Question 14745 — health professions

Summary

Mr. Nicolas Ray draws the attention of the Minister of Health, Families, Autonomy and People with Disabilities to the situation of nurses in advanced practice (IPA). Created by Law No. 2016-41 of January 26, 2016 to modernize our health system, the practice of advanced practice nurses helps improve the quality of care pathways by strengthening patient care alongside doctors. In a context of medical desertification, aging of the population and increase in chronic diseases, IPAs thus contribute to lightening the burden on doctors by carrying out certain medical procedures, particularly in the renewal or adaptation of treatments. Law No. 2025-581 of June 27, 2025 relating to the nursing profession has also broadened the skills of APNs, in particular by recognizing them as possibility of first-time prescription within a strictly supervised framework. APNs are thus part of this evolution in the role of nurses and, as such, follow particularly demanding training, including two additional years of study leading to a bac + 5 level diploma. However, despite a high level of qualification and the gradual broadening of their skills, nurses in advanced practice do not benefit from no statutory and salary recognition commensurate with their growing place in the organization of care. Their remuneration scales within the hospital civil service thus remain insufficiently differentiated from those of state-certified nurses, with regard to the scope of their missions and the responsibilities exercised. The conditions for exercising IPAs also remain insufficiently structured. Their missions are not always fully recognized in the organization of services and their positioning within care teams as well as coordination with doctors vary depending on the establishment. This situation harms the attractiveness of this form of exercise and slows down the dynamics of engagement in advanced practice. This is why in order to support the development of advanced nursing practice, whose beneficial effects in matters of access to care and smoother patient journeys are now established, the MP wishes to know the measures that the Government intends to take to strengthen the recognition of IPAs within the hospital public service. In this regard, he asks what measures are envisaged to improve their remuneration and their working conditions, in order to better take into account the scope of their missions. essential to the proper functioning of our health system.

Machine translation from French. The official text remains authoritative.

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