Question 36379 — hospital public service

Summary

Faced with an undeniable need to significantly improve access to care, Law No. 2016-41 of January 26, 2016 to modernize our health system introduced a new health player into the French health landscape, the medical assistant in advanced practice. The first application texts were published in July 2018 to primarily target the nursing profession, able to initiate these new methods of practice in collaboration with doctors and in particular with regard to the history of successful experiences relating to transfers of activities within the framework of the cooperation protocols system in particular. In addition, advanced nursing practice constitutes a real public health issue given the increase in patients with chronic diseases, the aging of the population and current demographic data. medical. Today, four focus areas have been created for advanced practice nurses (APNs) and a fifth, which concerns emergency medicine, is under development. In accordance with article 1 of Law No. 2021-502 of April 26, 2021 aimed at improving the health system through trust and simplification, a report must be submitted to Parliament taking stock of the implementation of auxiliaries medical professionals in advanced practice and cooperation protocols. This evaluation report examines in particular the deployment of advanced practice for all medical auxiliary professions, including specialized nurses, particularly with a view to opening up access to the exercise of advanced practice missions, the modalities of which would be defined by regulation. To this end, a mission was entrusted in May 2021 to the General Inspectorate of Social Affairs which will have to examine, in particular, the modalities according to which specialized nurses, and in particular nurse anesthetists, could be given access to the exercise of advanced practice. The expertise of these nurses should in fact allow them specific access to advanced practice (bridges in training, additional training, etc.). The conclusions of the mission are expected for the end of 2021. Regarding the salary increase for state-certified nurse anesthetists (IADE), it should be noted that nurse anesthetists and IPAs are classified on the same remuneration scale following the measures decided by the Ségur de la santé. The IADE, as specialized nurses, will spend their career in two of the four grades created for category A of the corps paramedics. Thus, IADEs will be recruited in the 2nd grade (G2) of category A like all specialized state-certified nurses. But, to take into account the current statutory situation and to recognize their specialization in 2 years, IADEs access, like IPAs, directly to the 2nd level of the 2nd grade while operating room nurses (IBODE) or childcare workers are recruited at the 1st level, i.e. a difference of almost 108 euros gross per month. In addition, as part of the reclassification of staff from their original scales to the upgraded scales, IADEs will benefit from an average gain on the 2nd and 3rd grades of 12.4 increased index points, or 58 euros gross per month. Finally, IADEs, like all paramedical agents in the hospital civil service, will benefit from the overhaul of their compensation system. In In addition, they currently benefit from bonuses specific to their body: a special IADE bonus in the amount of 180 euros gross monthly and a new index bonus (NBI) of 15 increased index points, or 70 euros gross monthly. This specific compensation plan now increases their remuneration by 250 euros gross monthly compared to other specialty nurses.

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