In Poland, treatment is conducted according to specified standards and guidelines in order to ensure the quality and safety of the provided health care benefits. The information presented below applies to all entities legally performing medical activity in Poland.

The patient is entitled to obtain treatment of appropriate quality, which is carried out in safe conditions, not threatening his life or health.
In Poland, the standards and guidelines for quality and safety of health care are specified in various legal instruments and documents such as acts and regulations, the orders of the President of the National Health Fund  on the rules of contracting various types of services, ethical codes of individual health professions as well as with the recommendations of scientific societies.

They usually take the form of standards, i.e. requirements for health care institutions providing medical care (hospitals, clinics, physicians, dentists, nurses, midwives and representatives of other medical professions), requirements for pharmacies, as well as requirements regarding medicines, medical devices, etc., so that they can be marketed in Poland.
Supervision over provision of health benefits is exercised by:

  • the Minister of Health.
  • the Chief Sanitary Inspector via the State Sanitary Inspectorate,
  • voivodes,
  • founding bodies of medicinal entities and
  • chambers of professional associations.

The National Health Fund exercises control over the implementation of the agreements concluded with health care providers providing benefits within the framework of the public health care system including the appropriate provision of health care benefits in accordance with all requirements.
With regard to medicines, foodstuffs intended for particular nutritional uses and medical devices the supervision is exercised by, respectively:

  • The Office for Registration of Medicinal Products, Medical Devices and Biocidal Products,
  • Main Pharmaceutical Inspector and Voivodeship Pharmaceutical Inspections.

MEDICAL ACTIVITY

A MEDICAL INSTITUTION may start its business activity after it has been entered in the Register of Entities Performing Medical Activities (more information about this register can be found here). In the course of the registration process, the entity is subject to verification regarding compliance with formal requirements. Verification of whether a facility meets the legal requirements for performing medical activity entered in the register is carried out under a supervision procedure after the entry is made.
With regard to the provision of health care services, a medical entity is required to meet the quality and safety standards, including:

  • standards regarding the premises in which the activity is to be carried out, depending on its nature and scope,

  • standards for medical equipment, including standards of equipment in connection with the nature of the health care services provided and requirements for the medical equipment used,

  • standards for medical devices used,

  • standards for the medical staff,

  • carrying out health resort treatment in towns with a health resort status.

The medical facility is required to conclude mandatory civil liability insurance contracts covering the damage resulting from the provision of or unlawful failure to provide health care services or damage in respect of medical events. Civil liability insurance shall be entered in registers of the institutions kept by the competent voivodes.


HEALTH CARE PROFESSIONS

A physician or dentist should have the right to practice the profession vested in him by a regional medical council and should be entered in the appropriate register (for more information on the registers click here).

A physician and a dentist has the obligation to carry out his profession in accordance with the current medical knowledge, with methods and means of preventing, diagnosing and treating diseases available to him, in accordance with the rules of professional conduct and with due diligence.

In diagnosis, treatment, rehabilitation and prevention of diseases, a physician and dentist should take into account medical standards stipulated in the code of ethics and developed by the scientific societies in the form of standards and guidelines, clinical practice guidelines and recommendations arising from current medical knowledge and evidence-based medicine - EBM.

Physicians and dental practitioners are obliged to constantly improve their qualifications and training, in particular in various forms of postgraduate courses.

The professional association of physicians and dental practitioners supervises the correctness of exercising this profession and has the power to discipline members of a given professional group, suspend or even revoke their license to practice.

Within the framework of tasks laid down by the law, voivodeship (provincial) consultants may apply to the regional medical council for a quality control of health care services provided by medical professionals.

Feldsher must have a licence to practise medicine issued by the Supreme Medical Council and must be entered in the appropriate register (more information about the registers can be found here).

Paramedic - possibly any person with full legal capacity and the health status allowing to exercise this profession, with sufficent Polish language skills to practise this profession and with relevant education. He has the right and obligation to pursue vocational training.

Nurses and midwives are required to practice their profession with due care, in accordance with the principles of professional ethics, respect for the rights of patients, care for their safety and taking into account the current medical knowledge.

The right to practise the profession of a nurse or midwife are granted by regional councils of nurses and midwives. Obtaining a licence to practise as a nurse or midwife is tantamount to fulfilment of standards on educational requirements and qualifications by that person.

