Patient Solidarity Day, 6 December (5) Rights of the patient (3)

8 December, 2019

I read Massimo's posting on HIFA about enforcement of patients rights and thought I should share our policy on the subject in Cross River State 2004 - 2008. The Clinical Governance unit is still evident in the state ministry of health, therefore I believe that the policy is still in operation. In particular I draw attention to item no. 3. It is interesting that the theme for the 2nd Nigeria Medical Association National Health Summit in November 2019, was 'Patient Centered Care' :


Given our circumstance, where there is acute shortage of every professional grouping in the state health service, from doctors and dentists to nurses, pharmacists, radiologists, laboratory specialists and so on, we developed, a deliberate policy to break down artificial inter-professional barriers that cocoon each professional group in its shell, thereby hindering working together as one health team in the best interest of the patient. Non-doctors are encouraged to take-on some of the activities that are traditionally reserved for doctors, after adequate training and supervision, as they work in accordance with approved Protocols and Guidelines. The same applies between nurses and nurse assistants; pharmacists and pharmacy technicians, etc. In this new skill-mix, working arrangement, the Duty of Care, good standard of practice and respect for human life applies to all health workers in Cross River State, if we create a patient-centered system. The patients' trust is a vital ingredient for successful communication, confidentiality and informed consent. The foundations for Clinical Governance, Quality and Safety initiative of the ministry was laid.

As a health worker in Cross River State you must:

- Have as your first concern, the provision of a professional, and ethical care of your patient.

- Treat every patient politely and with dignity.

- Listen to patients and respect their views, taking time to give them correct information about their condition.

- Respect patients' privacy and their confidential information given to yourself, at all times divulging same to no one, unless the patient authorizes, or for overriding public safety.

- Be trustworthy and honest as you deliver your duty of care to the patient.

- Keep your professional knowledge up to date at all times.

- Recognize and practice only to the limits of your competence.

- Practice early referral to colleagues with more competence for the patients condition.

- Protect patients from risk where you believe that you or your colleagues may not be fit to handle the case.

- Avoid abusing your position as a health professional.

- Work with other health workers only in ways to serve the patient's best interest.

- Never discriminate against patients on any grounds: gender; race, creed, age.

- Work cooperatively with your colleagues as a team member.

- Be sure that you can justly defend your actions as you take care of patients

Centre for Clinical Governance, Research and Training (CCGRT)

Cross River State Min of Health Calabar, Nigeria (adopted in part from GMC,UK)(March 2005)'

Joseph Ana.


@Health Resources International (HRI) WA.

National Implementing Organisation: 12-Pillar Clinical Governance

National Implementing Organisation: PACK Nigeria Programme for PHC

Publisher: Medical and Health Journals; Books and Periodicals.

Nigeria: 8 Amaku Street, State Housing & 20 Eta Agbor Road, Calabar.

Tel: +234 (0) 8063600642

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HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.

Email: jneana AT