The 41 measures of the “flash mission” to overcome a “high risk” summer in the emergency room

Arms, budgets, sorting, etc. The “flash mission” on unscheduled care gave Matignon its 41 proposals on Thursday to overcome a “high risk” summer in the emergency services.

Dr François Braun’s prescription is in the hands of Prime Minister Elisabeth Borne. A 60-page document, which the president of Samu-Urgences de France presented during a “working meeting” in Matignon, in the presence of the Minister of Health Brigitte Bourguignon, Health Insurance and the federation of patient associations France Assos Santé. This “non-final version” will be amended at the end of this meeting, indicated François Braun.

More than 100 emergency services forced to reduce their activity

The final version will therefore reveal in hollow the arbitrations of the executive. Because the head of government must now decide among 41 recommendations supposed to “facilitate the management of this high-risk summer period”.

Dr. Braun and his association had already alerted to the symptoms of this crisis, by identifying at the end of May 120 emergency services forced to reduce their activity or preparing for it. This had led President Emmanuel Macron himself to entrust him with a “flash mission” to provide “very strong answers”. Too many patients, not enough caregivers: the impossible equation spares no hospital, including large university hospitals such as Bordeaux, Toulouse and Grenoble, recently forced to restrict access to their emergencies.

Limit access in places to only “vital emergencies”

To save what can be saved, the “flash mission” recommends “regulating admissions”, either with “paramedical triage at the entrance” to emergencies, or by “systematic prior medical regulation” by the telephone switchboard of the Samu. The report even suggests limiting access in places to only “vital emergencies”, in particular at night, this “suspension of partial activity” which should make it possible to “pool the means of several services on a single site”.

At the same time, the mission wants a major information campaign on the “before you travel, call” mode, as well as an “upgrading of the workforce” of medical regulation assistants (ARM) to absorb the increase in plan calls to 15.

A revaluation of night work

Other budgetary efforts are requested to better pay independent doctors in regulation (up to 100 euros gross per hour “tax-free”) and in consultation (with an increase of 15 euros per act requested by the Samu). Ditto for hospital staff, with a revaluation of night work and bridges on July 14 and August 15, as well as a bonus for psychiatric, pediatric and gynecological emergency teams.

The “toolbox” also includes easier recourse to substitute and retired carers, telemedicine, independent nurses, firefighters… So many leads accompanied by “impact indicators”, in order to decide at the start of the school year “on the continuation or abandonment of these measures”. No trace, on the other hand, of any obligation of individual custody for city doctors, fiercely opposed to this type of constraint.

The “flash mission” received a rather favorable reception from the tempestuous president of the UFML union, Jérôme Marty, who welcomed “proposals that go in the right direction”, but also regretted “pious wishes in the absence of effectors”. to care for the sick.