Document Title: HAAD Standard for Primary Health Care in Emirate of Abu Dhabi

Document Ref. Number: HAAD/PHC/SD/0.9 Version: 0.9

Approval Date: 25/08/2016 Effective Date: 25/08/2016
Document Owner: HAAD Capacity Planning Department
Healthcare Facilities seeking to Provide Primary Health Care in the
Applies to:
Emirate of Abu Dhabi
Classification:  Public

1. Purpose

1.1 This Standard defines the requirements for Primary Healthcare Services in the Emirate of Abu Dhabi.
It aims to improve appropriate patient access to quality and safe primary healthcare services. It sets
the minimum requirements and specifications that Healthcare Providers are required to comply
with in providing high quality preventive, curative, palliative and high value healthcare in a cost-
effective manner in a primary care setting.

2. Scope

2.1 This standard applies to all Healthcare Providers, Public and Private, licensed by HAAD in the Emirate
of Abu Dhabi that wish to provide primary healthcare in accordance with the definitions of this
Standard.

3. Definitions

Primary HAAD adopts the World Health Organisation definition of primary healthcare, namely
Healthcare* “essential health care based on practical, scientifically sound and socially acceptable
methods and technology made universally accessible to individuals and families in the
community through their full participation and at a cost that the community and the
country can afford to maintain at every stage of their development in the spirit of self-
reliance and self-determination”.

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 Primary For the purposes of this document, it comprises of a range of services provided in
Healthcare support of preventive, curative and palliative healthcare as per section 8.
Services

Electronic Means a repository of patient medical data in digital form, stored and exchanged
Medical Record securely, and accessible by multiple authorized users. It contains retrospective,
concurrent, and prospective information and its primary purpose is to support
continuing, effective and efficient healthcare service and assure the continuity of high
quality, safe and integrated healthcare for patients. To comply with HAAD Data
protection policies and standards
Primary Any HAAD licensed facility and/or healthcare professional licensed to provide primary
Healthcare healthcare services in the emirate of Abu Dhabi.
Service
Providers
Primary Patients in this Standard mean adults and children who access and/or use primary
Healthcare healthcare services from HAAD purposefully licensed primary healthcare service
Patients providers.
*Note: Appendix 1 provides detailed descriptions for Primary Care

4. General Duties for Primary Healthcare Facilities, Providers and Professionals

All Healthcare Facilities and Professionals licensed by HAAD to provide Primary Care Healthcare
Services must:
4.1 Provide only the healthcare services defined in this Standard (see section 8), and in accordance
with the specified requirements of this Standard, ensuring the highest standards of care and
professionalism with the patient and their family members or carers;
4.2 The duty to ensure patients receive integrated and continuous care, including the following:
4.2.1 Provision of responsive reactive access to appropriate elective and urgent care;
4.2.2 Provide support for care to patients with chronic diseases that is already managed by
patients (and their families) themselves; and
4.2.3 For those patients requiring secondary or tertiary care, the facility must ensure streamlined
continuity of care with a seamless referral system to the appropriate service in either public
or private hospitals.
4.3 Ensure that healthcare services are accessible to patients determined as eligible for these services,
in accordance with the mandated criteria, and are offered in at least Arabic and English languages
and/or as per patient needs;
4.4 Comply with the requirement to safeguard and preserve patient rights through treatment with
dignity and respect, provision of the determined healthcare services in the home in accordance
with this Standard and on the basis of clinical need, assuring professionalism and confidentiality
during the course of providing healthcare services to the patient;
4.5 Comply with Patient consent and ensure patients and their families are informed of their rights
and responsibilities;
4.6 Protect the privacy concerns of the patient and the confidentiality and security of their medical
information and records when providing healthcare services. Confidentiality, privacy and security
of health data and records must comply with the Data Management Policy, Chapter VI, Healthcare
Regulator Policy Manual Version 1.0, the HAAD Policy on Medical Records- Health Information
Retention and Disposal and the HAAD Data Standards and Procedures Standard requirements and
UAE Laws;