Nurses and midwives who have the right to exercise the profession shall be registered in the appropriate register (more on the registers here).

Nurses and midwives are required to regularly update their knowledge and improve their professional skills.

Within the framework of tasks laid down by the law, voivodeship consultants in the field of nursing may apply to the regional councils of nurses and midwives for a quality control of health care services provided by medical professionals.

Laboratory Diagnosticians - the National Council of Laboratory Diagnosticians keeps a register of laboratories. Entering a given laboratory in that register is the condition for conducting such an activity. In addition, the National Council keeps the Register of Penalised Laboratory Diagnosticians. It includes information on diagnosticians regarding whom a disciplinary decision was made to adjudicate a penalty of a warning or reprimand, suspension or revocation of the licence to practise the profession as a laboratory diagnostician.

Pharmacies and pharmacists - A Polish citizen and a foreign citizen can be granted the right to practise the profession of a pharmacist by the regional council of pharmacists, competent for the area where the profession of a pharmacist is intended to be performed. In relation to a national of a Member State of the European Union the right is granted by the Supreme Pharmaceutical Council. The Register of Pharmacists is kept by the competent Regional Pharmaceutical Council.

A Pharmacy can only operate on the basis of an authorisation to run a pharmacy granted by the Voivodeship Pharmaceutical Inspector. Apart from granting authorisations to run pharmacies, the inspector has the power to amend or withdraw the authorisation, or declare that such authorisation has expired. The Voivodeship Pharmaceutical Inspector keeps the following registers of the entities operating in a given voivodeship: The Register of Authorisations to Run Generally Accessible Pharmacies and Pharmacy Outlets and the Register of Granted Permissions to Run Hospital and Company’s Pharmacies, Onsite Pharmacies and Hospital Pharmacy Departments. These records are available on the website of the Main Pharmaceutical Inspector: Http://www.gif.gov.pl/ .


QUALITY AND SAFETY OF HEALTH CARE SERVICES

The voivode, the regional medical council and the regional council of nurses and midwives are entitled to inspect health care facilities with regard to their activities’ compliance with the provisions governing the conditions for performing medical activity. In the event of a serious breach of the conditions required to carry out a medical activity and after one of the above-mentioned bodies issues a decision on the prohibition of performing the activity entered in the Register Of Entities Performing Medical Activity, the facility in question is removed from the register. Removing from the register also takes place when a final judgement prohibiting the facility to perform medical activity entered in the register, as well as in the case of failure to comply with the post-inspection recommendations. A re-entry into the register can take place not earlier than 3 years after the date of exclusion from the register.
Requirements for health care providers applying to conclude a contract on providing services in Poland within the framework of the public health care system, are determined by the minister competent for health in the regulations on the list of guaranteed benefits financed within the framework of this system. Requirements for health care providers are also determined by the President of the National Health Fund in his orders.

Supervision of the quality of doctors' practices is exercised by regional medical councils, which are entitled to inspect the practice. The aim of the inspection is to evaluate the practice of the profession by a physician or dentist. If it is found that a physician's behaviour was contrary to the principles of medical ethics or rules governing the practice of the profession of physician or dentist practitioner, the Council notifies the regional professional liability officer. And in the event of a serious breach of the terms of performing an activity entered in the above-mentioned register of entities performing medical activity, the regional medical council removes this practice from the register.

Supervision of professional activity of nurses or midwives, also in the terms of quality, is exercised by regional councils of nurses and midwives, which are entitled to inspect practices. The aim of the inspection is to evaluate the practice of the profession. If it is found that a nurse's or a midwife's behaviour was contrary to the principles of medical ethics or rules governing the practice of the profession of nurse and midwife, the chamber notifies the regional professional liability officer. And in the event of a serious breach of the terms of performing activity covered by entry in the above-mentioned register of entities performing medical activity, the chamber removes this practice from the register.


Detailed clinical practice guidelines in health care facilities were determined by means of regulations of the Minister of Health for two areas of medicine:

Health resort treatment may be conducted only in localities with a status of a health resort. Treatment is carried out in health care facilities specialized in providing health resort treatment, entered in the register of entities performing medical activity. A list of health resort facilities in Poland in towns which enjoy the health resort status can be found here.

The role of the State Emergency Medical Services (the EMS) assist each person in a medical emergency situation. The supervision over the system is exercised by the minister competent for health.

