Coordinating Visiting Healthcare Professionals in Residential Long-Term Care in Viet Nam: Professional Scope, Clear Responsibilities and Safe Follow-Up

Coordinating Visiting Healthcare Professionals in Residential Long-Term Care in Viet Nam: Professional Scope, Clear Responsibilities and Safe Follow-Up

A visiting doctor examines an older resident who has recently become less mobile and developed swelling in both legs. After assessing the resident and considering whether urgent treatment is needed, the doctor recommends further investigations, explains which changes would require immediate medical attention, and requests follow-up within a specified timeframe.

The resident's daughter attends the consultation and believes the facility will arrange the laboratory tests. A care worker assumes the doctor will contact the family about the next steps. The facility manager understands that the daughter will organize the testing.

Several days later, nobody has confirmed whether the tests were completed. The resident's condition has not improved, and the next care worker cannot establish what follow-up was originally intended.

The consultation took place, but the arrangements needed to continue care were never clearly established.

This situation illustrates a challenge in residential long-term care. Older people may receive appropriate clinical advice from visiting healthcare professionals, yet important recommendations can remain unresolved because several people or organizations assume that someone else is responsible.

For residential care providers in Viet Nam, visiting healthcare services can improve access to medical assessment, reduce unnecessary travel, and help older people receive appropriate care in a familiar environment. These benefits can be particularly valuable for residents with mobility limitations, multiple chronic conditions, or substantial care needs.

However, arranging a consultation is only one part of effective coordination. Organizations also need to understand which professionals may lawfully provide healthcare, how clinical information should be communicated, what care workers can safely do, and who will ensure that agreed follow-up actions take place.

The objective is not to make residential facilities responsible for clinical decisions outside their authority. It is to connect the responsibilities of healthcare professionals, residential care providers, residents, and families so that important care needs are not overlooked after a visit.

Where Healthcare and Residential Long-Term Care Meet

Residential long-term care facilities support older people with different combinations of health conditions, functional limitations, and personal care needs.

Some residents require assistance with meals, dressing, mobility, or everyday routines while their medical conditions remain relatively stable. Others live with multiple chronic diseases, cognitive impairment, or conditions requiring frequent professional assessment.

Their healthcare may involve several practitioners and organizations. A physician may review chronic disease management or investigate a new symptom. A specialist may provide advice about a particular condition. A nurse may undertake an authorized clinical intervention, while a rehabilitation professional may assess functional abilities and recommend ways to support mobility or independence.

These services may be delivered through licensed healthcare establishments, appropriately organized visiting services, or referrals to external providers.

From the resident's perspective, the different activities are closely connected. A medication change may affect daily routines. A rehabilitation recommendation may alter the assistance needed when walking. A diagnostic finding may lead to another appointment or a revision of the care plan.

The organizations involved, however, may operate under different legal, professional, contractual, and information systems.

A clinician makes healthcare decisions within the applicable professional and service arrangements. Residential care workers provide everyday support and report relevant observations. Facility coordinators may organize appointments, communicate with families, and help residents access healthcare.

Each has a contribution to make, but their responsibilities are not interchangeable.

The challenge is to establish dependable collaboration without allowing the boundaries between regulated clinical practice and personal care to become unclear.

Understanding Different Visiting Healthcare Arrangements

Not every visit by a healthcare professional creates the same relationship between the resident, the clinician, and the residential facility.

A facility may have a formal arrangement with a licensed healthcare organization to provide periodic consultations or selected clinical services. In another situation, a resident or family may independently arrange for their usual physician or another healthcare professional to visit.

A specialist may attend for a particular assessment, or a rehabilitation professional may be engaged to evaluate functional needs.

These arrangements can involve different responsibilities.

Where the residential provider directly organizes or contracts for clinical services, it should understand which organization is delivering the healthcare, the activities covered, the applicable professional arrangements, and how responsibilities will be coordinated.

Where a resident independently engages an external healthcare provider, the facility's role may be more limited. It may facilitate access, prepare relevant information with appropriate authorization, or support the implementation of recommendations within its own lawful services.

The distinction becomes important when difficulties arise.

A family-arranged consultation does not automatically make the residential facility responsible for every subsequent clinical decision. Equally, the facility should not disregard significant safety concerns simply because the clinician was independently engaged.

A formal arrangement with an external healthcare provider also does not automatically transfer all responsibility for the resident's everyday support to that provider.

Three matters need to remain clear: who is responsible for clinical decisions, who is responsible for organizing the external service, and what the residential provider has undertaken to deliver through its own care arrangements.

Clarifying these responsibilities before services begin is considerably easier than resolving uncertainty after an important recommendation has been missed.

Professional Qualifications Do Not Automatically Authorize Every Visiting Service

A visiting healthcare professional's qualifications and experience are important, but they do not answer every legal question concerning where and how clinical services may be delivered.

