(April 15, 2024)

HCJD G [2024] No. 14

Attention: all relevant units and all entities that apply to establish socially-run medical institutions:

       In accordance with the guiding principles of the Opinions of the Shanghai Municipal People’s Government on Promoting the High-quality Development of the Health Service Sector and Accelerating the Building of a Central City with First-rate Medical Capabilities, the Opinions on Optimizing the Establishment and Administration of Socially-run Medical Institutions in This Municipality, the Planning for the Establishment of Medical Institutions in Jing’an District During the 14th Five-Year Plan Period (2021-2025) and other documents, and in the light of the building and actual development of medical resources of Jing’an District at the present stage, the Guidelines of Jing’an District for Establishment of Socially-run Medical Institutions (2024 Version) are formulated under the leadership of this Health Commission, examined and approved by the Jing’an District People’s Government, and are hereby published for implementation.

Attachment: Guidelines of Jing’an District for Establishment of Socially-run Medical Institutions (2024 Version)

Attachment:

Guidelines of Jing’an District for Establishment of Socially-run

Medical Institutions (2024 Version)

With a view to implementing the important idea that “the people’s city should be built by the people and for the people” and fully carry out the important people-centered philosophy, further consolidating and deepening reform to separate out the business license from certificates, and regulate the registration and approval of socially-run medical institutions, and increasing transparency and predictability, the Guidelines of Jing’an District for Establishment of Socially-run Medical Institutions (2024 Version) are hereby formulated through careful study in accordance with the guiding principles of the Opinions on Optimizing the Establishment and Administration of Socially-run Medical Institutions in This Municipality, the Planning for the Establishment of Medical Institutions in Jing’an District During the 14th Five-Year Plan Period (2021-2025) (HCJD G [2022] No. 15) (hereinafter referred to as the “Planning”) and other documents.

I. Overall Requirements

By following the guidance of Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era and thoroughly implementing the guiding principles from the Party’s 20th National Congress, Jing’an District will give priority to the protection of people’s health. By implementing the Party’s policies on health work and adhering to the principle of putting people’s health first, the District will, on the basis of the actual circumstance and the supposed functions, scientifically plan and rationally determine the scale, structure and layout of socially-run medical resources, and promote increase of good-quality medical resources and their balanced distribution in various zones. By attaching importance to the “Planning” and acting on the principle of “ensuring what is basic, strengthening the primary level, and setting up mechanisms”, the District will support and guide the sound and healthy development of socially-run medical institutions of various levels and categories, various subordinate relationships, various business natures and various forms of ownership, and build a diversified socially-run medical service system characterized by a rational structure, scientific distribution and a congenial ecosystem, so as to meet people’s needs for comprehensive lifecycle health services.

II. Basic Principles

1. Openness, inclusiveness, and emphasis on quality. In accordance with the overall requirements of the reform to streamline administration and delegate power, improve regulation, and upgrade services, the District will free people’s minds to optimize the policy support system and the business environment, and open wider, step by step, the health service market. With focus on medical treatment and health service, the District will keep improving the environment for the development of socially-run medical institutions, the service environment and the legal environment, so that the market can play a leading role in allocating medical service resources. Social capital with fairly good potential for development and a good brand value is encouraged to invest in Jing’an District to run socially-run medical institutions characterized by high quality, special features, chain operation, and large scale, and keep enhancing these institutions’ competitiveness and brand effect.

2. Overall planning and diversified development. While aiming to develop the functions of an excellent global city and promoting diversified development of the health service sector, the District will attach importance to the quality and safety of medical service, protection of people’s health, observance of relevant state laws, rules and regulations, and compliance with the basic principles of medical ethics. On the basis of all this, the District will actively adapt to the present-stage economic growth, comprehensively open the market of the health sector, and guide social capital to run diversified medical institutions that are compatible with the current stage and level of the social and economic development and that match the demand of various types of people for health service.