The State Emergency Medical Services consist of the following units:

  • hospital emergency rooms,
  • medical rescue teams,
  • air medical rescue teams.

The occurrence of a sudden health risk in the whole area of Poland is notified via the following telephone numbers:
999 or 112

National and voivodeship consultants in various fields of medicine are an important element of the system of professional supervision in health care. They perform consultative, advisory and supervisory tasks for governmental entities, bodies creating medical entities, the National Health Fund and the Commissioner for Patients’ Rights.

In accordance with the national legislation every person diagnosed with certain infections and infectious diseases shall undergo compulsory treatment, regardless of whether he or she is a Polish citizen, or a national of another EU/EFTA Member State, or a non-EU/EFTA national, who is staying or residing in Poland. Health care benefits in relation to the treatment of these diseases/infections are provided to patients free of charge. Infectious diseases and infections treated in the above-described mode are listed here.

The quality and level of treatment safety in a specific health care facility in Poland is also certified by quality certifications, such as ISO 9001 certification, and accreditation certificates obtained by the facility. Both the accreditation process and procedures for obtaining certificates are voluntary. Information about the certificates and accreditations held by a given health care facility is recorded in the register of entities performing medical activity and is taken into account in the process of contracting health care services by the National Health Fund.

There is also a number of programmes and projects in the field of yteatment quality and safety in Poland, in which Polish health care facilities participate voluntarily. They are carried out by, among others, the WHO Regional Office for Europe, the National Centre for Quality Assessment in Healthcare, Polish Society for Quality Promotion in Healthcare, scientific societies affiliating specialists from different fields of medical expertise, such as anaesthesiologists, surgeons (PATH project - Tool for evaluating quality improvement in hospitals, the ‘Safe surgery saves lives’ programme, the patient satisfaction survey using PASAT standardised questionnaires, including PASAT HOPSPIT - hospitalisation, PASAT PEDIATRIA - Pediatrics, PASAT POZ - primary health care). A social campaign ’Childbirth with Dignity’ has been carried out in Poland since 1994, which aim is to improve the perinatal care in health care facilities across the country. In another programme called ’Hospital without pain’ facilities which meet the required criteria and thus contribute to improving the quality of postoperative pain management in Polish hospitals, are awarded ’Hospital without pain’ certificate.

Health care facilities including, in particular, hospitals, may take part in rankings organised by certain newspapers and periodicals, such as SAFE HOSPITAL.


Medicinal products

Medicinal products sold in Poland, including drugs and medical devices, may be placed on the market only with the permission of The President of the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products www.urpl.gov.pl (URPLWMiPB) with the exception of products specified by law.
Medicinal products can be purchased at pharmacies, pharmaceutical points or non-pharmacy trading facilities. An official list of medicinal products authorised for marketing in the territory of the Republic of Poland is set out in the notice of the President of the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products of 12 April 2013. 

The manufacturers and distributors of medicinal products authorised for marketing in Poland are legally obliged to apply the so-called good practices. Their purpose is to ensure appropriate quality of products. 

Medical devices manufactured by entities established in Poland, and also the clinical research carried out by these entities and data relating to certificates issued by Polish bodies are entered by the URPLWMiPB into the European medical devices database - EUDAMED. In addition, the URPLWMiPB inspects manufacturers, marketing authorisation holders, importers, distributors, entities assembling medical devices into systems or procedure sets, entities performing sterilisation of medical devices in order to place them on the market, as well as subcontractors who reside or are established in Poland in the scope of designing, marking, storing, distributing, assembling, processing, manufacturing, presenting products at trade fairs, shows and scientific symposia.
Physicians and dentists have a statutory obligation to notify the entity responsible for placing a medical device on the market and the President of the URPLWMiPB about each adverse reaction to a medicinal product.
Basic quality requirements and methods for testing medicinal products and their packaging as well as pharmaceutical raw materials is determined in Pharmacopoeia Poland (Farmakopea Polska), which is fully compliant with European Pharmacopoeia.
Supervision of manufacturing and importing medicinal products, supervision of quality and wholesale trade and retail trade in pharmacies, pharmacy outlets and points of out-of-pharmacy sale, as well as advertising of medicinal products is exercised by the State Pharmaceutical Inspection.
Registration procedures regarding medicinal products adopted in Poland (centralised, decentralised and mutual recognition) are in line with the European Union standards.