In Viet Nam, the Law on Medical Examination and Treatment No. 15/2023/QH15, as amended, establishes the framework for healthcare practitioner licensing, professional scope, healthcare establishment activities, and the conditions governing medical examination and treatment.

Article 79 is particularly relevant to healthcare delivered outside conventional clinical premises.

It identifies different forms of mobile medical examination and treatment, including services provided outside the location recorded in a healthcare establishment's operating license, medical examination and treatment at home, health examinations at organizations or institutions, and certain humanitarian healthcare activities.

The distinctions matter because the relevant statutory conditions and procedures are not identical.

For example, Article 79 contains provisions concerning approval by the provincial health authority for specified categories of mobile and humanitarian medical examination and treatment, subject to the exceptions established by law. Those requirements should not automatically be applied in the same way to every activity described in the article.

Government Decree No. 96/2023/ND-CP, as amended and applicable, provides further requirements concerning professional qualifications, licensed establishments, facilities, equipment, and relevant procedures.

Articles 82 and 83 address conditions and administrative arrangements for specified mobile and humanitarian medical examination and treatment activities.

It would therefore be inaccurate to assume that every healthcare professional visiting a residential care facility must follow one identical authorization procedure.

It would also be inaccurate to assume that an individual's professional practice license automatically permits every form of clinical activity to be organized at any location.

The residential nature of the premises does not, by itself, determine how a proposed healthcare service should be classified under the law.

The appropriate legal treatment depends on the actual activity, the healthcare organization providing it, the practitioner's authorized scope, the place of service delivery, and any applicable conditions or procedural requirements.

A residential facility should not assume that providing a consultation room, signing an agreement with a doctor, or purchasing medical equipment is sufficient to establish the legality of the healthcare service.

When establishing recurring visiting arrangements, the provider should clarify these matters with the licensed healthcare organization and obtain appropriate professional or regulatory advice where necessary.

The purpose is not to make legitimate healthcare access unnecessarily difficult. It is to ensure that services are organized lawfully and that residents, professionals, and facility employees understand their respective responsibilities.

Choosing the Appropriate Healthcare Response

A request for a visiting healthcare professional should begin with the resident's actual needs.

A routine clinical review is different from a new symptom that may indicate serious deterioration. A functional mobility concern may benefit from rehabilitation assessment, while an unresolved diagnostic problem may require physician evaluation or access to specialist services.

Care workers often provide the first indication that something has changed. They may notice that a resident is eating less, becoming unusually tired, requiring more assistance to walk, or appearing breathless during familiar activities.

Such observations can be important, particularly when the worker knows the person's usual condition.

However, recognizing a change is not the same as diagnosing its cause. Employees should describe what they have observed and follow appropriate reporting and escalation arrangements rather than making unsupported clinical conclusions.

Decisions about arranging a consultation should consider the nature and urgency of the concern, the resident's preferences, relevant clinical advice, and the availability of suitable services.

Existing relationships with treating clinicians may support continuity, especially when a resident has a complex medical history. Nevertheless, convenience should not take priority over timely assessment.

Some situations cannot safely wait for a scheduled visit.

Sudden changes in consciousness, severe breathing difficulties, new neurological symptoms, or other signs of potentially serious deterioration may require urgent medical evaluation.

In Viet Nam, emergency medical assistance can be requested through 115.

The facility's response should follow its established emergency procedures, the resident's condition, and advice from appropriately qualified professionals.

If a resident's condition worsens after a consultation, staff should not assume that an earlier follow-up appointment remains sufficient. New or worsening symptoms may require reassessment and escalation according to the circumstances.

Visiting healthcare should improve access to suitable services. It should not become a reason to delay emergency treatment, necessary diagnostic investigations, or referral to an appropriately equipped healthcare establishment.

Preparing for a Consultation Without Speaking for the Resident

A visiting clinician may have limited time with each resident. The value of that time depends partly on whether relevant information is available and whether the resident has an opportunity to explain their concerns.

Before a planned consultation, the facility should identify why the visit has been requested and gather information relevant to the resident's current circumstances.

This may include recent changes in health or function, observations recorded by care workers, known allergies, current medication information, and relevant previous clinical recommendations.

The information should be accurate, proportionate, and appropriately available to the clinician.

Staff should distinguish their direct observations from information provided by the resident, relatives, or other professionals.

For example, a worker may report that a resident has needed assistance to stand for the previous three days. The worker should not describe this as a particular neurological or musculoskeletal condition without appropriate professional assessment.

Changes observed over time may be more informative than a single isolated event. Where records are available, they may help the clinician understand whether a problem is new, persistent, or fluctuating.

The resident's own priorities also matter.

An older person may be more concerned about pain, fatigue, sleep, or difficulty participating in daily activities than the issue that originally prompted the appointment.

