Question 12267 — health professions

Summary

Ms. Anissa Khedher questions the Minister of Solidarity and Health on the implementation of advanced practice for nurses. The law to modernize our health system passed in 2016 establishes the legal framework for what is called “advanced practice” for medical assistants. The decree of July 18, 2018 specifies the terms of exercise. Faced with changes and new challenges in the French health system, in particular the increase in patients with chronic illnesses, aging, medical deserts, this measure increases the areas of expertise of nurses via master's training. The advanced practice nurse (or APN) will be able to work within a care team coordinated by a doctor either on an outpatient basis or within a health establishment. The expected benefits are numerous: for patients, improving access to care, diversified care and smoother pathways between town and hospital; for the nursing profession, new career prospects, with the opportunity for a more autonomous mode of practice and enhanced recognition; for doctors, a release of time and new possibilities for cooperation; for the health system, strengthening coordinated practice structures in primary care and reinforced cooperation between professionals at the territorial level. The IPA will be able to intervene in 3 areas identified in the texts: stabilized chronic pathologies and polypathologies common in primary care; oncology and hemato-oncology; chronic kidney disease, dialysis, kidney transplantation. Psychiatry and mental health were not included. This decision may have given rise to regrets that This concerns hospital unions, nurses, and even doctors. Indeed, psychiatric hospitals, as is the case in its district at the Vinatier hospital center, are facing an increase in the number of patients with a limited number of psychiatrists and advanced practice could thus free up more time for doctors, thus increasing the quality of care and the number of patients. treated. Advanced practice appears to be an effective way to improve the quality and access to care in France. Also, she would like to know if the Government is considering opening advanced practice to other fields and other professions, particularly mental health.

Machine translation from French. The official text remains authoritative.

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