 Orthopaedic Devices

The Office for Registration of Medicinal Products, Medical Devices and Biocidal Products (address of the URPLWMiPB website) monitors the safety of medical devices (address of the URPLWMiPB website: http://www.urpl.gov.pl/).
Medical devices authorised for marketing and use should in particular have a CE conformity marking (CE conformity marking does not apply to customised products, including custom-made orthopaedic medical devices), and meet essential requirements.

REGISTERS AND RECORDS

Register of Entities Performing Medical Activity
The register is available on the Internet at the following address: http://www.rpwdl.csioz.gov.pl/rpm/public/filtrKsiag.jsf
Each health care facility public or private, and every individual or group medical practice performed by a doctor, nurse or midwife (medical practices), has the legal obligation to be entered in the relevant register of entities performing medical activity (subpara. 8(a) of the most important information).

Being entered in the register of entities performing medical activity means that a given institution, or a physician, dentist, feldsher, nurse and midwife practising their profession within a medical practice comply with the quality and safety standards for the provision of health care services.
Registers for the entities providing health care benefits are kept by Voivodes competent for the head office or place of residence of the entity.
Registers for professional practices of physicians and dental practitioners are kept by regional medical councils competent for the place where the professional practice is conducted.
Registers for professional practices of nurses and midwives are kept by regional councils of nurses and midwives competent for the place where the professional practice is conducted.
The entity responsible for functioning of the register of entities performing medical activity is the Centre for Health Care Information Systems (Centrum Systemów Informacyjnych Ochrony Zdrowia). The Centre for Health Care Information Systems is an entity subordinate to the minister competent for health in relation to information systems in health care.

Central Register of Physicians and Dental Practitioners of the Republic of Poland
The register is available on the Polish Chamber of Physicians and Dentists website at the following address: http://rejestr.nil.org.pl/xml/nil/rejlek/hurtd

The Register provides information on licences to practice the profession in relation to a specific physician or dental practitioner.

Register of Penalised Physicians and Dental Practitioners of the Republic of Poland

This register is not generally accessible. Information on penalties imposed on physicians and dental practitioners is provided - upon request - to courts and prosecutors, bodies of appropriate professional associations and the health care professional in question.

The register is kept by the Polish Chamber of Physicians and Dentists.

Central Register of Feldshers of the Republic of Poland

Information about the register is available on the Internet at the following address: http://www.nil.org.pl/rejestry/centralny-rejestr-felczerow

The register is kept by the Polish Chamber of Physicians and Dentists. It contains information on the license to practice in relation to a specific feldsher.

Central Register of Nurses and Midwives

Is available on the Internet at the following address: http://www.nipip.pl/

It contains information on nurses and midwives who have the license to perform their profession. It is kept by the Main Council of Nurses and Midwives.

Register of Penalised Nurses and Midwives

This register can be accessed by persons who prove their legitimate interest. It is kept by the Main Council of Nurses and Midwives.

Register of Pharmacists

It is available on the Internet at the following address: http://www.nia.org.pl/page/17/

It is kept by the Regional Pharmaceutical Council.

Register of generally accessible pharmacies, hospital pharmacies, pharmacies in health care facilities and hospital pharmaceutical departments and pharmaceutical points

It is available on the Internet at the following address: http://www.rejestrymedyczne.csioz.gov.pl/rejestr-aptek

Register of laboratories

It is available on the Internet at the following address:http://kidl.org.pl/index.php?page=lista-laboratoriow

It is kept by the National Council of Laboratory Diagnosticians. Entering a given laboratory in that register is the condition for performing such an activity.

List of laboratory diagnosticians

It is available on the Internet at the following address:http://kidl.org.pl/index.php?page=lista-diagnostow.

It is kept by the National Council of Laboratory Diagnosticians.

Register of Penalised Laboratory Diagnosticians

It is kept by the National Council of Laboratory Diagnosticians. The register includes information on diagnosticians who were the subject of a decision imposing a disciplinary penalty of a warning or reprimand, suspension or termination of the license to perform the profession of a laboratory diagnostician.

Register of health resort facilities and health resort equipment

The registers are kept by Chief Medical Officers of Health Resorts. They are available on websites kept by the voivodeship offices.

