Filenews 5 February 2026 - by Marilena Panayi
An end to the waste of valuable time, an end to the back and forth and the frequent referrals without justification from one hospital to another and an end to the behind-the-scenes "deliberating" between hospitals about who should manage an emergency and who should not.
The Health Insurance Organization proceeded to a revision of the protocol under which serious and real emergencies are managed by each A&E separately, updating the capabilities of each Department and sent instructions to the hospitals asking for their compliance with the new data and especially the cooperation between them in order to serve patients in need of urgent specialized care without delay, since they are on the list of "unmanageable emergencies".
This specific, revised, protocol does not concern patients transported by ambulances but all other, serious and urgent cases that require specialized care and occur "suddenly" in the A&E of the GHS.
According to the relevant circular, the HIO defines an "unmanageable emergency" as an incident that occurs suddenly in an A&E and requires immediate medical intervention, which, however, exceptionally, the specific hospital cannot deal with at the given time.
The cases that may lead to referral mainly concern cases of increased severity and specialization, such as multi-trauma, cardiac and cardiac surgery emergencies, operations on the brain and large vessels, emergency interventional radiology procedures, as well as highly complex minor surgeries, such as amputation of an amputated limb.
The protocol specifies specific hospitals to which a referral can be made, depending on the type of case.
In the public sector, Nicosia General Hospital can accept all categories of cases that fall under the protocol, while Limassol General Hospital accepts cases of multi-injured people, interventional cardiology and operations of increased complexity.
In the private sector, Mediterranean Hospital and Hygieniki Polyclinic can accept all categories of unmanageable emergencies, while Apollonio Hospital accepts cases involving cardiac surgery, interventional cardiology, emergency neurosurgery, operations of increased complexity and interventional radiology procedures.
For each referral, the mandatory issuance of a referral is provided, to the hospital that is unable to serve is obliged to document the reasons why the incident could not be properly managed.
The whole process must be fully recorded, in order to ensure transparency and control, while the hospital that undertakes the management of the incident must state where it was referred from.
The HIO clarifies that the revised protocol does not concern the Ambulance Service, nor does it change the actions that the citizen must follow in case of emergency.
The Organization emphasizes, concluding in its circular, that referral is not the rule, as hospitals that have the required capabilities in terms of medical staff and infrastructure must make every effort to manage the case on the spot.
