Section 16 in West Bengal Clinical Establishment (Registration, Regulation and Transparency), Rules, 2017
16. Referral and Transfer.
(1)If it is medically necessary, the Primary Consultant or the RMO or any Registered Medical Practitioner shall have the right to refer the patient to another Consultant for a second opinion or advice or execution of a particular healthcare intervention in her capacity of being a Consultant having specialized knowledge, skill, expertise or experience:Provided that the Primary Consultant may or may not agree to change or modify his/her treatment plan according to the advice of the second Consultant or allow him to carry out any healthcare intervention.(2)The patient shall have the right to seek for a second opinion and subsequent opinions, if appropriate, from another consultant and the Primary Consultant shall explain her reason for non-agreement, if any, if she feels that such consultation is not medically necessary for the treatment plan.(3)If it is medically necessary, the clinical establishment shall have the right to permit or acquire the consultation service including telemedicine to be provided by a Visiting Consultant who is not an employee or empanelled, subject to following terms and conditions:(a)request for such service is being made either by the Primary Consultant or by the patient / patient party in writing; and(b)such Visiting Consultant is qualified enough to render such service; and(c)the name and particulars of such Visiting Consultant is entered in the staff register under rule 6 before rendering service; and(d)any such other terms and conditions as may be notified.(4)If it is medically necessary, the Primary Consultant or the RMO or any Registered Medical Practitioner may refer the patient to affect an 'appropriate transfer' to any appropriate Healthcare establishment for receiving and/or accommodating the patient.(5)A transfer to another Health care establishment shall be treated as an appropriate transfer if -(a)before transfer, the patient has been provided with highest possible medical treatment by the clinical establishment within its capacity to minimize the risks to the health of the patient;(b)before transfer, the patient and the party has been provided with adequate consultation and counseling regarding the necessity of such transfer; and(c)the transferring clinical establishment sends to the receiving Health care establishment or receiving Registered Medical Practitioner -(i)all medical records ( or copies thereof), relating to the screening and the emergency medical condition of the person, which are available at the time of such transfer, including records relating to the patient's medical condition, observation of signs or symptoms, preliminary diagnosis, treatment provided, results of any investigation and the informed written consent, if any, and(ii)a discharge certificate or a certificate of transfer that, based upon the information available at the time of transfer that the medical benefits reasonably expected from the provision of appropriate medical treatment at the receiving Health care establishment outweigh the increased risks, on account of the transfer, to the patient so far as the treatment of patients are concerned,(d)the transferring clinical establishment should provide necessary medical facilities including life support systems and qualified personnel within the capacity of the transferring clinical establishment or medical practitioner, to accompany the patient during the period covered by transport to the receiving Health care Establishment or receiving medical practitioner.(e)all such referral cases are being registered in the referral register as mentioned in sub-rule(6).(6)The clinical establishment shall generate and maintain a referral register as a part of mandatory record keeping containing particulars like Serial Number; name and registration number of patient; name, address and signature of the patient party to whom the discharge/transfer certificate along with the custody of patient is handed over, her relation with the patient; date and time of referral etc. and any such particulars as may be notified.(7)The clinical establishment having 100 (hundred) or more beds, shall provide and maintain one ambulance van or any such suitable conveyances for every 100 beds or part thereof with such sufficient attendants and other such requisites to transfer patients as may be notified by the Government from time to time.(8)The clinical establishment shall refer patients maintaining the medico legal formalities