3. Fairness, justice and stronger oversight. The system of government review and approval will be further reformed, a standard mechanism for reviewing and approving market access will be created, the “double publicity” system with online publication of government information such as administrative licensing and penalty will be firmly implemented, information will be actively disclosed, administrative review and approval will be more transparent, and initiative will be taken to accept social supervision. The principle that “whoever approves shall be held responsible” must be adhered to, administration of the medical quality and safety of socially-run medical institutions will be reinforced, and the responsibility for ongoing and ex post oversight will be properly fulfilled, so as to further regulate the medical practice and promote sustainable sound development of the health service sector.

4. Prioritizing efficiency and upgrading service. The guiding role of the Guidelines for Establishment of Socially-run Medical Institutions (hereinafter referred to as the “Guidelines”) will be strengthened, and the division of zones and the list of medical institutions to be established will be adjusted according to the realities and at an appropriated time. On the premise of following the health development plan for the zones and the plan for the establishment of medical institutions in the zones, annual dynamic administration will be conducted to the Guidelines, in synergy with the socio-economic development of Jing’an District, the changes in the demand for medical services in the zones, the trends of the health service market, and the operation quality, efficiency and benefits of the socially-run medical institutions. Meanwhile, to ensure the Guidelines are scientific and practical, efforts shall be stepped up to provide ex ante service and guidance to social capital that plans to establish medical institutions, thus avoiding disorderly and inefficient investment of social capital.  

III. Categories of Zones

In accordance with the objectives and tasks of the District Party Committee and the District People’s Government for the socio-economic construction and development, and in the light of the current resource distribution in the various zones, Jing’an District is divided into four categories of zones, and social forces may independently choose an appropriate zone where they can invest to establish socially-run medical institutions. The principle of the division and the delimitation of the zones are as follows:

Category A zones: In these zones the government encourages the concentration and development of the health service sector. These zones include: the Suhe Bay waterfront business agglomeration belt (delimited by Luofu Road—North Henan Road on the east, Suzhou River—Anyuan Road—Jiangning Road on the west, Xinzha Road (west of Shimen Road Number Two)—West Beijing Road (east of Shimen Road Number Two) on the south, and the railway on the north); and Shibei High and New Technology Service Park (delimited by Sitang on the east, the Pengyuepu River on the west, Wenshui Road on the south, and Zoumatang—Gonghexin Road—Changzhong Road on the north) ; and other “health service industry parks” newly planned and built by the District’s Development and Reform Commission, Planning and Natural Resources Bureau, and other government departments.

Category B zones: They are zones with fairly abundant medical resources and a fairly wide range of various types of medical institutions, and the medical resources in these zones can meet the demand of different kinds of people for basic medical service and diversified health service. These zones include: West Nanjing Road Sub-district, Jing’an Temple Sub-district, Caojiadu Sub-district, Jiangning Road Sub-district (west of Jiangning Road), Shimen Road Number Two Sub-district (south of Xinzha Road and west of Shimen Road Number Two as well as south of West Beijing Road and east of Shimen Road Number Two), and Daning Road Sub-district (west of Gonghexin Road and south of Daning Road). In the above zones there are many Grade 3 hospitals, specialized hospitals and regional medical centers, and there is a good layout of community health service centers and stations.

Category C zones: In these zones medical resources are unevenly distributed, there are not many types of medical institutions, the local people’s demand for basic medical service is basically met, but there is not yet a perfect diversified health service system. These zones include: West Tianmu Sub-district (north of the railway), West Zhijiang Road Sub-district, Baoshan Road Sub-district, Gonghexin Road Sub-district, and Daning Road Sub-district (excluding the area west of Gonghexin Road and south of Daning Road). In these zones, the layout of community health service centers and stations can basically meet the residents’ needs, but there are not enough Grade 3 hospitals, there are few specialized hospitals and few types of them, and the regional medical centers are rather far away. 

