The BMJ organizes trainings for regional coordinators in Ukraine

The Ministry of Health of Ukraine provides recommendations and guidance on preparing the required set of documents to qualify for consideration and referral by the MoH Treatment Abroad Advisory Committee for Ukrainian citizens who intend to receive medical treatment abroad.

According to Article 19 of the Constitution of Ukraine, ‘bodies of state power and bodies of local self-government and their officials are obliged to act only on the grounds, within the limits of authority, and in the manner envisaged by the Constitution and the laws of Ukraine’.

The Law of Ukraine ‘On the Fundamentals of Ukrainian Legislation on Healthcare’ (i) determines the legal, organizational, economic and social framework for health care in Ukraine, (ii) regulates social relations in this field with a view to ensuring the harmonious development of spiritual and physical powers; increasing the ability to do work, the participation and involvement of citizens of all ages; eliminating factors that negatively affect human health; preventing and reducing morbidity, disability and mortality, and achieving improvement in hereditary diseases.

According to Article 36 of this Law, Ukrainian citizens can apply for funding for treatment abroad and get the necessary treatment in another country if the required treatment or type of medical care is not available in Ukraine (‘if the provision of required medical treatment is impossible in any of health care facilities within Ukraine’). The public authorities do, at any rate, have the obligation to facilitate the travel and the stay of Ukrainian citizens abroad during the entire treatment period.

Since medical treatment abroad is defined as an exceptional measure for citizens when required treatment is not available to them in Ukraine, current legislation does not provide for differentiating between patients, regardless of their age, gender, social background, property or official status, place of residence etc.

The procedure for referring citizens of Ukraine for treatment abroad is governed and regulated by the Cabinet of Ministers of Ukraine.

Moreover, as part of its functions pursuant to sub-paragraph 8 of paragraph 4 of the Regulation of the Ministry of Health of Ukraine approved by the Resolution of the Cabinet of Ministers of Ukraine No. 267 dated March 25, 2015 (hereinafter referred to as the Regulation), the Ministry of Health of Ukraine decides on the funding and referral of Ukrainian citizens for medical treatment abroad.

Thus, Resolution of the Cabinet of Ministers of Ukraine No. 1079 dated December 27, 2017 "On procedure for sending citizens of Ukraine for treatment abroad" approved the Procedure for sending the citizens of Ukraine for treatment abroad (hereinafter referred to as the Procedure).

Paragraph 3 of this Procedure stipulates that the Ministry of Health of the Autonomous Republic of Crimea, regional healthcare offices, the Kyiv and Sevastopol city state administrations, relevant ministries and other central executive bodies shall ensure due preparation and submission for consideration of the MoH Treatment Abroad Advisory Committee (hereinafter - the MOH Advisory Committee) of all required documents, as follows:

• a completed application from a citizen of Ukraine who seeks medical treatment abroad (or his/her legal representatives) in the form approved by the Ministry of Health of Ukraine;
• extracts (data) from the outpatient (inpatient) medical records in the form approved by the Ministry of Health;
• a letter of referral from the Ministry of Health of the Autonomous Republic of Crimea, regional healthcare offices, the Kyiv and Sevastopol city state administrations, relevant ministries and other central executive bodies in the form approved by the Ministry of Health;
• proof of the citizen's residence and family information or number of persons registered in the same household;
• records from the State Register of Individual Taxpayers with a statement of income received and the income certificates of a patient and his/her family members;
• consent to personal data processing in accordance with the law in force;
• the citizen in question or his/her legal representative has an obligation to submit (no later than one month from the date of the patient’s return to Ukraine after medical treatment abroad under referral of the MoH Advisory Committee) to the Ministry of Health of Ukraine a written form (or report) with the specified scope of treatment and the amount of money spent for patient’s treatment in a foreign healthcare facility or a written refusal from the healthcare facility to provide such information when patients cannot receive from this institution any information on the amount spent for treatment and medical care.

