Thiruvananthapuram: The Kerala Health Department has issued a comprehensive referral protocol for hospitals under its jurisdiction and for medical colleges under the Department of Medical Education. The new guidelines aim to reduce the burden on medical colleges and ensure that patients receive quality treatment at the nearest hospital. The move follows the death of Venu (48), a Kollam native whose family alleged that he was denied timely treatment at the Government Medical College Hospital, Thiruvananthapuram.

According to the family, Venu, a cardiac patient, was referred from the Kollam District Hospital on October 31 for an emergency angiogram at the Thiruvananthapuram hospital, but died before the procedure could be performed. He was admitted to the cardiology wing on November 1 after complaining of chest pain and passed away on November 5. Medical College Superintendent Dr C G Jayachandran denied allegations of medical negligence, stating that an angiogram or angioplasty was deferred due to elevated creatinine levels. He said the patient had received all necessary modern treatments as per medical protocol.

In the first phase, protocols have been introduced for five specialities — Internal Medicine, General Surgery, Gynaecology, Paediatrics, and Orthopaedics. Protocols for other specialities will follow. Hospitals have been directed not to refer patients to medical colleges unnecessarily if adequate facilities exist locally.

The first referral protocol was introduced in 2010–11, but the Health Department has now carried out a comprehensive revision to account for the rise in patient numbers, changes in hospital infrastructure, advancements in treatment methods, and emerging diseases. A panel of experts formed in 2023 finalised the new framework after detailed discussions.

All government hospitals have been categorised into five groups — A, B, C1, C2, and D — based on available infrastructure and manpower. The protocol defines the facilities, treatments, and referral criteria for each category. It also outlines the warning signs that warrant referrals and identifies the appropriate hospitals for each medical condition.

Officials said the implementation of referral and back-referral protocols will help ease congestion in major hospitals and enable doctors at lower-tier institutions to provide effective treatment within their capacity. The system is also expected to discourage patients from bypassing local hospitals, ensuring better use of resources across the state’s public healthcare network.