Policy responses for Poland - HSRM


Policy responses for Poland

3. Providing health services effectively

The section on PROVIDING HEALTH SERVICES EFFECTIVELY describes approaches for service delivery planning and patient pathways for suspected COVID-19 cases. It also considers efforts by countries to maintain other essential services during periods of excessive demand for health services.

3.1 Planning services

On December 27, 2020, Poland began its national immunization programme against COVID-19. The Ministry of Health has ensured that the COVID-19 vaccine will be free for all citizens as well as all legal residents (i.e. individuals holding temporary or permanent residence card). This is of relevance for a large number of Ukrainian citizens who live and work or study in Poland.

Health professionals have been prioritized for vaccination (the so-called Group "0"):
• employees of nodal hospitals
• employees of other entities performing medical activities, including sanitary and epidemiological stations
• employees of nursing homes and employees of municipal social welfare centres
• employees of pharmacies, pharmacy outlets, medical devices supply points, pharmaceutical wholesalers, including companies transporting drugs
• employees of medical universities and students of medical faculties
• non-medical personnel of the above-mentioned entities (including volunteers and interns)

Cancer patients who received chemotherapy or radiotherapy after December 31, 2019 will be vaccinated as a priority group. Registration for vaccination is done automatically with the National Health Fund, in accordance with the ICD-10 disease code.

In January, registration has started for Group 1. The following persons can register for vaccination:
• residents of social welfare homes, care and treatment facilities, nursing and care facilities and other places of stationary stay
• people over 60 years of age, starting with the oldest ones
• uniformed services, including the Polish Army and teachers

Vaccinations have been encouraged through the social media of universities and government institutions (with the hashtag #SzczepimySię [which means “we get vaccinated”]. Politicians, including the Prime Minister, have been encouraging the population to get vaccinated.

By February 4, 1,462 thousand people have been vaccinated against COVID-19 (approx. 3% of population). In January, media reported some cases of queue jumping, mostly by political and cultural figures who were vaccinated at the same time as medical professionals who are in the priority group.

https://www.gov.pl/web/szczepimysie/do-listy-postanowien-noworocznych-zaszczepie-sie [access online 5.02.2021]
https://www.gov.pl/web/szczepimysie/raport-szczepien-przeciwko-covid-19 [access online 04.02.2021]
https://www.infodent24.pl/lexdentpost/szczepionki-przeciwko-covid-19-kto-nalezy-do-grupy-zero,117044.html [accessed online: 05.02.2021]



