Termination of General Clinic Licences in Abu Dhabi: Implementation of New Primary Healthcare Centre Licence

With effect from 1 January 2018, the Department of Health – Abu Dhabi (‘DOH’) stopped issuing licences for general clinics, with limited exceptions. All licensed general clinics have until 20 December 2018 to change their facility type to meet the requirements of a primary healthcare centre, or another type of specialist healthcare facility. All healthcare facilities wishing to provide family medicine and primary healthcare will have to first be licensed by the DOH.

Background

This change puts into full effect the DOH Standard for Primary Health Care in the Emirate of Abu Dhabi (‘Standard’), which is applicable to all healthcare providers, both public and private, wishing to provide primary healthcare in the Emirate of Abu Dhabi. The Standard, which was issued in August 2016, defines the requirements for ‘Primary Healthcare Services’ in the Emirate of Abu Dhabi, aims to improve patient access to quality and safe primary healthcare services, and sets the minimum requirements and specifications that healthcare providers are required to comply with in providing healthcare in a primary care setting. These changes reflect the authority’s initiative to create a more patient-centric care model, ensure continuity of care, and reduce fragmentation in the healthcare system.

According to the World Health Organisation, primary healthcare is a core basis of a successful healthcare system. The intention is that primary healthcare facilities will be able to better guide the care of patients, while reducing the burden on specialist and emergency medical services, arguably reducing the costs of the healthcare industry on the UAE economy.

“All licensed general clinics have until 20 December 2018 to change their facility type to meet the requirements of a primary healthcare centre.”

Practical Implications

The UAE healthcare system is faced with a rising demand on services, due to a rapidly expanding population caused by natural growth and a positive net migration. One of the challenges of the current model of care is the lack of sufficient prevention programmes integrated into care plans and patients’ direct access to services and specialty care leading to an increase in the inappropriate use and over-supply of services. At present, patients opt to approach specialists directly as the first point of care for general medicine needs and, in some cases, approaching more than one facility and specialist (‘doctor shopping’); this places an unnecessary burden and expense on the healthcare system.

Excluding certain exceptions (clinics located in construction sites, hotels, schools, sports and social clubs, and companies), DOH will no longer issue new licences for ‘general’ healthcare clinics in Abu Dhabi. Moreover, all licensed specialised clinics and medical centres wishing to practise family medicine must meet the Standard and submit a ‘change in type’ application in order to change the healthcare facility type to a ‘Primary Health Care Centre’. Likewise, hospitals in Abu Dhabi wishing to provide primary healthcare services must request to include such services under their clinical support services list approved by the DOH.

In order to meet the requirements of the Standard when updating the facility type, clinics that provide only general healthcare from general practitioners will have to employ a specialist or consultant to lead the care. Such supervising physician must be a consultant or specialist in family medicine, internal medicine or paediatrics, depending on the local population demographics served and in accordance with DOH health professional licensing requirements. It is expected that primary healthcare facilities will provide advanced levels of treatment led by a specialist or consultant, guiding the patients towards receiving the best care.

The DOH has determined that primary healthcare services in Abu Dhabi comprise a range of services provided in support of preventive, curative, and palliative healthcare. Services that must be provided in a primary care setting include:

1. family medicine, including planned and unplanned primary care services;
2. chronic disease management;
3. healthcare screening and prevention services;
4. vaccinations and immunisations;
5. non-communicable diseases management;
6. communicable diseases management;
7. unplanned and urgent primary care services, including, initial management, stabilisation and transfer of any presenting emergencies to an emergency department, as appropriate;
8. a pharmacy on site (this is discretionary if one already exists within 10 minute walk of the facility); and
9. access to basic on-site diagnostic services.

Additional services that may be provided, if required by the local population include:

1. maternal and child health;
2. visiting specialty clinics, such as obstetrics, gynaecology, paediatrics;
3. mental health management for mild-moderate cases;
4. substance/drug misuse services;
5. dentistry;
6. optometry;
7. minor surgery (e.g. dermatology);
8. monitoring services (e.g. anti-coagulation);
9. extended hours of operation to reflect the local population needs;
10. health education/nutritionist;
11. telemedicine;
12. community services, such as home care services;
13. palliative care; and
14. any other medical services having met the requirements of the Standard.

The DOH may impose sanctions in relation to any breach of requirements under the Standard, in accordance with Chapter IX of the DOH Healthcare Regulator Policy Manual of November 2017.

DOH’s ultimate aim is to have a licensed family medicine care provider within each precinct in Abu Dhabi. As a result, the DOH anticipates that there will be improved patient access to quality and safe primary healthcare services.

Should you require any advice concerning the Standard or adopting your healthcare facility to the new requirements, we would be happy to assist.

Al Tamimi & Company’s Healthcare Practice Group Corporate Commercial team regularly advises on healthcare issues in the UAE. For further information please contact Christina Sochacki (C.Sochacki@tamimi.com) or Andrew Fawcett (A.Fawcett@tamimi.com).