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 4.7 Comply with the data submission and reporting requirements specified in the Data Management
Policy, Chapter VI, Healthcare Regulator Policy Manual Version 1.0 and set out in the Data
Standards and Procedures (available from: www.haad.ae/datadictionary);
4.8 Comply with HAAD requests to inspect and audit records and cooperate with HAAD authorised
auditors, as required for inspections and audits by HAAD;
4.8Comply with the health insurance and/or third party administrator appointed by
HAAD to manage claims reimbursement requests to inspect and audit records and to
cooperate with their auditors as required for inspections and audits;
4.9Comply with all facility licensing and design, plans, engineering specifications and guidelines as set
out by HAAD;
4.10 Comply with Market Entry and Exit, General Duties, Governance, Change Control, EHSMS,
Staff and Staff Management and Standards of Care as set out in the HAAD Policy Manual for
Healthcare Providers;
4.11 Comply with the Professional Licensing and Clinical Privileging Framework, Duties of Healthcare
Professionals, Training and Education as set out in the HAAD Policy Manual for
Healthcare Professionals; and
4.12 Comply with the Abu Dhabi Health Insurance Scheme, Products and Recovery of Payment for
Healthcare services as set out in the HAAD Policy Manuals for Insurers

5. Enforcement and Sanctions

5.1 Healthcare service providers must comply with the terms and requirements of this Standard,
the HAAD Standard Provider Contract and the HAAD Data Standards and Procedures. HAAD
may impose sanctions in relation to any breach of requirements under this Standard in
accordance with the Complaints, Investigations, Regulatory Action and Sanctions Policy,
Chapter IX, Healthcare Regulator Policy Manual Version.

6. Standard 1. Primary Healthcare Service Specifications

Primary Health care Providers must comply with the following Primary Healthcare Service-specific
Requirements:

6.1 Principles of Quality Primary Care

HAAD seeks to develop an approach to the delivery of primary care that is based on the following
principles:
6.1.1 Patient-centered: A partnership among practitioners, patients, and their families ensures
that decisions respect patients’ wants, needs, and preferences, and that patients have the
education and support the need to make decisions and participate in their own care,
effectively and collaboratively;
6.1.2 Comprehensive: A team of care providers that is wholly accountable for a patient’s physical
and mental health care needs, including prevention and wellness, acute care, and chronic
care;
6.1.3 Coordinated: Care that is organised across all elements of the broader health care system,
including specialty care, hospitals, long term and home health care and broader
community services;
6.1.4 Accessible: Patients have access to services with shorter waiting time for urgent needs,
extended hours of clinic availability, tele health or electronic access to members of the care
team, with innovative communication and appointments that reflect the needs of the
patient population

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 6.1.5 Committed to quality and safety: Clinicians and staff commit to provide the highest quality
of preventive and curative care to their patients and the wider community they serve in a
culturally fit manner. This is through striving to continuously measure and improve quality,
using collaborative, open to learning and high reliability approach. While deploying the
latest tools that will achieve this e.g. health IT and other tools;
6.1.6 Evidence based: Assessment, treatment and interventions must be evidence based and in
line with agreed and culturally acceptable best practice; and
6.1.7 Integrated: The provider should play leading active and effective role in the provision of
integrated healthcare across the wider system. Advocating for the patient to ensure that
they get the full benefits of integrated care.

7 Standard 2. Primary Health Care Clinical Leadership

7.1 All HAAD licensed primary healthcare providers must ensure that healthcare professionals
employed by them work under the leadership and supervision of Consultants/Specialist in Family
Medicine, Internal Medicine or Pediatrics, dependent on the local population demographics being
served. Patients should have access to the most appropriate clinician, including the
Consultant/Specialist. All clinical staff must be licensed by HAAD (or locum agreement endorsed by
HAAD) and have privileges granted to them in accordance with the requirements of the HAAD
Standard for Privileging Framework, and that they limit their practice to their specified job,
competence and privileges.

