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国务院大督查来了,家庭医生签约6大政策要落实

2018-07-17 于小渔 基层医师公社

近日,国务院印发《关于开展2018年国务院大督查的通知》,部署开展2018年大督查。在医疗方面,明确提出要重点督查家庭医生签约服务情况。

2018国务院大督查启动了!重点查处政策不落实、管理不到位等问题。

近日,国务院印发《关于开展2018年国务院大督查的通知》,部署开展2018年大督查。在医疗方面,明确提出要重点督查家庭医生签约服务情况。




在今年4月份,国家卫健委发布了《关于做好2018年家庭医生签约服务工作的通知》(以下简称《通知》),对于年家庭医生签约服务工作提出了一系列要求,对家庭医生的待遇保障也做出了明确指示。

如今2018年已过半,这些政策都落实的怎么样了?督查查的就是这些,而政策落实,也是我们家庭医生的心声。

接下来我们一起看看,在2018年家庭医生签约服务方面,需要落实哪些政策和待遇?这些就是督查的重点:

一、不要层层加码,注重签约质量

《通知》里提出各地要结合服务能力及资源配置情况,实事求是、科学合理确定签约服务的工作目标。

在稳定签约数量、巩固覆盖面的基础上,把工作重点向提质增效转变,做到签约一人、履约一人、做实一人,不断提高居民对签约服务的获得感和满意度。不要盲目追求签约率,不要层层加码,同时要采取措施避免签约服务数量下滑。

要求很明确,各地方不能再秉承“唯指标”论给基层医生层层加码,要根据实际情况制定目标,重在质量不在数量,做实做细才是根本。

二、落实绩效收入,多劳多得

提高家庭医生签约积极性才是提高服务质量的根本,所以家庭医生签约的绩效收入必须得到保障。在《通知》当中,关于家庭医生收入一共提到以下三点:

1、签约服务费作为家庭医生团队所在基层医疗卫生机构收入组成部分,可用于人员薪酬分配。

2、推进服务价格调整。各地要协调价格主管部门,合理调整签约服务有关项目价格,特别是增补和调整充分体现家庭医生团队成员技术劳务价值的巡诊、家庭病床、家庭护理等服务项目价格。

3、基层医疗卫生机构要建立完善机构内部管理考核工作机制,考核结果要与家庭医生团队和个人绩效分配挂钩,坚持多劳多得、优绩优酬。

这些提高绩效的方法是否得到落实,应该是督查的内容之一。

三、二级以上医院要指定专人负责对接

家庭医生团队并不是基层医生的单打独斗,需要上下级医院来共同配合支持,才能完成基层首诊,双向转诊的任务。

国家卫健委医政医管局副局长焦雅辉曾提到,总理要求家庭医生签约团队中一定要有二级以上医院的医生,这样老百姓才信任,也能让大医院的医生下沉到社区,而不是把社区搞得大而全。

在今年3月份,甘肃就规定要根据患者病情需要,由省、市、县、乡、村五级医疗机构医务人员共同组成满足需要的若干个家庭医生签约服务团队。

省、市级医疗机构抽调相关专业副高级职称以上专家,作为签约团队的省市级专家,各县级医疗机构抽调相关专业副高级职称以上的专家作为签约团队的县级专家。并且专家还要定期入户随访,发现问题及时解决。

前不久内蒙古也要求家庭医生签约服务要有二级医院医疗技术支撑。在二级以上医院组建专科服务团队,与辖区或医共体内基层机构家庭医生服务团队结对,通过定期坐诊、设立慢病联合门诊、开展远程诊疗、接受转诊等形式参与复杂疾病、疑难病患者的签约医疗服务。

《通知》中也提到,二级以上医院要指定专人负责对接,为转诊患者建立绿色通道。因此,上级医院在家庭医生签约服务方面,对接与指导工作做得如何,也是家庭医生签约服务工作的重点内容之一。

四、落实全科医生津贴

《通知》要求有条件的地方在绩效工资内部分配时设立全科医生津贴项目,在绩效工资中单列。提升全科医生工资水平,使其与当地县区级公立医院同等条件临床医师工资水平相衔接。

今年年初,国务院发布《国务院办公厅关于改革完善全科医生培养与使用激励机制的意见》,对全科医生岗位实施多项利好政策,同时全科医生作为家庭医生的核心成员,其待遇落实情况必然是督查重点。

五、完善与二级以上医院用药衔接

基层缺药现象一直被基层医生和患者所诟病,并且,二级以上医院与基层用药衔接不好会直接导致家庭医生签约不顺利。

因此在年初的《通知》中明确提出要保障签约居民基本用药。合理配备基层医疗卫生机构药品,加快完善与二级以上医院用药衔接。有条件地区可开展药物第三方配送,为签约居民提供便捷服务。

