 1 Article 2 of this Circular

1. In case the health workers fail to possess an assistant doctor diploma or doctor training diploma and have completed a training program according to the professional contents specified in Clause 3 of this Article, they may provide medical examination and treatment within the permitted scope of operation according to:

a) The List provided in Appendix I to this Circular;

b) Designations of the persons licensed to practice medical examination and treatment: injection, taking test samples (blood, urine, secretions).

2. In case the health workers possess an assistant doctor diploma or doctor training diploma and have completed a training program according to the professional contents specified in Clause 3 of this Article, they may, in addition to the scope of provision of medical examination and treatment as prescribed in Clause 1 of this Article, provide medical examination for early detection, initial treatment, and advice patients to go to health establishments, in case of necessity, for diseases specified in Appendix II to this Circular.

3. Professional contents of the training programs: Health workers must be provided with training courses, and granted a professional certificate in occupational health as prescribed in the Minister of Health’s Circular No. 29/2021/TT-BYT dated December 24, 2021, guiding professional training in occupational health.

Article 4. Scope of medical examination and treatment provision, and professional contents of the training programs for health workers working in healthcare divisions of educational institutions specified at Point c Clause 1 Article 2 of this Circular

1. In case the health workers fail to possess an assistant doctor diploma or doctor training diploma and have completed a training program according to the professional contents specified in Clause 3 of this Article, they may provide medical examination and treatment within the permitted scope of operation in accordance with the provisions of Appendix I to this Circular.

2. In case the health workers possess an assistant doctor diploma or doctor training diploma and have completed a training program according to the professional contents specified in Clause 3 of this Article, they may, in addition to the scope of provision of medical examination and treatment as prescribed in Clause 1 of this Article, provide medical examination for early detection, initial treatment, and advice patients to go to health establishments, in case of necessity, for diseases specified in Appendix III to this Circular.

3. Professional contents of the training programs:

a) Professional contents of the training programs are provided in Appendix IV to this Circular;

b) The initial training period is 40 hours, including testing and evaluation time, focusing on training professional and practical skills. Professional update training shall be conducted every 5 years with a period at least equal to 50% of the initial training period, including testing and evaluation time;

c) Educational institutions in the health specialty, health establishments that have the function or are assigned the task of training medical human resources (hereinafter referred to as training establishments) shall develop, evaluate and promulgate training programs and materials suitable for each training subject; publicly announce information about the training courses on the their websites before organizing the training and granting certificates in accordance with applicable laws on education.

d) Forms of training: Full-time.

Article 5. Reference provisions

In case any documents referred to in this Circular are amended, supplemented or replaced, the new ones shall prevail.

Article 6. Effect

1. This Circular takes effect from January 01, 2024.

2. Health workers working in healthcare divisions of educational institutions may continue to carry out activities related to medical examination and treatment as prescribed in Joint Circular No. 13/2016/TTLT-BYT-BGDDT, Circular No. 33/2021/TT-BYT, and must complete the professional training courses on medical examination and treatment in accordance with this Circular before December 31, 2025.

Article 7. Implementation responsibility

Director of the Health Environment Management Agency, Chief of the Ministry Office, Directors and Director Generals of the Ministry of Health, Directors of Health Departments of provinces and centrally-run cities, and relevant agencies, organizations and individuals shall implement this Circular.

Any difficulties arising in the course of implementation shall be reported to the Ministry of Health (the Health Environment Management Agency) for consideration and settlement./.

 

 

FOR THE MINISTER
THE DEPUTY MINISTER



Nguyen Thi Lien Huong

 

Appendix I

Scope of medical examination and treatment provision of health workers working in healthcare divisions of agencies, units, organizations and educational institutions

(Attached to the Minister of Health’s Circular No. 28/2023/TT-BYT dated December 29, 2023)

__________________________

 

No.