8. Standard 3. Range of Services to be provided

8.1 Services that must be provided in a primary care setting include:

8.1.1 Family Medicine, including planned and unplanned primary care services;
8.1.2 Chronic disease management;
8.1.3 Healthcare Screening and prevention services;
8.1.4 Vaccinations and Immunisations;
8.1.5 Non-communicable diseases management;
8.1.6 Communicable diseases management;
8.1.7 Unplanned and urgent primary care services, including: initial management, stabilisation and
transfer of any presenting emergencies to an emergency department as appropriate;
8.1.8 Pharmacy on site (this is discretionary if one already exists within 10 minute walk of the
facility); and
8.1.9 Access to basic on site diagnostic services
8.2 Additional Services that may be provided if required by the local population
8.2.1 Maternal and child health;
8.2.2 Visiting Specialty Clinic’s e.g. Obstetrics, Gynecology, Pediatrics
8.2.3 Mental health management for mild-moderate cases;
8.2.4 Substance/drug Misuse services;
8.2.5 Dentistry;
8.2.6 Optometry;
8.2.7 Minor Surgery (e.g. dermatology);
8.2.8 Monitoring Services (e.g. anti-coagulation);
8.2.9 Extended hours of operation to reflect the local population needs;

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 8.2.10 Health Education/Nutritionist
8.2.11 Telemedicine
8.2.12 Community Services such as: Home Care Services
8.2.13 Palliative Care
8.2.14 Any other medical services having met the requirements of this Standard as approved by
HAAD from time to time upon an application of a healthcare provider or not.
Note: The above list is neither exclusive or exhaustive and provider should undertake their own local
health needs assessment of the population they serve.

9. Standard 4. Minimum Opening Hours

9.1 The Primary Care opening hours need to be sufficient to “meet the reasonable needs of its patients ”
taking into account both the time a patient has to wait for an appointment and the convenience of
the appointment. Whilst not specifying opening hours the table below provides the minimum
requirements expected of Primary Care providers

Clinic Physicians Population Opening Hours

Type (FTE) (000)
Rural 1-2 4-6 5 days a week with 1 evening, or weekend clinic
Village

Small 4-6 6-10 5 days a week with evening and weekend clinic

Medium 7-14 12-29 6 days a week with multiple evening clinics

Large 15-20 30-40 7 days a week with evening clinics each day

Note: The clinical size definition, number of physicians and notional population coverage information
is taken from the Abu Dhabi Community Facilitys Planning Standards, published by the Urban Planning
Council. For sake of clarity the minimum opening hours are established against the number of WTE
physicians working within the facility

10. Standard 5. Clinical and Quality Governance Systems

10.1 A HAAD licensed Primary Healthcare Provider must have in place documented
evidence of adherence to the range of services provided within their healthcare facility,
including but not limited to:
10.1.1Its scope of services and their service specifications
10.1.1.1 All HAAD licensed Primary Healthcare Providers must ensure that healthcare
professionals employed by them work under the leadership and supervision of
Consultants/Specialist in Family Medicine, Internal Medicine or Pediatrics,
dependent on the local population demographics and needs being served.
10.1.1.2 Patients shall have access to the most appropriate clinician, including the
Consultant/Specialist.

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 10.1.1.3 Appropriately skilled and trained staff of suitable skills-mix and number shall
commensurate with the size and needs of and the frequency of interactions with
the patient population it serves
10.1.2 Job descriptions and scope of practice for all staff employed within the healthcare
facility
10.1.2.1 All clinical staff must be licensed by HAAD (or locum agreement endorsed by
HAAD) and have privileges granted to them in accordance with the requirements
of the HAAD Standard for Privileging Framework, and that they limit their practice
to their specified job, competence and privileges.
10.1.3 Quality assurance and improvement framework including:
10.1.3.1 Establishing a Quality Committee and assigning a responsible physician for
Quality and performance monitoring;
10.1.3.2 Setting and monitoring performance against quality and safety metrics set out
by HAAD;
10.1.3.3 Maintenance of comprehensive Electronic Medical Records;
10.1.3.4 Implementing risk control and management processes to improve the quality
of care, optimise patient wellbeing and minimize

11. Standard 6. Performance Metrics

11.1 Healthcare providers licensed to provide Primary Healthcare Services must ensure that they meet
the key performance indicators noted in Appendix 2. HAAD may revise and update these metrics taking
into consideration service needs, performance and population health challenges.

12. Standard 7. Facility Licensing

12.1 Healthcare facilities wishing to provide primary healthcare services, must apply under the
established HAAD Facility Category, Centre, Sub Type: Primary Healthcare Centre.

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