Category D zones: These zones have fairly large populations, with a great demand for medical resources. These zones include: Pengpu Town, Pengpu Xincun Sub-district (excluding the area between Beijiao Station and Changzhong Road), and Linfen Road Sub-district (excluding the area between Beijiao Station and Changzhong Road). These zones are large in area with a large permanent population, they lack Grade 3 hospitals and specialized hospitals, the regional medical centers cannot radiate to cover the whole zones, the medical service teams are rather weak, and the community health centers and stations are not properly distributed, therefore unable to fully satisfy the local residents’ needs for medical service.  

IV. Measures of Support, Encouragement and Restriction

As required by the Opinions on Further Improving the Medical and Health Service System issued by the General Office of the CPC Central Committee and the General Office of the State Council, the governments at all levels must attach great importance to the building of a good-quality and highly-efficient medical service system, and incorporate the task into the objectives and assessment targets of the government work, and they must formulate specific implementation schemes, carry out various tasks, and make efforts to innovate new systems and mechanisms according to the local conditions. 

With a view to resolutely implementing the guiding principles of the CPC Central Committee and the State Council and deepening the reform to streamline administration and delegate power, improve regulation and upgrade services, further galvanizing the entrepreneurial passion of all health workers and various types of economic entities aspiring to engage in health work, giving full play to the market vitality and social creativity, and guiding social forces to actively invest in the establishment of medical institutions in an orderly way, in accordance with the guiding principles of the Opinions on Further Improving the Medical and Health Service System, the Opinions of Shanghai Municipal People’s Government on Promoting the High-quality Development of the Health Service Sector and Accelerating the Building of a Central City with First-rate Medical Capabilities, the Opinions on Optimizing the Establishment and Administration of Socially-run Medical Institutions in This Municipality and other documents, the following measures of support, encouragement and regulation are formulated:

1. Powerful support will be provided to speed up the development of the life and health industry. In the 14th Five-Year Plan Period, Jing’an District will endeavor to build a grand health industry ecological chain, plan and build a high-standard Jing’an grand health industry park, and construct a base for medical and health enterprises’ headquarters. Priority support will be given to the construction of socially-run medical institutions that match the planning and objectives of Jing’an District’s life and health industry.

2. Investors with good social credit, abundant experience in medical service management, a fairly large scale and special features will be encouraged and supported to establish socially-run medical institutions characterized by high quality, special features, chain operation and large scale.

3. Traditional medicine such as traditional Chinese medicine and ethnic minorities’ medicine will be vigorously fostered to ensure and promote the development of traditional Chinese medicine, and social forces with capabilities and excellent traditional Chinese medicine resources will be supported to establish medical institutions of traditional Chinese medicine and ethnic minorities’ medicine.

4. High-level medical institutions are encouraged to be established in Categories A and B zones. In Category A zones, high-end medical institutions of general practice are supported to be established, and good-quality brand-name family doctor teams are encouraged to provide service. In Shibei High and New Technology Service Park, independently-established pathological diagnosis centers, rehabilitation therapy centers, nursing centers, sterile supply centers, health check-up centers, etc. are supported to be set up, and they may provide service in the whole District or Municipality. In Category B zones, medical institutions of geriatric nursing and traditional Chinese medicine are supported to be established. Market entities with a certain scale and mature management experience are supported to establish high-end specialized medical institutions each with an investment of more than 80 million yuan in Category B zones. In Categories C and D zones, specialized medical institutions of traditional Chinese medicine, geriatric nursing, pediatrics, sports medicine, rehabilitation therapy, mental health, etc., which are rare there, are encouraged to be established. Support will be given to introduce brand-name family doctor service teams into Categories C and D zones to offer and improve the basic medical service there.

5. Applications for establishment of medical institutions of medical cosmetology (including medical cosmetology departments set up within other types of medical institutions) and general hospitals are suspended in principle, and the numbers of approved medical institutions of stomatology and dermatology are under control.