Primary healthcare outpatient clinics (known as POZ) continue to operate, although most services are provided electronically, via the internet or by the phone (telemedicine), and patients are encouraged to use these services (see Section 3.3).
Each province (voivodeship) has at least one designated single-infection hospital to deal with COVID-19 patients, (most regions have two). These constitute reference hospitals to which confirmed cases can be referred and treated. In addition, provinces have also nominated hospitals with infectious disease departments that will be the second choice to admit patients at risk; these hospitals are required to be at the highest levels of readiness, with appropriate equipment and PPE.
Because these selected hospitals need to be particularly well prepared, smaller hospitals in the same province may lag behind in terms of having basic personal protective equipment or the appropriate number of respirators. Although these small hospitals do not typically deal with infectious diseases or have such departments, it is likely that some patients with suspected COVID-19 may seek admission. Therefore, many hospitals have set aside specific wards to receive confirmed or suspected cases. These wards have been specially separated from other parts of the hospital which, for example, carry out planned procedures.
People in quarantine:
Assistance is available for people who live alone. Special help lines and an app have been developed so that people in home quarantine can receive help with their everyday activities. The app also allows users to contact social workers and local social assistance centres, which may provide medicines or food in justified cases. Social assistance centres have been mandated to focus especially on helping the elderly, lonely and disabled - especially those in need of quarantine support.
Many volunteer groups and non-governmental organisations are helping to provide care for particularly vulnerable people, particularly older people and people with disabilities. Social assistance centres also cooperate with the local Volunteer Fire Brigade units, the Police and the Territorial Defence Army to check in on vulnerable groups, provide services such as delivering meals and food, and refer them to social welfare centres if required.
Patients included in special drug programmes and in chemotherapy programmes:
Access to drugs and therapies has been simplified for patients included in dedicated national drug and chemotherapy programmes. For example, drugs may be dispensed for up to 6 months (based on an individual assessment conducted in person or remotely) and they may be delivered to the patient’s place of residence (or to their legal representative).
Foreign nationals:
All persons currently residing in Poland, including migrant populations who do not have Polish citizenship, have the right to health care services (incl. medicines) and sanitary-epidemiological tests that are related to combating infectious diseases, infections and infectious diseases, including COVID-19.
EU and EFTA nationals residing in Poland who are entitled to health insurance in their countries of origin are invariably entitled to receive in-kind health benefits (not only in relation to an infectious disease) to in Poland in accordance with the rules on the coordination of social security systems among EU / EFTA Member States.
Homeless people:
The Ministry of Family, Labour and Social Policy issued guidelines for facilities that provide shelter to homeless people during the epidemic covering the implementation of specific hygiene rules (equipment, surfaces and personal hygiene) and the preparation of an isolation room for people with suspected infection. These shelters are designed to minimize the movement of people within the facility. To ensure staff safety, it is recommended to minimize presence of staff in the facilities and monitor the health status of all persons (staff and residents) on an ongoing basis. Workers with cold or flu symptoms should be strictly prohibited from working.
The voievodes received guidelines on coordinating cooperation among the police, the fire brigade, and the city guards with social assistance facilities and sanitary and epidemiological stations, especially with regard to providing information on suspected COVID-19 cases among the homeless people, to preparing to receive potential cases and to organising resources, such as food aid.
Institutions that help homeless people can get help from various sources. For example, they can turn to the local social welfare centres to get help with food supplies (which receive support, via the voievodes, from the Food Assistance Operational Program 2014-2020). Food is also available from Food Banks, Caritas Poland, the Polish Social Welfare Committee and the Polish Red Cross. Supplies of disinfectant can be obtained from the KGHM Foundation and the Material Reserves Agency (see Section 3.2).
All activities undertaken by the Prison Service are aligned with the guidelines issued by the Ministry of Health and the Chief Sanitary Inspector. Directors of penitentiary units have appointed working teams to coordinate activities during the COVID-19 epidemic. These teams maintain ongoing cooperation with the provincial and county Sanitary and Epidemiological Stations.
Visits, teaching and group activities, such as religious services, were suspended in prisons. Restrictions on public gatherings in public places (no more than 2 people, see Section 1.2) also apply to residential prison cells. A prisoner with a confirmed infection is transported to an isolation room in a prison hospital, unless their condition requires treatment in an infectious hospital (in which case they are transported there).
Currently, there is no evidence on horizontal transmission of the coronavirus in penitentiary units. The vast majority of inmates who have been isolated show no disease symptoms (but they remain under observation).
Source: http://www.aotm.gov.pl/www/wp-content/uploads/covid_19/2020.04.23_zalecenia%20covid19_v1.0.pdf
https://www.rpo.gov.pl/raport_1/1122 [online access 24.04.2020]
https://www.nfz.gov.pl/aktualnosci/aktualnosci-oddzialow/zasady-leczenia-obcokrajowcow-ktorzy-nie-sa-ubezpieczeni-w-polsce,398.html [online access 24.04.2020]
https://www.gov.pl/web/rodzina/pomoc-dla-bezdomnych-w-czasie-epidemii [access online 24.04.2020]
https://www.medonet.pl/koronawirus/koronawirus-w-polsce,koronawirus-za-kratkami--jak-radza-sobie-polskie-wiezienia-,artykul,60169963.html [access online 24.04.2020]
https://www.nfz.gov.pl/aktualnosci/aktualnosci-centrali/programy-lekowe-a-covid-19,7684.html [access online 24.04.2020]

Visitation of prisoners by their close ones has been allowed from the 1st of August. The decision was taken by the Ministry of Justice and Prison Service, taking into account the current epidemiological situation. In order to protect the safety of officers, prisoners and their families, visititations will have to follow relevant sanitary guidelines.
Source:  https://www.sw.gov.pl/aktualnosc/centralny-zarzad-sluzby-wieziennej-komunikat%2009.07.2020 [access online 13.07.2020]
Older people:
On October 24, with red zone restrictions applied to all of Poland, the government launched the so-called Solidarity Corps for Supporting Seniors - a programme designed to coordinate assistance to the older people, both at the central and local levels, to provide them with the necessary help. The programme is coordinated by the Ministry of Family and Social Policy.  As part of the Corps, a dedicated helpline was launched (22 505 11 11), through which older people aged 70+ (or younger, in special cases) can request help in activities that would require them to leave their homes (e.g. buy groceries). Contact details of the person requesting such help are transferred to their local social welfare center, which will contact this person in order to determine the scope of assistance. Volunteers and non-governmental organizations, as well as the Volunteer Fire Department, Territorial Defense Forces and scouts are involved in providing such support. Provision of assistance is free of charge. Assistance in the form of the delivery of groceries and other purchases is not available to persons who use care services or specialist care services.
Municipalities are required is to keep a register of older people who have decided to stay at home and need support of volunteers. Municipal self-governments may benefit from state funding to organize and implement support services.
https://www.gov.pl/web/koronawirus/cala-polska-w-czerwonej-strefie-kolejne-zasady-bezpieczenstwa-oraz-solidarnosciowy-korpus-wsparcia-seniorow [access online 28.10.2020]
https://www.gov.pl/web/koronawirus/chronmy-osoby-starsze-rzad-tworzy-solidarnosciowy-korpus-wsparcia-seniorow-i-zacheca-do-akcji-wspierajseniora [access online 28.10.2020]