TOWNS IN POLAND WITH A HEALTH RESORT STATUS
1.    Augustów, Supraśl in Podlaskie Voivodeship
2.    Busko-Zdrój, Solec-Zdrój in Świętokrzyskie Voivodeship
3.    Ciechocinek, Inowrocław, Wieniec-Zdrój in Kujawsko-Pomorskie Voivodeship
4.    Cieplice Śląskie-Zdrój, Czerniawa-Zdrój, Długopole-Zdrój, Duszniki-Zdrój, Jedlina-Zdrój, Kudowa-Zdrój, Lądek-Zdrój, Polanica-Zdrój, Przerzeczyn-Zdrój, Szczawno-Zdrój, Świeradów-Zdrój in Dolnośląskie Voivodeship
5.    Dąbki, Kamień Pomorski, Kołobrzeg, Połczyn-Zdrój, Świnoujście in Zachodniopomorskie Voivodeship
6.    Goczałkowice-Zdrój, Ustroń in Śląskie Voivodeship
7.    Gołdap in Warmińsko-Mazurskie Voivodeship
8.    Horyniec-Zdrój, Iwonicz-Zdrój, Polańczyk, Rymanów-Zdrój in Podkarpackie Voivodeship
9.    Konstancin-Jeziorna in Mazowieckie Voivodeship
10.    Krasnobród, Nałęczów in Lubelskie Voivodeship
11.    Krynica-Zdrój, Muszyna, Piwniczna-Zdrój, Rabka-Zdrój, Swoszowice, Szczawnica, Wapienne, Wysowa-Zdrój, Żegiestów in Małopolskie Voivodeship
12.    Sopot, Ustka in Pomorskie Voivodeship
13.    Uniejów in Łódzkie Voivodeship

INFECTIOUS DISEASES AND INFECTION
1.    echinococcosis and cysticercosis;
2.    infectious diarrhoea and diarrhoea of unknown etiology in children under the age of 2;
3.    diphtheria;
4.    Lyme disease;
5.    brucellosis;
6.    chlamydia and other non-gonococcal urogenital infections;
7.    cholera;
8.    Creutzfeldt-Jakob disease and other spongiform encephalopathies;
9.    bacillary dysentery;
10.    typhoid fever and infection with typhoid bacteria;
11.    typhoid (including Brill-Zinsser disease) and other rickettsioses;
12.    paratyphi A, B, C, and infections with paratyphoid bacteria;;
13.    plague;
14.    giardiasis;
15.    Q fever;
16.    tuberculosis and other mycobacterial infections;
17.    influenza (including avian influenza in humans);
18.    invasive Neisseria meningitidis infections;
19.    invasive Streptococcus pneumoniae infections;
20.    invasive Streptococcus pyogenes infections;
21.    invasive Haemophilus influenzae infection;
22.    yersiniosis;
23.    campylobacteriosis;
24.    syphilis;
25.    cryptosporidiosis;
26.    pertussis;
27.    legionellosis;
28.    leptospirosis;
29.    listeriosis;
30.    mumps;
31.    glanders;
32.    measles;
33.    ornithosis;
34.    chickenpox;
35.    smallpox;
36.    infantile paralysis (poliomyelitis) and other acute flaccid paralysis, including Guillain–Barré syndrome;
37.    scarlet fever;
38.    foot-and-mouth disease;
39.    rubella and the congenital rubella syndrome;
40.    gonorrhea;
41.    salmonelloses other than those caused by Salmonella Typhi bacteria and Salmonella Paratyphi A, B, C and infections caused by them;
42.    tetanus;
43.    congenital toxoplasmosis;
44.    tularaemia;
45.    anthrax;
46.    Viral haemorrhagic fevers, including yellow fever;
47.    Viral hepatitis (A, B, C, other) and infections caused by hepatitis viruses;
48.    trichinellosis;
49.    rabies;
50.    gastro-intestinal infections and food poisoning of infective or unknown etiology;
51.    nosocomial infections;
52.    West Nile Virus infections;
53.    human deficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS);
54.    meningitis or encephalitis of infectious or unknown etiology;
55.    botulism;
56.    haemolytic-uraemic syndrome and other forms of infection with verocytotoxin-producing Escherichia coli (STEC/VTEC);
57.    severe acute respiratory syndrome (SARS);
58.    malaria;