The National Health Fund will not charge penalties if there is no doctor in specialist emergency teams (S) until the end of June 2025—according to the draft of the Regulation of the Minister of Health of September 16, 2024, amending the General Terms and Conditions of Contracts for the Provision of Health Care Services Regulation.[1] The Ministry of Health has submitted a draft regulation for public consultation assuming another extension of the period of exemption from contractual penalties for the lack of doctors in specialist emergency medical teams (S). Currently, the penalties have been abolished until the end of this year. The project extends the amnesty period by another 6 months—until the end of June 2025.

Changes due to the Covid-19 pandemic

During the COVID-19 pandemic, a new provision—Article 36a of the National Emergency Medical Services Act was introduced.[2] According to it, during the epidemic (from the legal perspective, it is the period of an epidemic threat or the state of an epidemic),  the specialist emergency medical team (EMT S) referred to in Article 36 Section 1 Point 1 of the Act could include three people with the qualifications required for a system doctor[3], paramedic or system nurse.[4]

According to the Article’s content: “During the period of declaration of an epidemic threat or a state of an epidemic, the specialist team may include three people with the qualifications required for a paramedic or system nurse.”

This provision was, therefore, an exception to the rule set in Article 36, Section 1, Point 1 of the Act, according to which a specialist team (EMT S) consists of at least three persons authorized to perform medical rescue activities, including a system doctor and a system nurse or a paramedic.

Thus, during the pandemic, this provision allowed units to have a paramedic or a system nurse instead of a doctor in a specialist emergency medical team.

Although this regulation was in force only until July 2023, specialist emergency medical teams continue to face staff shortages as they try to restore the situation from before the pandemic.

Staff shortages among system doctors of the emergency medical services teams: no changes on the horizon…

Although the state of the epidemic was canceled on July 1, 2023, the situation related to the staff shortages of system doctors of the emergency medical services teams has not improved. According to the data from the National Command Support System for State Emergency Medical Services, in 2024 alone, the percentage of missing doctors in specialist teams is usually as high as 57%.[5] Thus, only 43% of the required positions are manned in specialist teams. Initially, the Ministry of Health suspended the imposition of fines until the end of 2024, to give time to recruit doctors to fill staff shortages in the Emergency Medical Services Teams.

Will amnesty be extended until June 30, 2025? The Draft is in public consultation

The Ministry of Health is currently planning to extend the amnesty period again. Initially, it was to be valid until the end of this year.[6] As of now, the Ministry of Health has adopted a Draft Regulation, according to which the National Health Fund will not be able to impose contractual penalties for not having a doctor in the Emergency Medical Services Teas, until June 30, 2025, provided that the teams include at least three people authorized to perform medical rescue activities, including a paramedic or a system nurse.

According to the Draft regulation, the provision of § 3c Point 1 of the General Terms and Conditions of Contracts for the Provision of Health Care Services Regulation of the Minister of Health of 8 September 2015 as amended by the Draft, will apply until the end of June 2025.[7]

The draft is currently in the public consultation phase.[8] If enacted, the Regulation will apply from December 31, 2024, to June 30, 2025, giving the healthcare system more time to fill vacant positions among emergency medical service doctors.

The lawyers from Jabłoński Koźmiński are experienced in advising in medical law, as well as possess knowledge, supported by scientific and popular science publications, in the field of legal aspects of the functioning of the Polish health care system. Do not hesitate to contact us with any questions or doubts concerning this or a related issue.

[1] The Draft is available at: https://legislacja.rcl.gov.pl/docs//516/12389605/13081538/13081539/dokument683603.pdf, access from 09/26/2024.

[2] National Emergency Medical Services Act of September 8, 2006 (consolidated version: Journal of Laws 2024, item 652).

[3] A system doctor has a specialization or specialist title in the field of either anesthesiology, intensive care, emergency medicine, or neurology, or a doctor after the second year of specialization in one of these fields who is continuing specialist training, or has a specialization or specialist title in the field of either internal, diseases, cardiology, general surgery, pediatric surgery, orthopedics and traumatology of the musculoskeletal system, orthopedics, traumatology, or pediatrics or as part of the specialist training, has completed the basic module in the field of either internal diseases, pediatrics, or general surgery and is continuing or has completed specialist training and obtained the specialist title.

[4] A system nurse has a specialist title or specializes in the field of either emergency nursing, anesthesiology, intensive care, surgery, cardiology, or pediatrics or has completed a qualifying course in the field of either emergency nursing, anesthesiology, intensive care, surgery, cardiology, or pediatrics and has at least three years of work experience in departments of these specialties, emergency departments, emergency rooms or emergency medical services.

[5] National Command Support System for State Emergency Medical Services (SWD PRM) https://www.gov.pl/web/zdrowie/system-wspomagania-dowodzenia-panstwowego-ratownictwa-medycznego-swd-prm-, access from 09/25/2024.

[6] Regulation of the Minister of Health of June 3, 2024, amending the General Terms and Conditions of Contracts for the Provision of Health Care Services Regulation (Journal of Laws, item 843).

[7] Consolidated version: Journal of Laws of 2023, item 1194, as amended.

[8] https://legislacja.rcl.gov.pl/projekt/12389304, access from 09/26/2024.