The Supreme Court on 20 April 2026 endorsed uniform guidelines for intensive care units in India. The document, titled “Guidelines for Organisation and Delivery of Intensive Care Services,” was drafted by a three-member committee and vetted by medical experts. The court directed states and Union territories to prepare an action plan by 18 May for implementation of five core areas from the document.
ICU Discharge And Step-Down Care
The guidelines state that a patient who has been clinically stabilised and no longer needs organ support or close physiological monitoring should be shifted to a lower level of care. The lower level of care includes a hospital ward, a high dependency unit, or discharge, as decided by the treating physician. The document uses clinical judgement as the basis for deciding the most appropriate level of care for a critically ill patient.
Minimum Standards For ICU Functioning
The report sets common minimum standards for ICU services. It proposes a nurse-to-patient ratio of one nurse for every two or three ICU patients in a basic ICU, depending on medical acuity. It also provides for one-to-one nursing in a Level 3 ICU, which is meant for critically ill patients requiring multiple organ support.
Staffing And Monitoring Requirements
The guidelines provide for round-the-clock monitoring by a specialist holding a postgraduate degree recognised by the National Medical Council. They also require resident doctors to work in shifts for continuous monitoring. The document includes infection control, fire safety, documentation, allied healthcare personnel, and periodic audits as part of ICU administration.
Infrastructure And Bed Strength
The guidelines state that a basic ICU should have six to eight beds, while larger critical care units may extend to 12 beds. The size of an ICU may vary with the total number of hospital beds, the type of services offered, and the number of operation theatres. The document also lists bedside utilities, transport ventilators, portable oxygen cylinders, imaging services, and laboratory services among the required facilities.
Constitutional And Procedural Context
The matter arose from a 2024 petition linked to a medical negligence case before the national consumer forum. The Centre informed the court in the proceedings that the Union health ministry had prepared Model ICU and critical care unit guidelines in 2023. Health is a State subject under the Constitution, and implementation of such standards requires adoption by states and Union territories.
Last Modified: April 26, 2026