Supreme Court directs States, UTs to prepare action plan for ICU standards in hospitals

The Supreme Court recently directed States and Union Territories to prepare time-bound action plans to implement guidelines on minimum standards for Intensive Care Units (ICUs) in hospitals [Asit Baran Mondal & Anr. vs Dr Rita Sinha & Ors.].

In an order passed on April 20, a Bench of Justices Ahsanuddin Amanullah and R Mahadevan directed the Health Secretaries of States and Union Territories (UTs) to convene expert meetings within one week to prepare practical action plans.

The entire exercise must be completed within three weeks, the Bench added.

The Court said States and UTs must identify five essential requirements focusing on manpower and equipment. It stressed that the focus should be on what is “absolutely essential and mandatory” for ICU functioning.

It further mandated them to put in place a clear implementation strategy and a mechanism for monitoring and compliance.

The Court also ordered that the exercise must commence immediately.

The Bench directed Health Secretaries of States and UTs to convene meetings and attend them personally, with detailed discussions involving experts.

It added that the initial exercise will be carried out at the State and UT level, after which the reports will be sent to the Union Health Ministry for circulation to all States and UTs.

The Court was hearing a matter that first began in 2016. The original complaint concerned medical negligence in private hospitals and the absence of uniform standards for ICUs and CCUs. While the appeal itself was closed in 2024, the Supreme Court decided to continue monitoring the larger issue of standardising critical care across the country.

Since then, the Court has passed a series of orders directing the Centre and States to work together on a framework.

The Court had earlier constituted a main committee to oversee the process, comprising Additional Solicitor General (ASG) Aishwarya Bhati, advocates Shivika Mehra and Anirudh Singh, Amicus Curiae Karan Bharihoke and Dr Nitish Naik of AIIMS to formulate “Guidelines for Organization and Delivery of Intensive Care Services (ICUs)” across the country

It later expanded consultations to include leading experts such as Dr Naresh Trehan, Chairman & Managing Director, Medanta – The Medicity, Dr Devi Prasad Shetty, Chairman, Narayana Health, Dr Shiv Kumar Sarin, Director, Institute of Liver and Biliary Sciences, Dr Harsh Mahajan, Founder, Mahajan Imaging & Labs, Dr. Saumitra Rawat, Chairperson, Institute of Surgical Gastroenterology, Sir Ganga Ram Hospital, Dr Sheel Pushp Bhosale, Head of Department, Tata Memorial Centre – ACTREC, and Prof (Dr) Pankaj Chaturvedi, Director, ACTREC, Tata Memorial Centre.

During the hearing on April 20, the expert panel of doctors appeared before the Court and offered suggestions for incorporation in the final guidelines on minimum ICU standards.

The Bench also recorded that a consensus-based foundational document, titled Guidelines for Organization and Delivery of Intensive Care Services, has already been prepared and placed on record as the minimum standard framework for ICUs.

Taking this forward, the Court directed the Union Health Ministry to issue these guidelines to all States and UTs as an advisory and upload them on its website.

It further directed that State-level reports be forwarded to the Ministry for circulation to all States/UTs and the ASG, who shall then share it with the Amicus Curiae and the Court-appointed expert team.

The Bench added that a central meeting will then be held which will be led by the Union Health Secretary and attended by State Health Secretaries, the expert team, the ASG and the Amicus Curiae in order to work out a common draft. This final framework will be placed before the Court on the next date of hearing.

The Court was also told that there is a need to strengthen nursing faculty and specialised ICU training.

Taking note of this, it directed that the Indian Nursing Council be made a party to the case and issued notice to it. It also asked the newly added respondents to come up with a plan by the next hearing on how they will improve courses, curriculum and training so that healthcare workers are better equipped to handle ICU situations.

In the meantime, the Court also allowed experts and doctors involved in the process to share their suggestions in advance with the ASG or the Amicus Curiae so they can be passed on to the States, UTs and the Centre.

It also asked all members of the expert team to be present before the Court on the next date of hearing, either physically or through video conferencing.

The matter is now listed for further hearing on May 18.

[Read Order]