所以,相信药品保障和衔接情况也将是国务院此次对各部门在家庭医生工作方面督查重点。

六、家庭医生配备助手

为了分解家庭医生工作的压力,国家鼓励配备助手提供支持性服务,减轻家庭医生非医疗事务工作负荷。

另外,鼓励药师、健康管理师、心理咨询师、社(义)工等加入团队,发挥乡镇(街道)卫生计生专干、残疾人专职委员等在签约服务中的作用。

督查于7月底开始

全面自查阶段

各部门于2018年7月31日前、各地区于8月5日前将自查情况报告报国务院。

实地督查阶段

8月下旬起:对31个省(自治区、直辖市)、新疆生产建设兵团开展实地督查

9月中旬起:对国务院有关部门及单位开展实地督查

按照“1+5+地方特色+营商环境调查”的设计对地方进行实地督查。

在各地区、各部门开展全面自查的基础上,国务院派出督查组开展实地督查。

《关于开展2018年国务院大督查的通知》提出,督查结束后,根据督查结果,对贯彻执行中央决策部署不力、重大政策落实不到位、重大工程项目严重滞后、推进“放管服”改革不作为乱作为、督查发现问题整改流于形式的问题,依法依规予以严肃问责。

相信随着督查活动的开启,各部门会加快速度落实各项政策,同时有落实不到位的情况,国家也会做出相应措施来予以查处和纠正。

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    2018-07-18 bioon3
  3. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Tue Jul 17 08:02:36 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332150, encodeId=c6d1332150cc, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Tue Jul 17 07:40:31 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332141, encodeId=dddf33214162, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Jul 17 06:01:10 CST 2018, time=2018-07-17, status=1, ipAttribution=)]
    2018-07-18 yuanming8
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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Jul 17 06:01:10 CST 2018, time=2018-07-17, status=1, ipAttribution=)]
    2018-07-17 明月清辉

    谢谢分享.学习了

    0

  6. 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authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Tue Jul 17 07:12:48 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332125, encodeId=005a332125d1, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Jul 17 06:01:18 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332124, encodeId=a55e3321248a, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Jul 17 06:01:10 CST 2018, time=2018-07-17, status=1, ipAttribution=)]
    2018-07-17 zb1235672

    学习了!!!!!

    0

  7. 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createdName=bioon3, createdTime=Wed Jul 18 15:49:00 CST 2018, time=2018-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1422267, encodeId=260a142226e66, content=<a href='/topic/show?id=cb40e59604f' target=_blank style='color:#2F92EE;'>#签约#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75960, encryptionId=cb40e59604f, topicName=签约)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=24b63689109, createdName=yuanming8, createdTime=Wed Jul 18 15:49:00 CST 2018, time=2018-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449133, encodeId=9a1f14491330b, content=<a href='/topic/show?id=4f2c463698e' target=_blank style='color:#2F92EE;'>#家庭医生#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46369, encryptionId=4f2c463698e, topicName=家庭医生)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cc475462058, createdName=yilong5287544, createdTime=Wed Jul 18 15:49:00 CST 2018, time=2018-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332174, encodeId=94ef3321e44c, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Jul 17 08:19:07 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332166, encodeId=45ab332166b4, content=学习了!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Tue Jul 17 08:02:36 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332150, encodeId=c6d1332150cc, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Tue Jul 17 07:40:31 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332141, encodeId=dddf33214162, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Tue Jul 17 07:12:48 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332125, encodeId=005a332125d1, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Jul 17 06:01:18 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332124, encodeId=a55e3321248a, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Jul 17 06:01:10 CST 2018, time=2018-07-17, status=1, ipAttribution=)]
    2018-07-17 飛歌

    学习了很有用

    0

  8. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Tue Jul 17 08:02:36 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332150, encodeId=c6d1332150cc, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Tue Jul 17 07:40:31 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332141, encodeId=dddf33214162, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Tue Jul 17 07:12:48 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332125, encodeId=005a332125d1, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Jul 17 06:01:18 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332124, encodeId=a55e3321248a, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Jul 17 06:01:10 CST 2018, time=2018-07-17, status=1, ipAttribution=)]
    2018-07-17 龙胆草

    学习谢谢分享

    0

  9. 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authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Tue Jul 17 07:12:48 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332125, encodeId=005a332125d1, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Jul 17 06:01:18 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332124, encodeId=a55e3321248a, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Jul 17 06:01:10 CST 2018, time=2018-07-17, status=1, ipAttribution=)]
    2018-07-17 哈哈869

    学了

    0

  10. 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encryptionId=4f2c463698e, topicName=家庭医生)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cc475462058, createdName=yilong5287544, createdTime=Wed Jul 18 15:49:00 CST 2018, time=2018-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332174, encodeId=94ef3321e44c, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Jul 17 08:19:07 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332166, encodeId=45ab332166b4, content=学习了!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Tue Jul 17 08:02:36 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332150, encodeId=c6d1332150cc, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Tue Jul 17 07:40:31 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332141, encodeId=dddf33214162, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Jul 17 06:01:10 CST 2018, time=2018-07-17, status=1, ipAttribution=)]
    2018-07-17 哈哈869

    学了

    0

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