Government Plans New Referral Policy to Transform Services at Kenyatta National Hospital

NAIROBI, Kenya – The government is planning changes to Kenya’s hospital referral system that could reshape how patients access services at Kenyatta National Hospital (KNH), the country’s largest public referral facility.

Health Cabinet Secretary Aden Duale has announced that the government intends to reposition KNH as a specialised referral hospital, with patients expected to receive initial treatment at lower-level facilities before being referred for advanced medical care where necessary.

The proposed changes are intended to improve the organisation of healthcare services, reduce pressure on the national referral hospital and ensure that patients receive treatment at facilities equipped to handle their medical needs.

Speaking during the unveiling of refurbished wards at KNH on October 29, Duale said the hospital should focus on its specialised mandate rather than serve as the first point of contact for every patient.

“KNH must be a referral hospital and KNH must not be a first point of call,” he said.

A new approach to patient referrals

Under the proposed arrangement, patients would initially seek treatment at facilities closer to their communities, including health centres, sub-county hospitals and county referral hospitals.

Patients requiring more advanced medical services would then be referred to higher-level facilities.

The Ministry of Health intends to develop a policy that will guide the referral process and clarify the responsibilities of different levels of healthcare institutions.

The objective is to ensure that patients are directed to facilities based on the seriousness of their conditions and the level of treatment required.

For example, a patient with a condition that can be managed at a county hospital should not necessarily have to travel to Nairobi for treatment. However, patients requiring complex surgery, specialised diagnostics or advanced medical care would be referred to KNH or another appropriate national facility.

The proposed system could help reduce congestion at KNH, where patients from different parts of the country seek treatment.

Strengthening county hospitals

The success of the proposed policy will depend heavily on the capacity of lower-level health facilities.

For the referral system to work effectively, county hospitals must have sufficient medical personnel, essential medicines, diagnostic equipment and reliable emergency services.

Patients must also have confidence that they can receive appropriate treatment at their nearest public health facility without being forced to travel long distances.

This means county governments and the national government will need to coordinate investments in infrastructure, staffing and medical supplies.

A referral system cannot operate effectively if patients are sent to facilities that lack the capacity to provide the required treatment.

The Ministry will therefore face the challenge of ensuring that improvements at KNH are accompanied by meaningful strengthening of healthcare services across the counties.

Emergency response and digital coordination

Duale also pointed to the government's efforts to improve emergency referrals through the National Ambulance Dispatch Centre and the SHA-92 emergency line.

The National Ambulance Dispatch Centre is intended to coordinate emergency medical services and improve communication between ambulance providers and health facilities.

According to government information published in November, more than 200 ambulances accredited by the Kenya Medical Practitioners and Dentists Council had been onboarded into the national network, with further integration expected.

The government has also reported deploying 1,243 emergency medical service providers nationwide as part of efforts to strengthen emergency response capacity.

These measures are intended to improve the movement of patients requiring urgent medical attention and ensure that ambulances take them to facilities capable of managing their conditions.

Digital access to clinical information is another part of the proposed changes. Duale said the government wants patients referred to KNH to arrive with their clinical information available digitally, supporting faster and better-coordinated treatment.

KNH modernisation

The announcement came as KNH unveiled four refurbished and fully equipped wards as part of its ongoing modernisation programme.

The hospital, which serves patients from across Kenya, has a long history as a major public healthcare institution and continues to play an important role in providing specialised services.

Its modernisation is expected to support the delivery of more advanced treatment and improve the experience of patients who require referral-level care.

However, infrastructure improvements alone will not resolve all challenges facing the public healthcare system.

The availability of qualified personnel, medical supplies, sustainable financing and efficient patient management will remain critical to the success of the reforms.

What the proposed policy means for Kenyans

If implemented effectively, the referral policy could reduce unnecessary travel to Nairobi, improve access to specialised treatment and ease congestion at KNH.

However, its impact will depend on whether lower-level facilities are adequately prepared to handle increased patient numbers.

The government is expected to develop the policy and coordinate its implementation with county governments and healthcare providers.

For patients, the most important measure of success will be whether the changes lead to timely treatment, affordable services and improved health outcomes.