Policy responses for Latvia - HSRM


Policy responses for Latvia

3.3 Maintaining essential services

From 13 May, the availability of planned health care services will be expanded, still in strict compliance with precautionary measures, as follows:

In secondary outpatient health care:
•      Specialist consultations;
•      examinations - endoscopy, scintigraphy, neurography, mammography, myography, osteodensitometry;
•      outpatient rehabilitation, except day hospital services;

In day hospital:
•      coronarography, coronary angioplasty, invasive radiology services;
•      eye surgery;
•      invasive treatment of patients with arrhythmias;
•      maxillofacial surgery;

In inpatient care:
•      microsurgical treatment of bedsores, chronic skin, soft tissue ulcers;
•      eye surgeries
•      invasive treatment of patients with arrhythmias;
•      cochlear implantation;
•      organ transplantation;
•      joint replacement;

All kinds of dental services.

From 20 May  day hospital services that do not require general anesthesia will also be provided.

Medical institutions must ensure a separate flow of patients, limit the number of patients staying in the premises at the same time, and set a precise time of arrival for patients. Medical institutions have to provide personal protective equipment, and disinfection measures will be taken after each patient's visit.

For elective surgery or invasive procedures, the patient must have undergone a COVID-19 test paid for by the state no later than 48 hours before receiving the service. Patients are refered to the test by doctor in charge.

Medical institutions  are required, as far as possible, to initially provide healthcare to those who have previously been discharged due to the emergency situation.

Update 29 June:

The following will be in force until the end of 2020 (Amendments to Cabinet Regulation No. 555 of 28 August 2018 “Procedures for Organization and Payment of Health Care Services” June 9,2020)

-Remote consultations continue. The doctor will assess whether remote consultation is possible or if it is necessary to assess the patient's state of health in person. The patient will not have to pay for the remote consultation.

Emergency medical care, including the necessary examinations and counselling continue to be provided. This means that the patient's access to emergency care is not restricted. Family doctor practices are also continuing. Similarly, oncological and lifesaving operations will continue as scheduled. Pregnant women, oncology patients in the green corridor, HIV / AIDS and tuberculosis and other patients receive the help they need. Where possible, advice will be provided remotely.

A number of ambulatory services (e.g. psychologist, rheumatologist, urologists, paediatricians) are suspended during the COVID-19 outbreak.

Special guidance is given to home care providers with strict observance of the prescribed safety precautions and hygiene requirements. Municipalities have an obligation to individually address the issue of the provision of hygiene materials, liaising with purchase organizations and dealing with cost recovery. 

Long-term care facilities have introduced quarantine in the form of a ban on visits and a ban on patients leaving the institution. The placement of new patients in publicly funded social care centers has been suspended.

On April 20th, some of the health care services that were limited or suspended over the Covid-19 pandemic were resumed under strict compliance with precautionary measures. 

This relates to:

- state-organized breast cancer screening (mammography);

- echocardiography, ultrasonography and other radiology and examinations with a referral from a family doctor or specialist;

- initial consultations with an endocrinologist, cardiologist, rheumatologist, pneumonologist, ophthalmologist and neurologist;

- diabetic foot care;

- completion of initiated dental prosthetic and orthodontic treatments

Starting from April 20, the scope of planned health care services has been expanded. Medical institutions prioritize the registration of patients for whom the service was cancelled due to the state of emergency. Before the visit patients have to contact the institution by telephone or electronically and can go only after a specific time and date of arrival has been set.

Information about available publicly-funded healthcare services can be searched on the NHS website rindapiearsta.lv, where a "yes" or "no" next to the service indicates the availability of the specific service.