The Supreme Court has directed the Union Government, States and Union Territories, as well as hospitals and institutions not under government control, to strictly comply with prescribed guidelines for the organisation and delivery of Intensive Care Unit (ICU) services, imposing specific timelines for infrastructure, equipment and manpower requirements.
A Bench of Justice Ahsanuddin Amanullah and Justice R. Mahadevan was considering a proposal placed before it by the Committee concerning the “Guidelines for Organization and Delivery of Intensive Care Services: Time Frames for Compliance.” The proposal set out timelines for hospitals and States to bring Level I ICUs into compliance with the prescribed requirements.
The Committee had proposed that States be given up to 12 months for certain infrastructure requirements, while several procurement-related requirements were to be completed within three months. The Court, however, modified the longer timelines. The Court thereafter issued a mandamus requiring compliance with the guidelines for Level I ICUs within the stipulated time periods. The Bench recorded:
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“Broadly, we are in agreement with the time frames suggested therein. However, whereever a period of up to 12 months has been prescribed, the same shall stand substituted by a period of 9 months for the purpose of compliance. Accordingly, a mandamus is issued to ensure compliance with the aforesaid Guidelines, including completion of the works within the time frames stipulated therein, as modified in the preceding paragraph, in respect of Level I Intensive Care Units (ICUs).”
The guidelines cover ICU infrastructure, including location and size, bedside utilities, emergency equipment, nursing stations, imaging services, non-emergency equipment, laboratory services, infection control, additional services and safety.
The Committee proposed that procurement of bedside utilities be completed within a maximum period of three months, while procurement of emergency equipment, including issuance of purchase or delivery orders, was also to be completed within three months. Installation could receive additional time depending on delivery schedules, subject to a maximum additional period of three months.
The proposed timelines also provide for immediate compliance with requirements concerning infection control and safety, while additional services are to be completed within a maximum period of one month.
The Court also addressed the shortage of healthcare personnel required to operate ICUs. The guidelines contemplate recruitment of ICU specialists, trained MBBS doctors, nurses and other allied healthcare personnel. The Committee noted that shortages in these categories were systemic and dependent on availability for recruitment. While several States had sought 12 to 24 months for completing the recruitment process, the Committee considered that period excessive.
The Supreme Court consequently directed that the recruitment process be completed within six months:
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“With regard to manpower resources, a further mandamus is issued to the Union of India, the concerned States and Union Territories, as also to the stakeholders/parties/hospitals not under Government control, to ensure that the process for recruitment of sufficient personnel required for the functioning of the ICUs is commenced forthwith and completed, in any event, within a period of six months.”
The Bench further made clear that the timelines were mandatory and would have to be followed by the concerned authorities and institutions. The Court also issued a warning regarding non-compliance: “Any laxity or default noticed by this Court in adherence to the aforesaid Guidelines and the time frames stipulated herein may result in the Court taking a strict view against the defaulting parties.”
The Union Government, States and Union Territories have been directed to furnish their respective status reports by November 5, 2026, with copies to the Committee. The Committee will examine the reports and place its comments before the Court. The matter has been listed for further hearing on November 16, 2026 at 2:30 PM.
The Court also noted that certain hilly, remote or other areas requiring special consideration may warrant modification of the prescribed timelines. Any State seeking additional time will have to specify the area concerned, the work already undertaken and the additional time required.
The Bench clarified that such requests must be supported by relevant particulars and realistic estimates, adding that the Court would not grant unlimited extensions or any period beyond what is reasonably necessary.