Preparing for a consultation should not mean that employees decide in advance which concerns the resident is allowed to discuss.

The facility's role is to support communication and provide relevant information while preserving the healthcare professional's independent judgment and the older person's opportunity to participate.

Consent, Choice, and Privacy During Visiting Consultations

A residential care facility is also the older person's living environment.

Agreeing to receive accommodation and personal assistance does not mean that the resident has automatically consented to every healthcare consultation, examination, or treatment.

Viet Nam's Law on Medical Examination and Treatment establishes patient rights concerning information, privacy, participation in healthcare decisions, and refusal of medical examination and treatment within the applicable legal framework.

Residents should receive appropriate information about planned visits and have meaningful opportunities to express their preferences.

The healthcare professional remains responsible for obtaining the consent required for the clinical activities they undertake, subject to applicable legal requirements and exceptions.

Facility employees may assist with communication and practical arrangements, but organizing a visit does not give them authority to consent to treatment on the resident's behalf.

Age or a diagnosis of dementia does not automatically mean that someone lacks legal decision-making capacity.

Where capacity or representation becomes relevant, the applicable legal and professional requirements must be followed. Family participation should reflect the resident's rights, preferences, and the legal authority of those involved.

Privacy deserves equal attention.

Consultations involving sensitive health information should take place in an environment that reasonably supports confidentiality and dignity.

Care workers should not remain present simply because they arranged the appointment. Their involvement should have an appropriate purpose, taking account of the resident's preferences, communication needs, and clinical circumstances.

External professionals should likewise recognize that the setting is someone's home, even when it forms part of a larger care organization.

Clinical care should be organized in a way that respects residents' personal space, belongings, relationships, and privacy.

Keeping Clinical and Care Responsibilities Clear During the Visit

Once the visiting professional arrives, the responsibilities of those involved should remain clear.

The healthcare practitioner is accountable for clinical decisions and interventions within their lawful scope and applicable professional obligations.

The residential facility remains responsible for the support and services it has undertaken to provide, including relevant coordination and organizational safety arrangements.

Care workers may help the resident prepare for an examination, communicate observations, support movement within their competence, or assist with practical arrangements.

However, a clinician's request does not automatically authorize an employee to perform a regulated medical procedure.

The presence of a doctor, for example, does not by itself authorize an unqualified care worker to administer an injection, undertake an invasive procedure, or perform another activity requiring specific professional competence or authorization.

The same principle applies to clinical monitoring and treatment tasks involving professional interpretation.

The environment must also be appropriate for the proposed activity.

Certain procedures may require suitable equipment, infection prevention and control arrangements, medical waste management, emergency preparedness, or other safeguards.

The fact that a procedure can physically be performed in a resident's room does not establish that it is legally authorized or clinically appropriate there.

When the facility cannot safely support a proposed intervention, that limitation should be communicated. An alternative arrangement may be necessary through an appropriately authorized healthcare provider or at a more suitable location.

Effective collaboration depends on understanding what each person can contribute and where their responsibilities end.

The Consultation Is Not Complete When the Clinician Leaves

An important coordination challenge often begins after the visiting professional has finished the consultation.

The clinician may recommend further testing, request specialist assessment, prescribe treatment, identify symptoms requiring monitoring, or arrange a subsequent review.

Some actions may need attention immediately, while others may be planned over the following days or weeks.

If recommendations are not communicated clearly, important information can be lost between the clinician, resident, family, and care team.

The residential provider should have an agreed process for receiving and recording information necessary to fulfill its own responsibilities.

Depending on the service and applicable requirements, this may involve a consultation summary, relevant clinical documentation, an authorized prescription, a referral, or another suitable professional record.

The information should make clear what action is recommended, whether it is urgent, who is expected to act, and how follow-up will be arranged.

However, the residential facility should not assume responsibility for creating or maintaining statutory medical records belonging to an external healthcare provider.

Each organization must fulfill its own documentation obligations.

The residential provider needs sufficient information to organize its agreed support and recognize unresolved care needs. The licensed healthcare establishment and its practitioners remain responsible for their professional activities and records under the applicable legal framework.

Unclear verbal instructions create particular risks when several shifts or organizations are involved.

A statement such as "continue monitoring" may mean different things to different workers unless the intended observations, timeframe, and escalation arrangements have been explained.

Where instructions are incomplete or ambiguous, the appropriate response is to obtain professional clarification rather than leave non-clinical employees to interpret them independently.

Clear communication should also allow the resident, and appropriately involved family members or representatives, to understand the next steps and whom to contact if concerns arise.

Closing the Loop on Clinical Recommendations

A recommendation does not become completed care simply because it was mentioned during a consultation.

A doctor may request a test without knowing who will organize the appointment. A family member may agree to contact a specialist but later encounter practical difficulties. A care coordinator may record a follow-up requirement without confirming that anyone has accepted responsibility.

