ESIC circular U-16/30/649/2023-SST · 24 Jun 2026
Official title
Adoption and implementation of the Standard Operating Procedure (SOP) for P1 Referral Process across all ESI Institutions-reg
Official record
Open source pageSummary
Check the official recordThe Employees' State Insurance Corporation (ESIC) has issued a Standard Operating Procedure (SOP) to standardize the P1 referral process across all ESIC/ESIS hospitals, medical colleges, and regional offices. The SOP mandates specific protocols for generating P1 forms, including real-time patient photography, identity verification, and strict segregation of duties between the initiator, verifier, and approver. It requires the Competent Authority (Dean/Medical Superintendent) to sign all P1 forms, which are financial sanctions. The procedure establishes specific referral signature slots and claim ID generation timings to minimize patient waiting times. Additionally, it emphasizes the use of the Dhanwantri system, prohibits the outsourcing of P1 generation, and mandates surprise inspections to monitor referral trends and practices.
What you must do
Who is affected
If you do not comply
File No.: U-16/30/649/2023-SST 23-06-2026
CIRCULAR
Subject: Standard Operating Procedure (SOP) For P1 Referral Process across all ESI Institutions.
Enclosed herewith is a copy of Standard Operating Procedure (SOP) for P1 Referral Process for adoption and compliance by all ESIC/ESIS Hospitals, Medical Colleges, Regional Offices and other concerned field units.
The SOP has been formulated to streamline P1 Referral Process and to ensure uniformity, transparency and timely decision-making across all locations.
This is issued for kind information.
Encl.: SOP for P1 Referral Process.
(Dr. Bijoy Chandra Deka) Deputy Medical Commissioner (SST)
Copy to:
U-16/30/649/2023-SST I/4041138/2026
A real-time/live photograph of the patient shall be captured and saved in the P1 form and should be legible.
The P1 referral form shall be generated through the system (Dhanwantri). P1 should be generated by the Referring Doctor only.
Strict segregation of duties is to be ensured as follows:
Sharing of User ID and Password is a security risk and is strictly prohibited.
The Dean/Medical Superintendent (Competent Authority), as the case may be, should sign as the authorized signatory in the P1 form, as these are financial sanctions and the MS/Dean should have first-hand information regarding overall functioning, since referrals reflect the overall deficiencies in hospitals on a daily basis.
All P1 forms should contain the Diagnosis/Provisional Diagnosis.
The Referring Doctor should draft the P1 form in consultation with the Head of the Department (HOD).
The Referring Doctor shall check for possible impersonation, i.e., identity verification.
The active eligibility and entitlement status of the Insured Person (IP) or dependent family members shall be confirmed before initiating any referral action.
The patient or their attendant must provide their signature or thumb impression on the P1 form.
The Referring Doctor shall select:
Selection shall be made as applicable and with due diligence to avoid conversion of a genuinely Secondary Care referral into a Tertiary Care referral.
Proper justification shall be provided if an "Open Billing Package" or an extended stay is clinically necessary.
(The proforma for extension of stay already circulated shall be used.)
P1 generation should not be outsourced.
The P1 form shall bear:
Full signatures shall be used instead of initials.
"Reasons for Referral" is a mandatory field and is available through radio button options.
All doctors shall select the most appropriate and genuine reason for referral, considering that the respective doctor has precise knowledge of the department/facility where the case can be treated.
Example: If there is no in-house ICU facility, the reason should be selected as "Lack of ICU" and not "Lack of Specialist."
After verifying all details, the Referring Doctor shall save and submit the P1 referral form in the system, ensuring completeness and correctness of the information entered.
All signatures fields as mentioned in the P1 form are mandatory.
The signature of the Competent Authority (Dean/MS) shall be present in the P1 form as specified.
In case of routine referrals from eligible Dispensaries and DCBOs:
This provision shall apply to all routine referrals.
All referrals may be issued on the same day.
To reduce patient waiting time, the Competent Authority’s final signature may be planned through referral slots as follows:
Referral Signature Slots a) First Slot – 11:00 AM b) Second Slot – 1:00 PM c) Last Slot – 4:00 PM
Saturday: Only the first two slots shall be followed, considering the half-day schedule.
The person assigned for generating Claim IDs shall be placed on duty:
After obtaining the signature of the Competent Authority, Claim IDs shall be generated promptly to reduce waiting time and referral-related grievances.
Surprise inspections may be conducted at any location by officials of ESIC, as assigned, to:
All ESIS Hospitals and Dispensaries shall prioritize routine referrals to ESIC Hospitals and Medical Colleges as the first preference.
All treatment details, investigation reports, entitlement certificates, and other relevant supporting documents shall be attached with the P1 form.
U-16/30/649/2023-SST I/4041138/2026