Please also note that:

• an extract from medical records must be prepared and submitted in hard copy;
• the document confirming registration of the citizen's place of residence is a copy of the patient’s passport;
• records from the State Register of Individual Taxpayers with income statement for the past six months should be provided;
• consent to personal data processing in accordance with the law in force – in any form, should be provided;
• the obligation of a citizen or his/her legal representatives to submit (no later than one month from the date of the patient’s return to Ukraine after treatment abroad under referral of the MoH Advisory Committee) to the Ministry of Health of Ukraine a written form (or report) with the specified scope of treatment and the amount of money spent for patient’s treatment in a foreign healthcare facility can be satisfied by fulfilling this obligation in any form.

We shall also note that for consideration by the MoH Advisory Committee of the case falling into the ‘Cardiology. Surgery of the Heart and Great Vessels’ category and for referral for the procedure of transplantation of the heart, lungs or heart-lungs, a citizen of Ukraine or his/her legal representatives must submit all required documents, including medical records of all necessary examinations.

For consideration by the MoH Advisory Committee of the case falling into the "Transplantology" category, a citizen of Ukraine or his/her legal representatives must also submit the Advisory Opinion of the leading transplantation centers confirming the possibility or impossibility of organ transplantation from a family member in Ukraine.

Pursuant to paragraph 4 of the Procedure, the Ministry of Health of the Autonomous Republic of Crimea, regional healthcare offices, Kyiv and Sevastopol city state administrations, relevant ministries and other central executive bodies shall:

• conduct continuous monitoring of the patient’s health and ensure the provision of the necessary medical care, after the registration of this citizen for medical treatment abroad;
• inform the MoH Advisory Committee without delay and no later than three days after a change in the patient's status that would make travel for treatment abroad impossible or the patient’s death, and subsequently submit all relevant supporting documents;
• organize regular medical follow-up and check-ups at the patient’s registered place of residence prior to the MoH Advisory Committee’s decision on sending a citizen of Ukraine for treatment abroad, and submit to the MoH Advisory Committee’s information about the patient’s health status at least once every three months;
• in the case of a failure or impossibility of providing information about the patient’s health or conducting due monitoring, to notify the Ministry of Health of Ukraine in writing no later than one week from the date of receipt of the relevant information.

As part of its functions pursuant to subparagraph 16 of paragraph 4 of the Regulation, the Ministry of Health of Ukraine shall provide and coordinate methodological support for the activities of relevant structural subdivisions of the local executive authorities.

However, paragraph 5 of the Model Regulation ‘On the structural subdivision of the regional state administrations’, approved by Resolution of the Cabinet of Ministers of Ukraine No. 887 dated September 26, 2012, stipulates that the primary function of any structural subdivision is to ensure implementation of the state policy in one or more fields of activity in the territory concerned.

In view of the above, health care departments and regional offices, including the Kyiv city state administration, are responsible for the preparation of an appropriate package of documents, as specified in paragraph 3 of the Procedure, and are also obliged to perform other functions, as stipulated in the Procedure, necessary for sending citizens of Ukraine for medical treatment abroad.

The BMJ, one of the world’s leading medical knowledge providers, is implementing an ambitious Clinical Decision Support (CDS) Training Initiative, aimed at improving evidence-based knowledge and healthcare outcomes in Ukraine. In the course of this year, the BMJ team will train regional coordinators who will then become advisers for institutionalization and project advocacy, and will also discuss the opportunities for continuous education and professional development of medical community in Ukraine. The BMJ has already conducted four seminars in Zhytomyr, Poltava, Odesa and Lviv.

The main goal of these trainings is to improve and facilitate engagement of new resource users. Equally important, training participants will discuss the opportunities for continuing medical education and professional development through the use of the BMJ portal, tools and resources.

This initiative allows Ukrainian healthcare professionals gain access to the most up-to-date resources and trusted, evidence-based medical knowledge. Doctors will improve their skills in the most convenient and economic format – online learning.

The next steps include an active engagement of a wide network of practicing doctors in the BMJ project, as well as development of a highly professional medical community, and improvement of clinical decision support in daily medical practice.

If you are interested in this project, just contact your regional coordinator. Please note that the list of regional coordinators will be updated on a regular basis.