Supreme Court directs states to roll out ‘realistic, practical’ ICU standards, sets 3-week deadline for action plan
As part of the implementation process, the Supreme Court asked states and UTs to identify five priority issues relating to ICU infrastructure, particularly in terms of manpower and equipment/logistics.
States have been asked to devise clear implementation strategies and monitoring mechanisms to ensure compliance on the ground. (Image generated using AI)
Supreme Court news: In a push to standardise critical care infrastructure across the country, the Supreme Court has directed all states and Union territories (UTs) to prepare time-bound action plans for implementing minimum standards for Intensive Care Units (ICUs) in hospitals.
A bench of Justices Ahsanuddin Amanullah and R Mahadevan was hearing a batch of proceedings arising out of its earlier judgment dated July 5, 2024, which has since evolved into a court-monitored exercise to frame and implement uniform, minimum standards for ICUs across the country, based on expert inputs and consensus guidelines on critical care infrastructure.
Justices Ahsanuddin Amanullah and R Mahadevan issued the directions on April 20.
The court asked the health secretaries of states and UTs to convene expert meetings within a week to draw up practical, implementable plans, stressing the need for coordinated and immediate action.
“As an immediate measure, let all the Additional Chief Secretaries/Secretaries, as the case may be, heading the Department of Health and Medical Education in the States and the UTs, convene a meeting of all experts involved in this exercise for the purpose of preparing an action plan for implementation of the guidelines. Such a plan shall be realistic and practical,” the Supreme Court said on April 20.
Evolving proceedings on healthcare standards
The directions came in proceedings arising out of the Supreme Court’s earlier judgment dated July 5, 2024, with the matter now expanding into a broader exercise to frame and implement uniform minimum standards for ICU facilities across the country.
Underscoring urgency, the top court directed that the entire exercise, from consultations to preparation of a concrete implementation roadmap, must be completed within a strict three-week timeline.
States to prioritise key ICU requirements
As part of the implementation process, States and UTs have been directed to identify five priority issues relating to ICU infrastructure, particularly in terms of manpower and equipment/logistics.
The Supreme Court observed that the central challenge lies in determining what constitutes “absolutely essential and mandatory” requirements and emphasised that initial efforts must focus on these critical areas.
States have also been asked to devise clear implementation strategies and monitoring mechanisms to ensure compliance on the ground.
The court said it expects the exercise to commence immediately and the first meeting to be held within one week.
The Supreme Court laid down a structured process under which state-level reports will be submitted to the Union Health Ministry, followed by a national-level meeting involving all stakeholders to prepare a common, agreed framework.
A meeting of all the additional chief secretaries/secretaries heading the Department of Health and Medical Education in the states and UTs shall be convened under the secretary, Department of Health, Government of India.
The team constituted by the court shall prepare and circulate to all the states a final common agreed draft by the health secretary.
The Supreme Court directed that such a meeting shall be attended personally by the Secretary, Union Ministry of Health and the additional chief secretaries/secretaries, as the case may be, heading the department in the states and UTs.
The ASG, Amicus Curiae and the members of the team constituted by the court are also requested to participate in the meeting.
A final report/recommendation shall be prepared and placed before this court.
Guidelines finalised, to be issued as advisory
The bench noted that a consensus-based foundational document titled “Guidelines for Organization and Delivery of Intensive Care Services” has already been prepared and placed on record.
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Describing the guidelines as practical and implementable, the Supreme Court directed that they be shared with all states and UTs. It also asked the Union Ministry of Health to formally issue them as an advisory and upload them on its official website.
Expert consultation shapes framework
During the hearing, several eminent medical professionals and institutional heads, including representatives from leading healthcare institutions such as AIIMS, Medanta and Tata Memorial Centre, assisted the Supreme Court and offered practical suggestions.
The apex court recorded that these inputs were “highly practical” and should be incorporated into the final framework. Suggestions included prescribing timelines, ensuring proper training for personnel handling specialised equipment, developing standard operating procedures through checklists, and creating a GPS-based hospital locator to help patients identify nearby facilities in emergencies.
Nursing training flagged as critical gap
Highlighting the importance of skilled personnel, the Supreme court stressed the need to strengthen training of nursing staff, noting their continuous role in patient care in ICUs.
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The Indian Nursing Council and the Para Medical Council of India have been impleaded as parties and directed to propose measures for enhancing curriculum and training to meet ICU requirements.
Next hearing on May 18
The Supreme Court directed that the entire exercise be completed within three weeks and listed the matter for further hearing on May 18, 2026, when a comprehensive report is expected to be submitted.
The order marks a significant step toward building a uniform and robust critical care system across India through coordinated, expert-driven reforms.
Vineet Upadhyay is an Assistant Editor with The Indian Express, where he leads specialized coverage of the Indian judicial system.
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Justices Ahsanuddin Amanullah and R Mahadevan issued the directions on April 20.