The Ministry of Health and Population has issued the Hospital Service Improvement Procedure, 2082 to make hospital services more accessible, patient-friendly, prompt and accountable. The nine-page procedure requires hospitals to ensure easy access to quality services, increase ticket and cash counters where patient pressure is high, and give priority to senior citizens, persons with disabilities, pregnant women and emergency patients. Laboratory and radiology reports should generally be made available within 24 hours. Hospitals must also operate OPD services throughout official working hours and may provide approved extended services outside regular hours, while emergency health services must remain available 24 hours a day.
A major focus is digitalisation and reduction of waiting times. Hospitals are instructed to introduce online appointment booking and report-display systems, provide reliable high-speed internet at service points used for health insurance and electronic medical records, enable online and QR-code payments, and develop an integrated electronic medical record system for treatment history and follow-up. Hospitals must also display staff rosters, service charges and clear Nepali-language directions to departments such as OPD and pharmacy. Emergency treatment cannot be delayed simply because a patient is unable to immediately pay; where necessary, treatment must first be provided and financial responsibility handled according to applicable law and insurance arrangements.
The procedure also establishes stricter standards for cleanliness, staff behaviour and medicine management. Hospital toilets, taps and other facilities must be cleaned at least twice daily, waste must be properly managed, damaged buildings and equipment repaired promptly, and biomedical equipment maintained or disposed of according to procedure. Electronic attendance is compulsory for health workers, uniforms and identification cards must be worn, and hospitals must promote respectful communication with patients. Staff found behaving improperly may be required to attend a soft-skills session, while hospitals are also directed to provide continuous medical education and stress-management activities. Government hospitals must operate their own “Sulabh Pharmacy,” maintain adequate stocks of essential medicines, keep digital inventory records and ensure doctors prescribe from medicines available through the hospital pharmacy.
The rules further strengthen referral, consent, confidentiality and accountability. If a government hospital cannot provide a required emergency service, it must give all immediately available care before coordinating referral—preferably to the nearest capable government hospital—and referred patients should receive priority at the receiving facility. Written informed consent is required for surgery and complex treatment, patient information must remain confidential, hospitals must establish a QR-based feedback and complaint system, and complaints should be addressed promptly by hospital leadership. A discharge summary must be provided when patients leave hospital, while pharmaceutical sales representatives are barred from entering clinical service areas during official service hours.