List of medical examination and treatment activities

Health workers in healthcare divisions of agencies, units, and organizations specified in Clause 2 Article 2 of this Circular

Health workers working in healthcare divisions of educational institutions

Specified at Point a Clause 3 Article 2 of this Circular

Specified at Point b Clause 3 Article 2 of this Circular

1

Observation, evaluation, and assessment of the entire body condition of the patients

x

x

x

2

Assessment of nutritional status, measure height and weight

x

x

x

3

Measuring and counting the patients’ vital signs: pulse, temperature, blood pressure

x

x

x

4

Consulting on the prevention and control of refractive errors

x

x

x

5

Consulting on the prevention and control of overweight, obesity, and malnutrition

x

x

x

6

Consulting on the prevention and control of scoliosis

x

x

x

7

Consulting on the prevention and control of dental diseases

x

x

x

8

Psychological counseling

x

x

 

9

Consulting on nutrition and exercise

x

x

 

10

Consulting on prevention, control and initial treatment of measles

x

x

 

11

Consulting on prevention, control and initial treatment of mumps

x

x

 

12

Consulting on prevention, control and initial treatment of hand, foot and mouth disease

x

x

 

13

Consulting and initial care for people with diarrhea

x

x

 

14

Consulting and health care for pregnant women

x

  

15

Consulting and care for people with upper respiratory tract infections

x

x

 

16

Consulting and caring for flu patients

x

x

 

17

Consulting and caring for flu patients

x

x

 

18

Consulting and initial care for dengue fever patients

x

x

 

19

Consulting on health promotion care

x

x

x

20

Consulting on epidemic prevention and control

x

x

x

21

Consulting on prevention and control of diseases related to occupation

x

  

22

Initial first aid for signs of respiratory, circulatory, and cardiovascular danger

x

x

x

23

First aid and bandage for bleeding soft tissue wounds

x

x

x

24

First aid and temporary immobilization of all types of fractures, sprains, and dislocations

x

x

x

25

First aid and initial treatment for burns

x

x

x

26

First aid for poisoning (food, toxic gas)

x

x

x

27

First aid for sunstroke and heat stroke

x

x

x

28

First aid for drowning

x

x

x

29

First aid for foreign objects in the airway

x

x

x

30

First aid for electric shock and lightning

x

x

x

31

First aid for other accidents:  falls, burial, eye injuries

x

x

x

32

Treatment of snake bites, immobilization and first aid for snake bites

x

x

x

33

Initial treatment when bitten or stung by animals or insects

x

x

x

34

Handling mass accidents

x

x

x

35

Initial treatment of atopic dermatitis, hives, rash

x

x

 

36

Initial treatment of abdominal pain

x

x

 

37

Techniques to move patients safely

x

x

x

38

Gua sha

x

x

x

39

Changing bandages, cutting stitches

x

x

 

40

Manual acupressure massage

x

  

41

Acupressure massage for treatment of functional headaches

x

  

42

Acupressure massage for treatment of low back pain

x

  

43

Acupressure massage for treatment of sciatica pain

x

  

44

Acupressure massage for treatment of colds and flu

x

  

45

Acupressure massage for treatment of neck and shoulder pain

x

  

Note:

“x”: List of medical examination and treatment activities allowed to be provided

 

Appendix II

List of diseases examined for early detection, initial treatment and consultation at healthcare divisions of agencies, units and organizations

(Attached to the Minister of Health’s Circular No. 28/2023/TT-BYT dated December 29, 2023)

_________________

 

No.

Disease

1.

Hypertensive diseases (I10-I15)

2.

Diabetes mellitus (E10-E14)

3.

Conjunctivitis (H10)

4.

Allergic rhinitis (J30.1 - J30.4)

5.

Acute nasopharyngitis (common cold) (J00)

6.

Acute sinusitis (J01)

7.

Acute pharyngitis (J02)

8.

Acute tonsillitis (J03)

9.

Acute laryngitis and tracheitis (J04)

10.

Acute upper respiratory infections (J06)

11.

Acute lower respiratory infections (J20-J22)

12.

Atopic dermatitis (L20)

13.

Allergic contact dermatitis (L23)

14.

Irritant contact dermatitis (L24)

15.

Acute appendicitis (K35)

16.

Epilepsy (G40)

17.

Acute diarrhea

18.