The result can be a gap in care even when everyone involved intended to help.

For each significant recommendation, it should be clear who is responsible for the clinical decision and who has agreed to arrange any necessary practical action.

These may be different people or organizations.

The healthcare provider ordering an investigation should establish appropriate arrangements for receiving, reviewing, and acting on the results in accordance with its professional responsibilities and the applicable service arrangements.

A residential facility that agrees to organize transport, schedule an appointment, or communicate information should carry out that task and report problems that prevent completion.

Family members may also undertake agreed arrangements, but their involvement should not be used to transfer professional responsibilities that belong to appropriately qualified healthcare practitioners or licensed establishments.

For a residential provider, a simple record may be sufficient to track agreed coordination tasks. It may identify the outstanding action, the person or organization responsible, the relevant timeframe, and how completion or a difficulty will be communicated.

This is a practical quality improvement approach rather than a universal reporting template required by Vietnamese law.

Importantly, confirming that a test was performed or a referral was arranged does not establish that the associated clinical issue has been resolved.

The residential provider should be able to recognize whether an agreed organizational task remains outstanding, while the appropriate healthcare professional remains responsible for clinical interpretation and decisions.

If an agreed step cannot be completed, the relevant person or organization should be informed so that further arrangements can be considered.

The aim is to prevent important recommendations from disappearing between services, not to transfer clinical accountability to an administrative tracking process.

Diagnostic Results Need an Identifiable Clinical Follow-Up Pathway

Laboratory investigations and diagnostic imaging create particular risks when several organizations are involved.

A visiting clinician may request a test performed by another provider. Results may be sent to the ordering clinician, delivered to a family member, or made available through a system the residential facility cannot access.

It may then become unclear whether the findings have been reviewed and whether additional action is needed.

An appropriately qualified healthcare professional must interpret diagnostic results and determine their clinical significance.

Residential care workers should not be expected to decide whether a laboratory value is acceptable, whether an imaging finding is important, or whether treatment should be changed.

However, a facility can contribute to safer coordination by recognizing gaps in the follow-up process.

If a test was recommended and nobody knows who will receive the result, the facility should raise that concern with the relevant healthcare provider.

Where the facility has agreed to organize testing, it should confirm whether that organizational task occurred and communicate any difficulty or delay.

The clinical pathway should also address how significant or urgent findings are communicated, especially when the resident's condition may be changing.

Receiving a test report is not the same as completing clinical follow-up. The responsible professional needs to review the findings, determine their significance, and arrange the appropriate response.

The residential provider's contribution is to support the agreed pathway, recognize unresolved issues, and escalate concerns without taking over clinical interpretation.

Medication Changes Require Clear and Verified Instructions

Visiting healthcare professionals may recommend starting, stopping, or changing medicines.

Such recommendations can affect the resident's daily care, particularly when several clinicians are involved.

An informal discussion about a possible treatment change is not necessarily an actionable prescription or complete clinical instruction.

The facility should understand how medication changes will be confirmed, communicated, and incorporated into the resident's care arrangements.

Where a prescription or another legally recognized instruction is required, the relevant professional and legal requirements must be satisfied.

Care workers should not independently prescribe medicines, change doses, resolve conflicting prescriptions, or undertake medication-related activities outside their lawful responsibilities and competence.

If a recommendation appears inconsistent with existing medication information, the discrepancy should be referred through an appropriate professional channel.

The facility should also consider whether it has the authorization, qualified personnel, and operational arrangements necessary to support the revised treatment.

Some forms of medication assistance may fall within the responsibilities of appropriately trained personnel under applicable arrangements. Other activities may require licensed healthcare professionals or delivery in a different setting.

International guidance, including the National Institute for Health and Care Excellence's Managing Medicines in Care Homes, emphasizes clear communication, accurate records, and appropriate coordination when medicines are started, changed, or stopped.

The specific operational requirements of that guidance reflect the UK care context and should not be interpreted as automatically establishing Vietnamese legal obligations.

For residential providers, the important question is whether valid treatment instructions reach the right people and can be implemented safely within the organization's actual capabilities.

Translating Rehabilitation Advice Into Safe Daily Support

Visiting rehabilitation professionals can help older residents maintain function, regain confidence, and participate in everyday activities.

A rehabilitation assessment may lead to recommendations concerning mobility, positioning, exercise, assistive equipment, or the level of support needed during daily routines.

These recommendations must be practical for the person and the care environment.

A professional may recommend an activity that requires a particular level of supervision, specialized equipment, or assistance from trained personnel.

The residential facility needs to understand which activities can be supported through its existing services and which require continued professional involvement.

Workers should not attempt unfamiliar or hazardous techniques simply because a general rehabilitation recommendation mentions an activity.

The facility should also communicate practical limitations that may affect implementation.

