**Patients Risk Being Left ‘In the Middle’ During Hospital Transfers, Report Finds**
A recent report from the Patient Advocate’s Office has highlighted significant gaps in the referral and transfer processes between medical facilities in Cyprus, raising concerns that patients may be left without clear responsibility for their care. The report, published on Tuesday, examined 23 typical scenarios involving patient transfers and referrals, revealing that in many cases, patients could find themselves “in the middle” of the system.
According to the findings, in 12 of the scenarios analyzed, the existing framework allows for violations of patients’ rights. In six additional scenarios, the outcome of the transfer process hinges on whether a single step is executed correctly. Only five scenarios were found to operate in accordance with legal requirements.
A central issue identified in the report is the ambiguity surrounding responsibility for a patient during the transfer process. While the law mandates that any medical institution approached by a patient must either admit them or arrange for their transfer to an appropriate facility, it fails to clearly define when this process is considered complete or who remains accountable for the patient until the transfer is finalized.
Marios Charalambides, the Patient Advocate, emphasized the inadequacy of current practices, stating, “A phone call is not an assumption of responsibility and a recommendation to ‘go elsewhere’ is not a referral.” He stressed that when there are disagreements between medical providers, the patient should already be receiving care instead of waiting for the resolution of the dispute.
The report examined various situations, including the transfer of hospitalized patients and those arriving at emergency departments. It found that effective transfers are characterized by three essential elements: written documentation, confirmed acceptance by the receiving facility, and a clearly designated individual responsible for the patient’s care. The absence of any one of these elements can leave patients vulnerable and without adequate support.
Additionally, the report pointed out discrepancies in the Health Insurance Organisation’s (HIO) referral protocol, which covers seven categories of emergencies at accident and emergency departments, while the relevant law applies to all patients. This inconsistency could further complicate the transfer process and impact patient care.
Concerns were also raised regarding the recording of referrals, acceptances, and refusals. The report noted that critical decisions are often made over the phone, and these interactions frequently go unrecorded, despite existing regulations requiring documentation.
Another significant issue arises when two medical institutions disagree on which facility should take responsibility for a patient. The report indicated that there is no authoritative body to resolve such disputes swiftly, potentially leaving patients in limbo while the disagreement persists. Approximately 380 patient transfers occur each month, underscoring the urgency of addressing these procedural deficiencies.
The report also highlighted the challenges faced by patients with complex medical needs. It warned that when compensation does not accurately reflect the costs associated with treating such cases, there may be an incentive for facilities to transfer these patients elsewhere, rather than providing the necessary care.
The shortcomings identified in the report could infringe upon several rights guaranteed under the Patients’ Rights Law. In response, the Patient Advocate has called for a more structured approach to patient responsibility, advocating for the treating doctor to be explicitly designated as responsible for the patient’s care during transfers. Furthermore, the report recommends that a mandatory replacement be appointed whenever the primary treating doctor is unavailable.
The findings of this report signal a critical need for reform in the patient transfer process within Cyprus’s healthcare system. By addressing the highlighted gaps and ensuring clear lines of responsibility, the healthcare system can better safeguard patients’ rights and enhance the overall quality of care.