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In accordance with Article 37 of the Federal Law of November 21, 2011 No. 323-ФЗ “On the Principles of the Protection of Citizens’ Health in the Russian Federation” (Collected Legislation of the Russian Federation, 2011, No. 48, Art. 6724, 2012, No. 26, Art. 3442 , art. 3446) order:

Approve the attached Procedure for the provision of palliative care to adults.

Registered in the Ministry of Justice of the Russian Federation on February 11, 2013. Registration No. 26973

The procedure for the provision of palliative care to the adult population (approved by the order of the Ministry of Health of the Russian Federation of December 21, 2012 No. 1343n)

1. This Procedure establishes the rules for providing palliative medical care to the adult population, aimed at improving the quality of life of terminally ill citizens, except for patients with HIV infection *.

2. Palliative care can be provided in the following conditions:

on an outpatient basis (under conditions that do not provide for round-the-clock medical observation and treatment);

in the day hospital (in conditions that provide for medical observation and treatment during the daytime, which do not require round-the-clock medical observation and treatment);

inpatient (in conditions that provide round-the-clock medical observation and treatment).

3. The provision of palliative care is carried out by medical organizations of the state, municipal and private health care systems, taking into account the patient’s right to choose a medical organization and a doctor.

4. Palliative medical care is provided to an incurable patient who has significantly limited physical or mental abilities and needs intensive symptomatic therapy, psychosocial care, and long-term care.

5. The provision of palliative care to incurable patients is carried out by palliative care doctors who have been trained in providing palliative care, in collaboration with specialist doctors in the profile of the underlying disease of the patient and other specialist doctors.

Medical workers providing palliative care are guided by the recommendations of specialist doctors who have been trained in the provision of palliative care.

6. Information on medical organizations providing palliative medical care is communicated to citizens by the attending physicians, including by posting on the Internet information and telecommunications network.

7. Palliative medical care on an outpatient basis is provided in the offices of palliative medical care, organized in accordance with Annexes 1-3 to this Procedure, as well as by the teams of the outpatient patronage department of the Palliative Medical Care.

Palliative medical care in a day hospital is provided in day hospital palliative medical care, organized in accordance with Annexes 4-6 to this Procedure.

In-patient palliative care is provided in the palliative care units and palliative care centers organized in accordance with Annexes No. 7-12 to this Procedure.

8. The referral of patients to medical organizations providing palliative medical care is carried out by district general practitioners, general practitioners (family doctors) and specialist doctors in the profile of the patient’s underlying disease.

9. In a medical organization that provides palliative care in outpatient conditions or in day hospital conditions, therapeutic measures are taken, medical indications for referral of the patient to inpatient treatment are carried out, and if there are medical indications, specialist medical advice is organized.

10. In the absence of the possibility of providing the patient with palliative care in outpatient conditions or in day hospital conditions, the patient is routinely sent to a medical organization with a palliative care unit or a palliative care center.

* Order of the Ministry of Health and Social Development of the Russian Federation of September 17, 2007 No. 610 “On measures to organize the provision of palliative care for patients with HIV infection” (registered with the Ministry of Justice of the Russian Federation on October 19, 2007 No. 10355)

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Appendix No. 1k Procedure for the provision of palliative care to adults, approved. by order of the Ministry of Health of the RFot on December 21, 2012 No. 1343n

Rules of organization of the activity of the palliative care cabinet

1. These Rules determine the organization of the activity of the palliative care cabinet (hereinafter referred to as the Cabinet).

2. The Cabinet is a structural subdivision of a medical organization (hereinafter referred to as the Medical Organization) and is created with the aim of providing primary health care to terminally ill citizens.

3. The structure of the Cabinet and its staffing are established by the head of the Medical Organization, which included the Cabinet, based on the amount of medical diagnostic work and the number of the population served, taking into account the recommended staffing standards provided by Annex No. 2 to the Procedure for providing palliative care to the adult population approved by this order.

4. A specialist who has been trained in the provision of palliative medical care is appointed to the position of the doctor of the Cabinet.

5. A specialist is appointed to the position of a nurse in the Cabinet, which corresponds to the Qualification Characteristics of the positions of employees in the health sector of the Unified Qualification Guide for the positions of managers, specialists and employees, approved by order No. 541n of the Ministry of Health and Social Development of the Russian Federation dated July 23, 2010 (registered by the Ministry of Justice of the Russian The Federation of August 25, 2010, No. 18247).

6. The Cabinet performs the following functions:

provision of palliative care on an outpatient basis, including at home;

examination, dynamic observation of patients in need of palliative care;

extract of prescriptions of medicinal products containing narcotic and psychotropic substances from the list II and III of the list of narcotic drugs, psychotropic substances and their precursors that are subject to control in the Russian Federation, approved by the Government of the Russian Federation of June 30, 1998 No. 681 (Meeting of the legislation of the Russian Federation , 1998, No. 27, Article 3198; 2004, No. 8, Article 663; No. 47, Article 4666; 2006, No. 29, Article 3253; 2007, No. 28, Article 3439; No. 26, Article 3183 ; 2009, No. 52, Article 6572; 2010, No. 3, Article 314; No. 17, Article 2100; No. 24, Article 3035; No. 28, Article 3703; No. 31, Article 4271; No. 45, St. 5864; No. 50, Article 6696, Article 6720; 2011, No. 10, Article 1390; No. 12, Article 1635; No. 29, Article 4466, Article 4473; No. 42, Article 5921; No. 51, Article 7534; 2012, No. 10, Article 1232; No. 11, Article 1295. ; No. 19, item 2400; No. 22, item 2864; No. 37, item 5002), in accordance with the Instruction on the procedure for prescribing medicines and preparing prescriptions and invoice requirements approved by the order of the Ministry of Health and Social Development of the Russian Federation February 12, 2007 No. 110 (registered with the Ministry of Justice of Russia on April 27, 2007, registration No. 9364), as amended by orders of the Ministry of Health and Social Development of the Russian Federation of August 27 Charter No. 560 2007 (registered with the Ministry of Justice of Russia on September 14, 2007, registration number 10133), September 25, 2009 No. 794n (registered with the Ministry of Justice of Russia of November 25, 2009, registration No. 15317), dated January 20, 2011 No. 13n (registered by the Ministry of Justice of Russia on March 15, 2011, registration No. 20103), as amended by order of the Ministry of Health of the Russian Federation of August 1, 2012 No. 54n (registered by the Ministry of Justice of Russia on August 15, 2012 No. 25190);

referral of patients to a medical organization that provides palliative care in inpatient conditions;

organization of consultations for patients with a specialist doctor in the profile of the underlying disease of the patient and doctors of other specialties;

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providing advice to doctors of other specialties on palliative care for patients;

development and implementation of measures to improve the availability and quality of palliative care and the introduction into practice of new effective and safe methods to improve the quality of life of patients;

providing social and psychological assistance to patients and their relatives, training relatives in patient care skills;

other functions in accordance with the legislation of the Russian Federation.

7. Equipment of the Cabinet is carried out in accordance with the standard of equipment provided for in Annex No. 3 to the Procedure for the provision of palliative medical care to the adult population approved by this Procedure.

8. To ensure the fulfillment of its functions, the Cabinet uses medical equipment of other structural subdivisions of the Medical Organization in which it is established.

Appendix No. 2k Procedure for the provision of palliative care to adults, approved. by order of the Ministry of Health of the RFot on December 21, 2012 No. 1343n

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