A recommended movement may be unsuitable for the available space, staffing, or equipment. In such circumstances, the rehabilitation professional and relevant care personnel should consider an appropriate alternative.

The goal is not to turn everyday care workers into rehabilitation practitioners. It is to help residents benefit from professional advice through coordinated support that respects safety, competence, and individual goals.

When Several Clinicians Are Involved

Older residents may receive care from several healthcare professionals who work independently and use different medical record systems.

A primary care physician may manage chronic conditions while specialists address particular problems.

Over time, recommendations, prescriptions, and follow-up arrangements may become difficult to reconcile.

The residential care team should understand which information is relevant to its responsibilities and where professional clarification is necessary.

However, non-clinical employees should not resolve conflicting clinical recommendations through their own judgment.

If two practitioners appear to have provided inconsistent instructions, the relevant healthcare professionals should be asked to clarify the intended plan.

The most recent consultation does not necessarily replace every earlier recommendation. Different practitioners may be managing different conditions, and their decisions may need to be reconciled through appropriate clinical communication.

For residents with complex needs, identifying a coordinating clinician may be beneficial where suitable healthcare arrangements are available.

The residential facility can contribute by recognizing discrepancies, reporting observations accurately, and supporting agreed follow-up.

More specialist appointments do not necessarily result in better care when recommendations remain disconnected.

The quality of information exchange matters as much as access to professional expertise.

Family Involvement Should Support Professional Accountability

Families often make substantial contributions to healthcare coordination for older people living in residential facilities.

Relatives may identify clinicians, attend consultations, arrange transport, pay for investigations, or obtain prescribed medicines.

Their knowledge of the resident's medical history and preferences can be valuable.

However, family participation should not automatically make relatives responsible for every outstanding healthcare task.

The responsibilities of clinicians, residential providers, residents, and family members need to be understood separately.

A family member may agree to schedule an appointment, but the healthcare professional remains responsible for clinical decisions and actions within the applicable professional arrangements.

Similarly, the residential facility remains responsible for the support and services it has undertaken to provide.

The older person should participate in healthcare decisions wherever possible.

Family members do not automatically have unrestricted authority to consent to treatment or receive confidential information merely because they are relatives or pay for care.

The appropriate legal basis and circumstances must be considered.

Healthcare costs should also be explained clearly.

Residents and families may need to know whether a consultation is included in the residential service package, provided through a separate healthcare arrangement, or charged directly by an external provider.

Financial transparency is important, but payment responsibilities should not be confused with clinical accountability.

Clear communication helps prevent misunderstandings without shifting inappropriate responsibilities onto residents, families, or care workers.

Protecting Confidentiality Across Organizational Boundaries

Effective coordination often requires information to move between several organizations.

A visiting clinician may need relevant medical history, medication information, or observations made by the residential care team.

The facility may need a consultation summary or appropriate instructions to support everyday care.

Much of this information may constitute sensitive personal data.

Viet Nam's Law on Personal Data Protection No. 91/2025/QH15 and Government Decree No. 356/2025/ND-CP both took effect on January 1, 2026.

These instruments establish relevant requirements concerning the lawful processing and protection of personal information.

The Law on Medical Examination and Treatment also addresses patient confidentiality and healthcare records within its applicable scope.

Residential providers and visiting healthcare organizations should establish appropriate arrangements for exchanging information.

The legal basis for processing, authorized recipients, relevant consent requirements, confidentiality, information security, and access controls should be considered according to the circumstances.

The fact that a clinician is providing care does not automatically justify unrestricted access to every personal record held by the residential facility.

Likewise, a family member's involvement in appointment scheduling or payment does not automatically authorize disclosure of the resident's complete medical information.

Information sharing should support legitimate care needs without unnecessary disclosure.

Digital communication can make coordination easier, but convenience should not replace appropriate safeguards.

Informal messaging groups, personal accounts, and shared devices should not become uncontrolled repositories of sensitive health information.

Organizations should consider how information is transmitted, who may access it, and how relevant clinical instructions are incorporated into appropriate records.

The objective is to ensure that necessary information reaches the people with a legitimate role while respecting privacy, professional confidentiality, and Vietnamese law.

Applying Viet Nam's Legal and Regulatory Framework

The distinction between residential care and regulated medical examination and treatment is central to organizing visiting healthcare services.

Viet Nam's Law on Medical Examination and Treatment No. 15/2023/QH15 took effect on January 1, 2024, and has subsequently been amended.

Consolidated Document No. 26/VBHN-VPQH, issued on February 26, 2026, provides an official consolidated reference incorporating amendments reflected at that time.

The law addresses patient rights, healthcare practitioner responsibilities, professional scope, healthcare establishments, and the conditions governing medical activities.

Article 79 is particularly relevant to medical examination and treatment delivered outside the usual premises of healthcare establishments.

