Guiding Opinions on Optimizing the Layout and Construction of Primary Medical and Health Institutions

Health and Wellness Commissions, Party Committee Organization and Compilation Offices, Development and Reform Commissions, Education departments, civil affairs departments, finance departments, Human Resources and Social security departments, Natural resources departments, housing and Urban-Rural development departments, Agriculture and rural affairs Departments, medical insurance bureaus, traditional Chinese medicine bureaus, and disease control bureaus of all provinces, autonomous regions, municipalities directly under the Central Government, and the Xinjiang Production and Construction Corps:

Primary-level medical and health institutions provide basic medical and health services to all urban and rural residents. They are an important part of the medical and health service system and the first line of defense for safeguarding the health of the people. To adapt to the requirements of people-oriented new urbanization, population aging and population migration and mobility changes, further improve the primary-level medical and health service system, enhance the capacity of primary-level medical and health services, and promote the construction of the hierarchical medical treatment system, the following opinions are hereby put forward on optimizing the layout and construction of primary-level medical and health institutions.

一、General Requirements

 In combination with the formulation and implementation of the national spatial planning and related special plans, taking into account both the present and the long term, and comprehensively considering factors such as the integrated development of urban and rural areas, changes in population structure, and the health needs of the people, the layout and construction of primary medical and health institutions should be improved in a way that suits local conditions. It is necessary to fully consider the differences among various regions, prevent a one-size-fits-all approach that may lead to service "hotspots", and also avoid idle and wasted resources, so that the general public can obtain effective basic medical and health services nearby and conveniently.

By 2027, all primary-level medical and health institutions at the township and sub-district levels will be fully covered, and basic medical and health services will be fully covered in administrative villages and communities. Efforts will be made to ensure that residents can reach the nearest medical service point within 15 minutes, and the infrastructure conditions of primary-level medical and health institutions will be significantly improved. By 2030, the layout of primary-level medical and health institutions will be more balanced and reasonable, telemedicine and intelligent services will be basically popularized, and primary-level medical and health services will be more convenient and accessible. By 2035, the layout and construction of primary-level medical and health institutions, as well as their capacity for disease prevention, treatment and health services, will be more in line with the people-oriented new urbanization and the comprehensive revitalization of rural areas, and better serve the high-quality health life needs of urban and rural residents.

二、Main Tasks and Measures

（一）Run township health centers well. In principle, one health center should be well established in each township. For the merged and dissolved townships, in light of the actual situation, the original township health centers can be transformed into branches of the established township health centers or merged to make good use of the original resources in a coordinated manner. Central township health centers and general township health centers should be built based on the classification of the service population. According to actual needs, focus on building 1 to 2 central township health centers outside the county town that serve a large population and are far from the county hospital, so that they can gradually reach the service capacity of secondary hospitals. Priority should be given to strengthening the construction of township health centers in areas with weak foundations and border areas.

（二）Set up village clinics reasonably. In principle, one village clinic should be set up for each administrative village. Where an administrative village has multiple village clinics, they should be combined and set up. Other clinics can be retained as medical service points based on actual conditions such as population distribution, or they can voluntarily be converted into other medical institutions such as clinics in accordance with regulations. Administrative villages with a small population or area and convenient transportation can jointly set up village clinics with adjacent administrative villages. The administrative village where the township health center is located may not have a separate village clinic. Improve the equipment conditions and service capabilities of village clinics with a large service population. The construction of village clinics in border and ethnic minority areas should be strengthened. Medical service points should be reasonably set up in villages that have been relocated or merged with a smaller population, as well as in remote areas, mountainous regions, islands and other special areas. We should make good use of the existing village clinics or Party-mass service centers to build fixed mobile medical stations.

（三）Run community health service centers well. In principle, one community health service center should be established in each sub-district. For streets that have not established community health service centers, priority should be given to transforming government-run first-level hospitals within the jurisdiction into community health service centers. If there are no government-run first-level hospitals within the jurisdiction, new ones should be built in accordance with standards, or other medical and health institutions within the jurisdiction should be transformed into community health service centers. Where a township is reorganized into a sub-district through administrative division adjustments, the original township health centers will be transformed into community health service centers, and their service functions remain unchanged. Streets with a population of more than 100,000 May expand the scale of existing community health service centers as needed. If it is truly necessary, community health service institutions can also be added in accordance with procedural planning.

