Empowering Grassroots Healthcare: China’s New Three-Year Action Plan for Primary Medical Quality Improvement (2026–2028) and Its Strategic Implications for the Greater Bay Area

On April 1, 2026, China’s National Health Commission (NHC) and the National Administration of Traditional Chinese Medicine (NATCM) jointly issued the Three-Year Action Plan for Improving Medical Quality in Primary Medical and Health Institutions (2026–2028). This landmark national initiative marks a decisive step toward strengthening the foundation of China’s healthcare system — the grassroots level — by enhancing service standardization, patient safety, and overall quality.

For the Greater Bay Area (GBA), which spans Guangdong, Hong Kong, and Macao, this policy arrives at a pivotal moment. As we advance our shared vision of a “Healthy Greater Bay Area” through cross-border collaboration, digital innovation, and integrated care models, the Plan offers clear alignment and exciting opportunities for our region’s medical institutions, professionals, and technology partners.

China’s New Three-Year Action Plan for Primary Medical Quality Improvement (2026–2028)

Why This Matters: Building a Stronger Primary Care Foundation

The Plan is rooted in the Medical and Health Strong Foundation Project Implementation Plan. Its core objective is to elevate the normativeness and homogeneity of basic medical services at the grassroots level, reduce unnecessary referrals to higher-tier hospitals, and support the “primary care first” principle of hierarchical diagnosis and treatment.

Key targets by year:

• By end of 2026: Full coverage of central township health centers (including county sub-centers) and community health service centers with 30+ beds. These institutions must establish robust quality management systems and conduct routine quality work.

• By end of 2027: Extension to all other township and community health centers.

• By end of 2028: Inclusion of village clinics and community health stations, establishing a nationwide primary healthcare quality management system.

Implementation focuses on township health centers and community health service centers. In rural areas, it leverages tightly-knit county-level medical communities (医共体); in urban settings, it adopts the “city leads district, district-community integration” model.

Nine Core Tasks: A Comprehensive Quality Overhaul

The Plan outlines nine focused work tasks, supported by 39 detailed self-assessment and rectification items for practical local use:

1. Strengthen management systems — Establish dedicated quality organizations within medical alliances, with institutional leaders as first responsible persons.

2. Enhance staff training — Full training for physicians, pharmacists, nurses, technicians, and village doctors on guidelines, norms, and core skills.

3. Improve outpatient quality — Optimize processes, enforce first-visit responsibility, standardize chronic disease management, family doctor contracts, and home-based services.

4. Elevate emergency care — Bolster emergency drugs, equipment, pre-hospital to in-hospital coordination, and early identification of critical cases.

5. Promote rational drug use — Strict prescription management, especially for vulnerable groups, controlled substances, and antimicrobials.

6. Ensure inspection and testing quality — Full-process controls, inter-laboratory quality evaluation, result mutual recognition within alliances, and critical value reporting.

7. Advance nursing services — Implement responsibility-based holistic nursing and core safety protocols.

8. Reinforce hospital infection control — Strict adherence to disinfection, hand hygiene, waste management, and no reuse of single-use devices.

9. Optimize inpatient and surgical quality — Standardized ward rounds, surgical grading, perioperative management, and clinical blood use protocols.

These tasks are supported by annual cycles of self-check/rectification (Jan–Mar), quality improvement implementation (Apr–Oct), and performance assessment (Nov–Dec), culminating in a consolidation phase at the end of 2028.

Spotlight on Innovation: Smart Construction and AI Empowerment

One of the Plan’s most forward-looking elements is its explicit call to strengthen smart county medical communities and primary institution digitalization. It urges the use of artificial intelligence (AI) to empower grassroots healthcare and mandates that quality control centers fully leverage informatization tools for monitoring, analysis, feedback, and continuous improvement.

This is not merely technical — it is transformative. AI can assist in diagnostic support, risk prediction, rational prescribing, automated quality auditing, and telemedicine linkages, directly addressing common grassroots challenges such as limited specialist availability and inconsistent practices.

GBAHA Perspective: Opportunities for Cross-Border Leadership and Innovation

As the Greater Bay Area Healthcare Association, we view this national Plan as a powerful catalyst for our region’s unique strengths:

• Technological synergy: The GBA is already pioneering cross-border medical data spaces and AI-driven platforms. Shenzhen and Guangzhou’s innovation ecosystems, combined with Hong Kong’s world-class clinical and regulatory expertise, position us perfectly to pilot AI tools for primary quality control — from intelligent triage systems to real-time infection monitoring and predictive analytics for chronic diseases.

• Cross-border integration: With existing mechanisms for mutual recognition of Hong Kong- and Macao-registered drugs/devices and growing digital health platforms serving Hong Kong residents in the mainland, the Plan’s emphasis on data sharing and result mutual recognition within medical alliances aligns seamlessly with our “one-hour living circle” vision. This can further reduce duplication, enhance continuity of care for cross-border patients, and support aging populations through coordinated elderly care and chronic disease management.

• Talent and training collaboration: GBAHA members can lead joint training programs that blend mainland guidelines with Hong Kong/Macao best practices, incorporating AI literacy for grassroots staff. Our network of 30+ clinics and 20+ medical programs provides an ideal testing ground for scalable models.

• Long-term impact: By embedding quality culture, smart systems, and “patient-centered” service at the grassroots, the Plan will ease pressure on tertiary hospitals, improve equity between urban-rural and cross-border populations, and accelerate the GBA’s goal of becoming a world-class healthy bay area.

We encourage our member institutions to proactively map the 39 self-assessment items against current operations, explore AI partnerships, and share successful pilots through GBAHA platforms. The Plan’s call for long-term mechanisms — government oversight, industry self-regulation, institutional autonomy, and public supervision — mirrors our own multi-stakeholder approach.

Looking Ahead: From Policy to Practice in the GBA

The Three-Year Action Plan is more than a compliance exercise; it is a blueprint for resilient, intelligent, and equitable primary healthcare. In the Greater Bay Area, where innovation meets integration, we have the opportunity — and responsibility — to lead by example.

GBAHA stands ready to facilitate knowledge exchange, pilot innovative solutions, and amplify best practices across borders. Together, we can turn this national mandate into regional excellence, ensuring every resident — whether in a Guangdong township, Hong Kong community, or Macao neighborhood — benefits from safer, smarter, and more accessible care.

Stay connected with GBAHA for updates on implementation workshops, AI healthcare forums, and cross-border collaboration opportunities. Let’s build the Healthy Greater Bay Area — one high-quality grassroots service at a time.

Greater Bay Area Healthcare Association Promoting high-quality, integrated healthcare across Guangdong-Hong Kong-Macao