Decree No. 96/2023/ND-CP, as amended and applicable, provides implementing requirements, including relevant provisions in Articles 82 and 83 concerning specified mobile and humanitarian medical examination and treatment arrangements.

The application of these provisions depends on the actual activity and its legal classification.

Organizations should not assume that every visiting consultation is subject to the same licensing, approval, or notification procedure.

They should also avoid assuming that an individual's practice license, without considering the healthcare establishment and service arrangements, establishes the legality of every activity delivered at a residential facility.

Where recurring clinical services are planned, the residential provider and external healthcare organization should clarify the legal and operational arrangements before services begin.

Social assistance facilities are subject to a separate regulatory framework.

Decree No. 103/2017/ND-CP, as amended and applicable, remains relevant to the establishment, organization, operation, and management of social assistance facilities before its replacement.

Government Decree No. 395/2026/ND-CP on the operation and management of social assistance facilities was issued on October 23, 2026, and is scheduled to take effect on December 7, 2026.

At the time of this article's review on November 3, 2026, the new decree has been issued but is not yet in force.

Article 6 of Decree No. 395/2026/ND-CP addresses the tasks of social assistance facilities within its defined scope.

In particular, Clause 6 provides for the delivery of medical examination and treatment services where the facility meets the legal conditions for doing so, or for connecting residents with healthcare establishments and arranging appropriate referrals.

The distinction is significant.

A social assistance facility may have responsibilities for supporting residents' access to healthcare without being legally authorized to provide every clinical service directly.

The new decree does not independently authorize regulated medical activities without compliance with the relevant healthcare legislation.

Nor should every organization describing itself as a nursing home, elderly care center, or residential facility be assumed to have the same legal classification.

The applicable requirements depend on the organization's status, authorized activities, healthcare providers involved, contractual arrangements, and services actually delivered.

Organizations within the scope of Decree No. 395/2026/ND-CP should prepare for its implementation while continuing to comply with the requirements currently in force.

Building a Practical Visiting Healthcare Coordination System

Reliable coordination does not necessarily require complicated technology or a large clinical governance department.

Smaller residential facilities can often improve their processes by establishing clear responsibilities and maintaining accurate, controlled records.

Before a visit, the organization should understand why the consultation is being arranged, which provider will deliver the service, and what information the resident and relevant parties need.

Appropriate arrangements should support the resident's participation, privacy, and consent.

During the consultation, clinical and non-clinical responsibilities should remain clear.

Afterward, the facility should obtain the information needed for its own care obligations and identify recommendations requiring further coordination.

Where the provider agrees to arrange transport, organize an appointment, communicate a recommendation, or complete another task within its responsibilities, that action should have an identifiable owner.

Outstanding issues should remain visible until the relevant task has been completed, responsibility has been appropriately transferred, or a further plan has been established.

For larger facilities, a designated coordinator or structured referral system may help manage multiple visiting professionals and unresolved recommendations.

Electronic tracking can be useful, particularly when residents receive healthcare from several organizations.

However, technology cannot replace professional accountability or clear responsibilities.

A tracking system has limited value if nobody reviews unresolved tasks.

Equally, the facility should not create documentation that assigns clinical responsibilities to employees who lack the legal authority or professional competence to perform them.

The arrangement should be proportionate to the service and realistic for the people expected to use it.

Its purpose is to prevent important recommendations from being forgotten because everyone assumes somebody else will act.

Measuring Whether Follow-Up Is Actually Completed

Residential care organizations may track the number of visiting consultations or how frequently particular specialists attend.

These figures describe service activity, but they reveal relatively little about the quality of coordination.

A facility may arrange numerous visits while still experiencing missed appointments, unclear treatment instructions, or unresolved diagnostic findings.

A more meaningful quality improvement approach examines what happens after consultations.

Organizations may review whether relevant recommendations were received and documented, whether follow-up responsibilities were clear, whether agreed organizational actions were completed, and whether delays or difficulties were appropriately escalated.

Communication between shifts and between external healthcare providers should also be considered.

Repeated requests to clarify unclear instructions may reveal weaknesses in documentation. Delays in arranging investigations or appointments may indicate problems with coordination.

These findings require careful interpretation.

An increase in identified unresolved tasks may reflect better reporting rather than worsening care quality. Conversely, few reported problems do not necessarily establish that coordination is reliable.

Resident experience provides another important perspective.

Older people should be supported to understand why a healthcare professional visited, what was recommended, and what is expected to happen next, in a manner appropriate to their communication and decision-making needs.

Family feedback may provide additional insight, particularly when relatives assist with external healthcare arrangements.

The aim is not to create an extensive set of administrative indicators.

It is to determine whether consultations lead to appropriate care, timely follow-up, and a clear understanding of outstanding responsibilities.