6. In accordance with the Interim Administrative Measures for the Filing of Medical Institutions (NHCMP G [2022] No. 33), the establishment of clinics is subject to the filing administration. The clinics to be established do not fall within the scope regulated by these Guidelines, and relevant administrative requirements shall be formulated separately. 

V. Supplementary Provisions

1. A building chosen for establishment of a medical institution shall be a legal and compliant building used for medical, health, commercial or shopping purpose, the applicant shall provide the valid property ownership certificate that shows clear property ownership and complies with the relevant requirements of the government administrative departments of health, market regulation, planning and natural resources, ecology and environment, construction and management (including fire protection), etc.

2. A socially-run medical institution shall have the capability for health information management, and its information system must be able to connect with the information management platforms of the health administrative department and the medical quality control department, so as to achieve connectivity of relevant professional and managerial information.

3. When an applicant submits an application, he/she shall follow the principle of honesty; if he/she submits false materials or conceals relevant facts, such dishonest conducts shall be recorded in his/her credit file.  

4. An applicant shall pay taxes in accordance with the state laws and municipal rules and regulations as well as Jing’an District’s administrative norms.

5. During the implementation period of these Guidelines, approval of establishment of all non-profit medical institutions except clinics shall follow these Guidelines. The relocation and construction of the existing medical institutions shall, in principle, select locations in the same zone as delimited by these Guidelines. Relocation and construction in a different zone shall, in principle, be regulated by these Guidelines. The internal medical institutions established by government departments, public institutions, enterprises and elderly care institutions to serve their internal employees are not subject to the number of approvals regulated by these Guidelines.

6. Where the establishment of medical institutions and related construction projects is concerned with the overall work and annual key tasks of Jing’an District Party Committee and Jing’an District People’s Government, it is not subject to the regulation of these Guidelines. 

7. These Guidelines will be updated and published every year. The valid period of the present-version Guidelines is from the date of publication until December 31, 2024. Where the previous provisions do not comply with the content of these Guidelines, the latter shall prevail.

8. The interpretation of these Guidelines lies in the Health Commission of Jing’an District.

Attachment:

Guidelines of Jing’an District for Establishment of Socially-run Medical Institutions (2024 Version)

Attachment:

Guidelines of Jing’an District for Establishment of Socially-run

Medical Institutions (2024 Version)

I. The establishing entities shall be enterprises related to health service, and their approved business scope shall include (but is not limited to) medical service, clinics service, health service, medical management, medical investment or other relevant projects.  

II. The establishing entities may apply to establish the types of medical institutions for which the State and this Municipality have published the basic standards.

III. The newly established institutions shall, in principle, be a certain distance from the same types of medical institutions in the neighborhood. All medical institutions shall keep a reasonable distance from nurseries, kindergartens, primary and high schools, and food processing or production companies. Establishment of medical institutions by using commercial-residential buildings (including commercial rooms within a residential building’s podium structure) and buildings with a straight-line distance of less than 50 meters from residential buildings shall not be accepted. Establishment of a hospital shall, in principle, use an independent building.

IV. Newly established medical institutions shall comply with the relevant conditions provided in the Basic Standards for Medical Institutions published by the State or Shanghai Municipality. On this basis of that and in the light of the actual circumstances of this District, part of the commonly-seen medical institutions are encouraged to reach the following basic standards:

1. Specialized hospitals: The number of inpatient beds of a specialized hospital other than a stomatological hospital shall be ≥ 50. The number of inpatient beds of a stomatological hospital shall be ≥ 40, and the number of its dental chairs shall be ≥ 30. The floor space of hospital buildings shall comply with the Basic Standards of Medical Institutions and the Construction Standards of the State.

2. Nursing homes: The number of nursing beds of a nursing home shall be ≥ 100, with its total investment being ≥ 50 million yuan. The floor space of a nursing home’s buildings shall comply with the Basic Standards for Nursing Homes (2011 Version), with reference to the Construction Standards for the same-level general hospitals.

