Minister of Health: Regulating and controlling surgical procedures in the public and private sectors

Abdul Karim Al-Abdullah

Minister of Health Dr. Ahmed Al-Awadi issued Ministerial Decision No. (220) of 2026 concerning the requirements, regulations, and standards to be adhered to when performing surgical operations or medical interventions in the public and private sectors.

The decision establishes a comprehensive regulatory framework for conducting surgical operations and medical interventions under the Ministry of Health, aiming to organize the professional authorities and privileges of physicians, as well as the mechanisms for supervision, follow-up, documentation, and post-operative patient care.

The decision assigned the responsibility of granting and accrediting authorities and privileges to perform surgical operations and medical interventions to departmental councils. This is done by classifying approved procedures for each specialty according to the job title specified in the professional license, as well as the physician’s specialization and experience, and the nature of the procedure. It also mandates the establishment, periodic review, and updating of the specific requirements, regulations, and standards for each specialty in line with the latest medical developments.

In this regard, the decision reinforced the supervisory and regulatory role of the Deputy Minister of Health. It stipulated that the Deputy Minister shall approve the classifications of operations and the associated requirements, regulations, and standards submitted by the departmental councils. Each council must submit its list of classified surgical procedures for its respective specialty to the Deputy Minister within three months of the decision’s publication for approval.

Furthermore, the decision authorized the Deputy Minister or their delegate, according to the administrative hierarchy, to temporarily suspend a physician’s authority to perform operations or medical interventions when medical necessity dictates. It also empowered them to review requests concerning overlapping authorities among different medical specialties within three months of the decision’s publication.

The decision emphasized that surgical operations and medical interventions must be linked to the physician’s area of specialization, their license, and their accredited professional privileges. It stipulated that elective scheduled operations must be approved by a physician at the specialist level or higher. It also defined the required levels of supervision for physicians based on their job titles, including a prohibition on assistant registrars or residents performing surgical operations or medical interventions independently. Exceptions regarding minor procedures were regulated according to the classification, accreditation, and direct supervision specified in the decision.

The decision strengthened patients’ rights by obligating the attending physician or a designated member of the medical team at the specified job level to obtain informed consent from the patient or their legal representative before performing any operation or medical intervention, and to document this in the medical file. It also required disclosing the identity of the medical team performing the procedure to the patient, and prohibited delegating the procedure to another physician without the patient’s or their representative’s consent, provided that the substitute physician holds the necessary authority.

Additionally, the decision regulated the handling of cases requiring additional expertise during operations. It obliged a physician encountering difficulties or challenges during a procedure to seek assistance from experienced colleagues before changing the type of operation or stopping it, if the patient’s condition permits. It also prohibited surgeons from performing more than one surgical operation simultaneously or leaving the operating room during a procedure, except in cases of extreme necessity and after ensuring the patient’s complete safety, with such instances documented in the medical file.

Regarding the handling of emergency and urgent cases, the decision permitted physicians working in the public sector, within the scope of their license and specified regulations, to perform surgical operations and medical interventions in other government hospitals when necessary, after obtaining the required approvals. It also mandated that the host hospital be prepared and have a qualified medical team available to monitor potential complications.

It also authorized, in emergency or necessary cases aimed at preserving the patient’s life or preventing serious harm, the assignment of surgeons employed by the Ministry of Health to provide surgical care in private health facilities, in accordance with the approvals and procedures specified by the decision.

The decision emphasized the continuity of medical care, obligating on-duty physicians to report to the operating department whenever requested, and prioritizing this duty over clinic consultations or scheduled procedures. It also mandated that the on-duty team, including specialists, senior specialists, and consultants, review new admissions and patients who underwent surgery on the same day, in addition to requiring physicians at specified levels to visit all patients in surgical wards daily.

The decision further required heads of surgical departments to hold regular Morbidity and Mortality meetings at least once a month to review cases, analyze their causes, and assess deficiencies or observations related to the quality of care and patient safety, while formulating necessary recommendations and corrective actions to prevent recurrence. Reports on these matters must be submitted to the quality management department of the health facility through the head of the medical board.

Additionally, the decision mandated that health facilities appoint a responsible person from the specified professional categories to organize surgical operating rooms. This individual is tasked with overseeing their operation, readiness, and the efficiency of equipment, instruments, supplies, sterilization systems, and supply chain integrity. The role also includes coordinating surgical schedules, allocating operating rooms and nursing staff, and preventing schedule conflicts or unauthorized simultaneous surgeries, thereby supporting optimal resource utilization and reinforcing the highest standards of surgical quality and safety.

The decision included additional controls to enhance patient safety and professional governance, such as prohibiting any additional interventions during surgery unless there is an urgent or necessary need, ensuring sufficient operating rooms are operational to accommodate time-sensitive emergency cases, and prohibiting clinical trials through surgical procedures or medical interventions unless approved by the Standing Committee for Coordination of Medical and Health Research and the relevant departmental council.

The decision also obliged the attending physician to follow up with the patient after surgery or medical intervention, or to delegate a qualified substitute physician in their absence, while documenting the follow-up, treatment plan, and review appointments. It stressed the comprehensive recording of data related to surgeries and medical interventions in the medical record and the Operating Theater Logbook, including patient data, diagnosis, procedure name, primary surgeon, assisting surgeons, and nursing staff.

Furthermore, the decision established specific controls for cases involving amputation of body parts or organs, and for excision or tissue sampling (biopsy), including completion of approved forms, sending samples for examination or documenting the reason for not doing so, following up on histopathology results, informing the patient of the outcome, and documenting this in their medical file.