（四）Facilitate the establishment of community health service stations. In communities with a large population, a wide service radius, and where community health service centers are difficult to cover, community health service stations should be set up as needed. Where conditions permit, they should be managed in an integrated manner with community health service centers. Appropriately expand the scale of community health service stations that serve a large population and are far from community health service centers, and improve their service capacity and level. In addition, efforts should be made to give full play to the role of clinics, outpatient departments, etc., to further meet the personalized and diversified medical needs of the people.

（五）Optimize the collaborative interaction of services. Relying on the close medical alliance, we should strengthen the integration of counties and townships, the integration of villages and towns, and the linkage between urban and rural areas, promote the downward flow of medical and health resources centered on personnel to the grassroots level, and do a good job in medical rounds, dispatches and extended services. Accelerate the construction of resource sharing centers for medical laboratory testing, medical imaging, electrocardiogram diagnosis, pathological diagnosis, and disinfection supply within the county, and achieve mutual recognition of results among grassroots examinations, higher-level diagnoses, and other aspects. Expand the types of drugs for common and chronic diseases at the grassroots level, promote the unification of the drug list for county medical communities, and ensure the connection of drug use.

（六）Strengthen the service capacity at the grassroots level. We will implement the project of strengthening the foundation of medical and health care, improve the departmental setup and equipment allocation of primary medical and health institutions, enhance the capacity for prevention, treatment and rehabilitation of common and chronic diseases, give full play to the role of traditional Chinese medicine, and strengthen the capacity for diagnosing and reporting infectious diseases, emergency rescue and responding to public health emergencies. Promote family doctor contract services, and apply technologies such as telemedicine and artificial intelligence-assisted diagnosis to provide residents with all-round and full life-cycle health services.

（七）Develop and strengthen the primary-level medical and health care workforce. To meet the demands of optimizing the layout, construction and development of primary-level medical and health institutions, we will increase the training of urgently needed talents, strengthen the allocation of traditional Chinese medicine personnel, and continuously expand the primary-level medical and health team through various means such as the special program for college students to become rural doctors, the training of free medical students based on rural orders, conducting personnel training and further education, and promoting the 下沉 of personnel from urban hospitals. Strengthen the training of primary medical and health personnel through various online and offline methods to enhance their capabilities in basic medical care, public health and health management.

三、Organization, Implementation and Guarantee

（八）Strengthen organizational leadership. All regions should take optimizing the layout and construction of primary-level medical and health institutions as an important, fundamental and continuous task. In accordance with the work requirements of central guidance, provincial and municipal coordination, and county-level implementation, they should formulate implementation plans based on their actual conditions and determine phased goals and tasks. We should promote the optimization of the layout and construction of primary-level medical and health institutions in an integrated manner with the deepening of the medical and health system reform, the improvement of the primary-level operation mechanism, and the strengthening of the construction of the primary-level talent team. We should enhance policy coordination and consistency in orientation to promote the construction of the hierarchical medical treatment system.

（九）Strengthen planning guidance. All regions should incorporate the layout and construction of primary-level medical and health institutions into their local national economic and social development plans, and make it a key focus of the medical and health service system construction during the "15th Five-Year Plan" period. The reasonable land use demands of primary-level institutions should be included in the "one map" of the territorial space planning for overall guarantee. Encourage the overall planning and adjacent construction of primary-level medical and health institutions and elderly care service facilities. Improve the standards for the construction and equipment allocation of primary-level medical and health institutions, and optimize the policy environment for primary-level reform and development.

（十）Implement policy guarantees. Subsidy policies shall be implemented for primary medical and health institutions in accordance with relevant regulations. Strengthen the primary responsibility for the layout and construction of grassroots medical and health institutions at the municipal and county levels. We should coordinate multiple funding channels to strengthen the construction of primary-level medical and health institutions, and the central funds should be mainly inclined towards areas with weak foundations. Promote the coordinated development and governance of medical care, medical insurance and medicine, and pay attention to giving full play to the regulatory role of medical insurance in payment and pricing.

（十一）Do a good job in publicity and guidance. Timely summarize the progress, achievements and typical experiences of optimizing the layout and construction of primary medical and health institutions in various regions, and strengthen publicity, promotion, exchanges and mutual learning. We should do a good job in policy interpretation, proactively respond to social concerns, and create a favorable atmosphere for optimizing the layout and construction.