Some common infectious diseases:

- Cholera (A00)

- Shigellosis (A03)

- Amoebiasis (A06)

- Typhoid and paratyphoid fevers (A01)

- Foodborne intoxications (A05)

- Viral hepatitis (B15, B16)

- Influenza and pneumonia (J09-J18)

- Tuberculosis (A15-A19)

- Dengue (A97)

- Malaria (B50-B54)

- Typhus fever (A75)

- Rabies (A82)

- Rubella (B06)

- Encephalitis (G05)

- Meningitis (G00)

- Meningococcal meningitis (A39.0)

- Measles (B05)

- Mumps (B26)

- Varicella (chickenpox) (B01)

- Smallpox (B03)

- Diphtheria (A36)

- Whooping cough (A37)

- Tetanus (A35)

- Leptospirosis (A27)

- Hand, foot and mouth disease (HFMD)

- Severe acute respiratory syndrome (ARDS) (U04)

- COVID-19 (U07.1, U07.2)

- Human immunodeficiency virus [HIV] disease (B20-B24)

19.

Occupational diseases on the list of occupational diseases covered by social insurance (35 occupational diseases as prescribed in the Minister of Health's Circular No. 15/2016/TT-BYT dated May 15, 2016, providing for occupational diseases covered by social insurance, and the Minister of Health's Circular No. 02/2023/TT-BYT dated February 9, 2023, amending and supplementing a number of articles of the Minister of Health's Circular No. 15/2016/TT-BYT dated May 15, 2016, providing for occupational diseases covered by social insurance).

20.

Diseases related to occupation: Hypertension, varicose veins of the lower limbs, musculoskeletal disorders, psychological-behavioral disorders, skin diseases, diseases caused by biological agents.

 

Appendix III

List of diseases examined for early detection, initial treatment and consultation at healthcare divisions of educational institutions

(Attached to the Minister of Health’s Circular No. 28/2023/TT-BYT dated December 29, 2023)

____________

 

No.

Disease

1.

Acute tonsillitis (J03)

2.

Conjunctivitis (H10)

3.

Allergic rhinitis (J30.1 - J30.4)

4.

Allergic contact dermatitis (L23)

5.

Acute diarrhea

6.

Epilepsy (G40)

7.

Common diseases and illnesses in school age

- Disorders of refraction and accommodation (H52)

- Scoliosis (M40-M41)

- Malnutrition (E40-E46)

- Dry eye disease due to Vitamin A deficiency

- Goiter due to iodine deficiency (E01)

- Obesity (E66)

- Dental disease

- Asthma (J45)

- Mental and behavioral disorders (F00-F99)

8.

Some common infectious diseases:

- Cholera (A00)

- Shigellosis (A03)

- Amoebiasis (A06)

- Typhoid and paratyphoid fevers (A01)

- Foodborne intoxications (A05)

- Helminthiases (B65-B83)

- Hand, foot and mouth disease (HFMD)

- Influenza (J9-J11)

- Acute respiratory infections in children (J00-J06)

- Whooping cough (A37)

- Tuberculosis (A15-A19)

- Diphtheria (A36)

- Measles (B05)

- Mumps (B26)

- Dengue (A97)

- Encephalitis (G05)

- Varicella (chickenpox) (B01)

- Meningitis (G00)

- Rubella (B06)

- COVID-19 (U07.1, U07.2)

- Malaria (B50-B54)

- Trachoma (A71)

- Scabies (B86)

- Pediculosis and phthiriasis (B85)

 

Appendix IV

Professional contents of the training programs for health workers working in healthcare divisions of educational institutions

(Attached to the Minister of Health’s Circular No. 28/2023/TT-BYT dated December 29, 2023)

____________________

 

No.

Professional contents

Health workers of educational institutions specified at Point a Clause 3 Article 2 of this Circular

Health workers of educational institutions specified at Point b Clause 3 Article 2 of this Circular

1

Overview of school health work

x

x

2

Characteristics of physical and psychological development of school age

x

x

3

Preventing risk factors for accidents, injuries, school illnesses and diseases

x

x

4

Essential drugs and how to use them

x

 

5

Providing first aid

x

x

6

Initial treatment of some common symptoms, diseases and illnesses in educational institutions, counseling to go to medical examination and treatment establishments in case of emergency.

x

 

7

Nutrition and food safety in schools

x

x

8

Mental health, reproductive health

x

 

9

Communication, consulting, health education

x

x

Note:

“x”: Professional contents to be trained

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