Learning From International Frameworks

International guidance offers useful principles for coordinating healthcare in residential long-term care, although regulatory requirements differ between countries.

Australia's strengthened Aged Care Quality Standards took effect on November 1, 2025, for providers within their defined scope.

Standard 5 addresses clinical care, while Outcome 5.1 focuses on clinical governance.

Action 5.1.4 specifies that providers and health professionals agree on their respective roles, responsibilities, and protocols for delivering quality clinical care services.

Associated guidance emphasizes professional competence, coordination with external healthcare professionals, appropriate communication, and organizational accountability.

These provisions establish requirements within the relevant Australian aged care framework. They do not automatically apply to residential care organizations in Viet Nam.

Nevertheless, the underlying principle is transferable: effective collaboration depends on agreed responsibilities rather than informal assumptions.

In England, the Care Quality Commission updated its guidance, Working with External Healthcare Professionals, on May 21, 2026.

The guidance emphasizes appropriate information sharing, documentation of external professional interventions, and processes enabling care workers to follow relevant instructions safely.

NHS England's Providing Proactive Care for People Living in Care Homes — Enhanced Health in Care Homes Framework, version 4, updated March 31, 2026, provides a broader approach to collaboration between care homes, primary care networks, community healthcare services, and multidisciplinary teams.

Its framework includes coordinated assessment, shared care planning, clinical leadership, and arrangements for communication across organizational boundaries.

These structures reflect the English healthcare system and its service arrangements.

A residential facility in Viet Nam should not assume that it must establish an identical primary care network, multidisciplinary review schedule, or contractual system because those arrangements appear in NHS guidance.

The principle that can be adapted is the importance of dependable relationships, appropriate clinical leadership, and clear responsibility across different providers.

The World Health Organization Regional Office for Europe's 2024 publication, Promoting Quality Management in Long-Term Care: Principles, Key Components and Directions for Policy Action, and its 2025 technical document, Setting the Foundation for Quality Management in Home- and Community-Based Long-Term Care, offer additional perspectives on continuous improvement and the coordination of care services.

ISO 25557:2026, Ageing Societies — Care Quality for Older Persons at Home and in Care Facilities, also addresses person-centered care, coordination across health and social care, workforce considerations, and organizational responsibility.

These references can support quality improvement but do not replace clinical guidelines, practitioner licensing rules, or Vietnamese healthcare law.

Their shared lesson is that access to professional services matters, but access alone is not sufficient. Healthcare recommendations must be connected to practical arrangements that allow appropriate care to continue.

From Visiting Consultations to Reliable Follow-Up

A healthcare professional may spend only a short time inside a residential care facility, but the consequences of that visit can affect the older person's care for days, weeks, or longer.

A diagnostic investigation, new prescription, rehabilitation recommendation, or specialist referral may require action from people working in different organizations.

When responsibilities remain unclear, the resident can become caught between them.

The clinician may believe the facility is arranging follow-up. The facility may believe the family is responsible. The family may assume that the clinician will contact them.

Everyone may be acting in good faith, yet the necessary care may still be delayed.

For residential long-term care organizations in Viet Nam, improving coordination begins with respecting professional boundaries and ensuring that visiting services are lawfully organized.

It continues through meaningful resident participation, accurate information sharing, clear allocation of responsibilities, and timely escalation when recommendations cannot be implemented as planned.

Residential providers do not need to assume authority over clinical decisions that belong to appropriately authorized healthcare professionals.

They do need reliable ways to recognize unresolved care needs, carry out the tasks they have agreed to organize, and communicate concerns to the appropriate professionals.

Visiting healthcare practitioners, in turn, should understand the capabilities and limitations of the residential setting and communicate their recommendations in a way that supports safe and realistic follow-up.

The quality of visiting healthcare is not demonstrated simply by the number of doctors, nurses, or rehabilitation professionals who attend a facility.

It is demonstrated by whether residents receive appropriate care, whether important recommendations are followed through, and whether everyone involved understands what needs to happen next.

That is how visiting healthcare becomes a meaningful part of safer, more coordinated, and person-centered long-term care.

Key References and Regulatory Context

National Assembly of Viet Nam. (2023). Law on Medical Examination and Treatment No. 15/2023/QH15, as amended. Particularly provisions concerning patient rights, professional practice, healthcare establishment activities, and Article 79 on mobile medical examination and treatment.

Office of the National Assembly of Viet Nam. (2026). Consolidated Document No. 26/VBHN-VPQH — Law on Medical Examination and Treatment. Issued February 26, 2026.

Government of Viet Nam. (2023). Decree No. 96/2023/ND-CP Detailing Certain Articles of the Law on Medical Examination and Treatment, as amended and applicable. Particularly Articles 82 and 83 concerning specified mobile and humanitarian medical examination and treatment activities.