3. Outpatient departments: The floor space of the business premises of a general outpatient department shall be ≥ 1000 m².  The floor space of the business premises of a specialized outpatient department (except the stomatological outpatient department) shall be ≥ 800 m². In the case of a stomatological outpatient department, the number of its dental chairs shall be ≥ 6, and the average floor space of each dental treatment unit shall be ≥ 6 m².^, The internal usable area of a dental clinic room shall be ≥ 10 m², with only 1 dental chair in each dental clinic room. An operating room, an oral implant room, etc. shall be divided into three areas (clean area, potential contamination area, and contamination area), and the internal usable area of an operating room or an oral implant room shall be ≥ 25 m².

IV. The staffing principle for health technical personnel for various grades and types of medical institutions:

For a Grade 1 specialized hospital: The number of associate chief physicians and higher physicians shall be ≥ 3, with each clinical department having at least 1 attending physician or higher physician, the number of associate chief nurses and higher nurses shall be ≥ 1, the number of supervising nurses shall be ≥ 2, the number of supervising technicians and higher technicians shall be ≥ 1, the number of supervising laboratorians or higher laboratorians shall be ≥ 1, the number of supervising pharmacists and higher pharmacists shall be ≥ 1, and the number of clinical dietitians shall be ≥ 1.

For a Grade 2 specialized hospital: The number of associate chief physicians and higher physicians shall be ≥ 4, with each clinical department having at least 1 attending physician or higher physician, the number of associate chief nurses and higher nurses shall be ≥ 1, the number of supervising nurses shall be ≥ 3, the number of supervising technicians and higher technicians shall be ≥ 1, the number of supervising laboratorians or higher laboratorians shall be ≥ 1, the number of supervising pharmacists and higher pharmacists shall be ≥ 1, and the number of clinical dietitians shall be ≥ 1.

For a general outpatient department: The number of associate chief physicians and higher physicians shall be ≥ 2, with each clinical department having at least 1 attending physician or higher physician, the number of supervising nurses and higher nurses shall be ≥ 2, and the number of other health technical staff members with an intermediate professional title or higher shall be ≥ 2.

For a specialized outpatient department: The number of associate chief physicians and higher physicians shall be ≥ 1, with each clinical department having at least 1 attending physician or higher physician, and the number of supervising nurses or higher nurses shall be ≥ 2.

All physicians and nurses shall complete their practice registration within three months after they obtain the Practice License of Medical Institutions. Other health technical personnel shall be employed for their posts before they obtain the Practice License of Medical Institutions.

V. Establishment of medical institutions of the traditional Chinese medicine (excluding traditional Chinese medicine hospital of Grade 2 and above) is, in principle, not subject to the restrictions of the planning and quotas. The requirements for setting up the business premises of medical institutions of traditional Chinese medicine may be appropriately lower than those for other medical institutions of the same grade.

VI. Newly established medical institutions shall have the basic conditions for informatization management. In accordance with the provisions of the Guide to the Application Functions of the Hospital Information Platform, the Guide to Applied Technologies for IT Development of Hospitals, and the System of Investigation of the Medical Resources and Medical Service, all medical institutions shall set up a corresponding informatization management platform, which shall be able to connect with Jing’an District’s medical service and monitoring network information system. 

VII. Before a newly established medical institution submits the Application of Medical Institutions for the Practice Registration Certificate and other relevant documents, its relevant information of practice shall be publicized by the health administrative department. Where complaints and objections are received during the process of publicity, they shall be handled according to the Regulations on Public Complaint Letters and Visits and other relevant norms. Prior to the completion of the handling, the application for practice, in principle, shall not be accepted, or shall be suspended or terminated.

The List of Socially-run Medical Institutions Permitted to Be

Established in Jing’an District (2024 Version)