The existing guidelines on the referral protocol system in the state for referring cases from secondary- to tertiary-level institutions—such as district hospitals, general hospitals, medical college hospitals, and other specialty institutions—were developed in response to the need for a well-organized and efficient referral system in Kerala. However, healthcare institutions across the state, spanning primary, secondary, and tertiary levels of care, vary significantly in terms of infrastructure, availability of equipment, and human resources. This created a need to further contextualize the existing referral guidelines and make them more practical and applicable to the realities of service delivery in the state.

Accordingly, SHSRC–Kerala undertook a detailed review of the referral protocol. During the previous financial year, the draft underwent several unofficial revisions following its submission to the Directorate of Health Services and the Directorate of Medical Education. These revisions were carried out through a series of online and offline meetings and discussions. After extensive vetting and consultations, the referral protocol was finalized.

In light of the decisions taken during the meeting chaired by the Hon’ble Minister for Health on 09-05-2024, as recorded in the minutes, the Executive Director of SHSRC– Kerala submitted the final draft of the Referral Protocol. The Government examined the matter in detail and approved the Referral Protocol for implementation. Accordingly, the Government of Kerala has issued the official order for the Referral Protocol.

Subsequently, SHSRC–Kerala prepared the latest edition of the Referral Protocol and initially printed a limited number of copies for distribution to the Office of the Hon’ble Minister for Health and the Directorate of Health Services.