Can I go to Kenyatta National Hospital without a referral?

Summary

• Kenyatta National Hospital (KNH) primarily operates as a tertiary referral hospital requiring referral letters from lower-level health facilities
• The Accident & Emergency (A&E) department accepts walk-in patients with urgent medical conditions without referrals
• Specialized clinics and outpatient services generally require referral letters from health centers or district hospitals
• Self-referral is discouraged except in genuine emergency situations
• The referral system helps manage patient flow and ensures appropriate use of specialized tertiary care resources
• Private wing services may have different policies and may accept patients without referrals for a fee

Kenyatta National Hospital (KNH), located in Nairobi, Kenya, stands as the country's largest and oldest referral hospital. For many patients seeking medical care, a common question arises: can you visit KNH without a referral letter? The answer depends on the type of service you need and the nature of your medical condition.

Understanding the Referral System

KNH operates primarily as a tertiary referral hospital, which means it's designed to handle complex cases that require specialized care beyond what primary health centers and secondary hospitals can provide. The Kenyan healthcare system follows a structured referral pathway, starting from dispensaries and health centers at level 2 and 3, moving to district and county hospitals at level 4 and 5, and finally reaching national referral hospitals like KNH at level 6.

This hierarchical system exists for good reasons. It ensures that specialized resources at tertiary hospitals are available for patients who genuinely need them, prevents overcrowding, and allows healthcare professionals to focus on complex cases requiring their expertise. It also helps manage healthcare costs and improves the overall efficiency of the national health system.

When You Can Visit Without a Referral

The primary exception to the referral requirement is the Accident and Emergency (A&E) department. If you're experiencing a medical emergency—such as severe injuries from an accident, acute chest pain, difficulty breathing, severe bleeding, or other life-threatening conditions—you can go directly to KNH's emergency department without a referral letter. Emergency care is provided based on the urgency of your condition, not on whether you have paperwork.

Additionally, some outreach programs and special medical camps organized by KNH may allow direct access without referrals. These are typically announced in advance and target specific conditions or communities.

Services That Require Referrals

Most outpatient clinics and specialized services at KNH require a valid referral letter. This includes consultations in departments such as cardiology, neurology, oncology, orthopedics, and other specialty clinics. The referral letter typically comes from a doctor at a lower-level facility who has assessed your condition and determined that you need specialized care available only at a tertiary hospital.

The referral letter serves multiple purposes: it provides KNH doctors with your medical history and previous treatments, helps prioritize cases based on urgency and medical need, and ensures continuity of care between different levels of the healthcare system.

The Private Wing Option

KNH also operates a private wing that offers services on a fee-for-service basis. The policies for accessing the private wing may differ from the public hospital, and in some cases, patients might be able to access certain services without referrals by paying privately. However, it's advisable to contact the private wing directly to confirm their current policies and requirements.

What to Do If You Don't Have a Referral

If you believe you need specialized care at KNH but don't have a referral, the recommended approach is to first visit your nearest health center or county hospital. The medical officers there can assess your condition and provide a referral if they determine that tertiary care is necessary. Attempting to bypass the referral system for non-emergency cases may result in being turned away or redirected to appropriate lower-level facilities.

While KNH's emergency department remains accessible without referrals for urgent cases, the hospital's structured approach to referrals ensures that Kenya's premier tertiary facility can effectively serve those with the most complex medical needs. Respecting this system ultimately benefits all patients by preserving specialized resources for those who need them most.