National Assembly of Viet Nam. (2009). Law on Older Persons No. 39/2009/QH12, as amended.

Office of the National Assembly of Viet Nam. (2026). Consolidated Document No. 23/VBHN-VPQH — Law on Older Persons. Issued February 26, 2026.

Government of Viet Nam. (2017). Decree No. 103/2017/ND-CP on the Establishment, Organization, Operation, Dissolution and Management of Social Assistance Facilities, as amended and applicable.

Government of Viet Nam. (2026). Decree No. 395/2026/ND-CP on the Operation and Management of Social Assistance Facilities. Issued October 23, 2026; scheduled to take effect December 7, 2026. Particularly Article 6 concerning the tasks of social assistance facilities.

National Assembly of Viet Nam. (2025). Law on Personal Data Protection No. 91/2025/QH15. Effective January 1, 2026.

Government of Viet Nam. (2025). Decree No. 356/2025/ND-CP Detailing Certain Articles and Measures for Implementation of the Law on Personal Data Protection. Effective January 1, 2026.

Australian Government Department of Health, Disability and Ageing. (2025). Strengthened Aged Care Quality Standards. Effective November 1, 2025. Particularly Standard 5, Outcome 5.1: Clinical Governance.

Australian Aged Care Quality and Safety Commission. Strengthened Quality Standards Guidance — Outcome 5.1: Clinical Governance. Particularly Actions 5.1.3 and 5.1.4 concerning professional competence, roles, responsibilities, and coordination with healthcare professionals.

Care Quality Commission, England. (2026). Working with External Healthcare Professionals. Updated May 21, 2026.

NHS England. (2026). Providing Proactive Care for People Living in Care Homes — Enhanced Health in Care Homes Framework. Version 4, updated March 31, 2026.

National Institute for Health and Care Excellence. (2014). Managing Medicines in Care Homes. NICE Social Care Guideline SC1.

World Health Organization Regional Office for Europe. (2024). Promoting Quality Management in Long-Term Care: Principles, Key Components and Directions for Policy Action.

World Health Organization Regional Office for Europe. (2025). Setting the Foundation for Quality Management in Home- and Community-Based Long-Term Care.

International Organization for Standardization. (2026). ISO 25557:2026 — Ageing Societies — Care Quality for Older Persons at Home and in Care Facilities.

About Healthy Longevity Vietnam

Healthy Longevity Vietnam (HLVN) is an independent initiative focused on advancing quality, safety, and implementation in age-friendly, integrated, and long-term care for older people in Viet Nam. Through evidence-informed approaches, quality improvement, measurement, and collaboration, HLVN supports healthcare and care organizations in developing safer, more coordinated, and person-centered care across settings.

Disclaimer

This article is intended for general educational, quality improvement, and organizational development purposes. It does not constitute individualized clinical advice, authorization to provide medical examination or treatment, professional licensing advice, legal advice, an official regulatory interpretation, or a mandatory national standard for residential long-term care in Viet Nam.

The legality of visiting healthcare services depends on the activities performed, the professional authorization and scope of the individuals involved, the legal status and operating authorization of the healthcare provider, the place and form of service delivery, and applicable Vietnamese laws and regulations.

The presence of a licensed healthcare professional at a residential facility does not automatically establish that every clinical activity at that location is authorized. Not every visit is subject to the same regulatory procedure. Organizations should determine the applicable requirements according to the specific circumstances and relevant legal provisions.

Residential care providers must distinguish their responsibilities for accommodation, personal assistance, service coordination, and continuity of care from clinical responsibilities belonging to appropriately authorized healthcare practitioners and establishments.

Clinical recommendations do not automatically authorize non-clinical care workers to perform regulated medical procedures, independently prescribe or change medicines, interpret diagnostic results, or undertake tasks outside their lawful responsibilities and competence.

Healthcare decisions, treatment changes, clinical interpretation of findings, and management of medical deterioration require appropriate professional arrangements. Urgent or potentially life-threatening conditions require timely clinical or emergency assessment.

Personal health information must be handled in accordance with applicable confidentiality, personal data protection, and healthcare record requirements. Family involvement, appointment coordination, or financial responsibility does not automatically establish unrestricted authority to consent to treatment or access confidential information.

Government Decree No. 395/2026/ND-CP was issued on October 23, 2026, and is scheduled to take effect on December 7, 2026. Its provisions must not be treated as already in force on the review date of this article or as independently authorizing regulated medical activities without satisfying the applicable healthcare requirements.

International standards, foreign regulatory provisions, and healthcare coordination models discussed here are provided as reference points. They do not automatically create binding obligations or equivalent professional powers in Viet Nam.

Organizations should develop locally appropriate arrangements in consultation with qualified healthcare, social care, quality management, and legal professionals and seek clarification from competent authorities where necessary.

Information and regulatory context reviewed as of November 3, 2026.