On the occasion of his wishes to the “living forces” of health on January 30, 2023, the Minister of Health and Prevention, François Braun, presented his roadmap for the coming year, and more generally his vision of the future of the health system. Overview of ” ten key goals to invent the future of the healthcare system ».
“2023 will mark a turning point” and will be a year “decisive” for the health of the French, and for the whole of the health system, indicated F. Braun in the preamble. Recalling that health is one of the priorities of the Government, and following the course set by the President of the Republic, E. Macron, during his vows on January 6, he declined “ten key objectives to invent the future of the health system”.
• Guaranteeing all French people suffering from a long-term illness (ALD) access to a general practitioner
F. Braun points out that “more than 600,000 of them are deprived of regular monitoring. » under the aegis of health insurance, “a steering body will be set up at the national level in the coming weeks with all the players”. All concerned will be contacted “by the end of June”. At the same time, the ministry will work “the development of multi-professional treating teams, to guarantee local support around the treating doctor”, also giving a place to peer helpers.
• Giving back medical and caring time, in town and in the hospital
This is to accelerate the decompartmentalization of the health system, continue to strengthen the workforce and mobilize all the levers allowing us to save care time, at the service of patients. “While medical demography will continue to deteriorate over the next few years, we have an absolutely major challenge here: allow caregivers to focus on their core business. » Various measures are announced to increase the number of medical assistants and identify, at the hospital “logistical, technical and administrative support” to be deployed as close as possible to services. It will also take “strengthen the coordinated exercise (…) and mobilize ourselves so that the exercise isolated becomes the exception ». As such, the Health Insurance will have to quickly relaunch the work around the primary care teams and the specialized care teams. “This approach goes hand in hand with the new dynamics of the distribution of tasks between health professionalsin particular to concentrate medical time on what gives it added value”, corollary movement of that which aims to build teams around the general practitioner.
In this context, ” the advanced practice, cooperation protocols, sharing and delegation of skills » are important levers, which must be deployed in coordinated territorial organizations.
• Allow continuity and permanence of care throughout the territory
It is a question of guaranteeing to all, without exception ” the possibility access to a doctor during the day “, but also ” evenings, weekends and public holidays ». It now falls under the collective responsibility of professionals in a territory to guarantee this promise. The achievements made on the preliminary call to 15 before moving to the Emergency Department must be consolidated, which involves securing the Medical Dispatch Assistants. “A plan to develop the attractiveness of this profession and increase their recruitment will be presented by end of first semester ». To support this organization in all territories, “a Tour de France of Access to Care Services will be engaged by end of February “. This work “will also identify the means of consolidating a few specialized sectors in the SAS, such as psychiatry, geriatrics or pediatrics to better meet these specific needs.
• Improve the quality of life in the hospital and stabilize the teams
Restore confidence in the future to hospital professionals is a major issue, which involves remuneration but also the way ” of renewal and diversity of practices”, ie give new responsibilities and career opportunities. It is also ” take into account the search for a quality of life and a balance between professional and family life. » By summera new way of organizing caregivers’ working time, to limit overtime, give more stability to schedules and thus better reconcile personal and professional life, will be offered. From now until the end of March, the ministry is undertaking a preparatory phase (consultation with the labor organizations and the federations et conferences), to identify priority levers. « En avrilguidelines and tools will be put at the service of the establishments, which will consult with the teams, taking into account the aspirations of the services, and will negotiate local agreements on organizational changes. »
A plan will also be deployed in favor of service managers, and in particular health executives. “We must continue to strengthen the head of department / health manager duothrough training but also through modern tools for leading work groups”, underlined F. Braun, continuing “by the summer, the management of our hospitals will be renovated with the establishment of administrative and medical tandems responsible for implementing the changes in practice.
Sur ce sujet de la qualité de vie et de l’attractivité, le ministre a souligné que la psychiatrie était une de ses priorités de l'année : « Nous devons aller plus vite sur le sujet de la psychiatrie de secteur. Nous avons là un enjeu majeur qui est de renforcer ces fondamentaux de notre service public hospitalier, en tenant compte de la pénibilité de ces professions, de leur spécificité, tout en accompagnant toutes les innovations importantes pour les patients. ».
• Train more caregivers, and train them better
“The year 2023 will be the year of nurses, the year of clarified perspectives”, noted F. Braun, referring to several important measures. Without detailing them here, let us indicate that they concern the securing of student pathways and the re-engineering of training; the evolution of the decree of acts of the nursing profession; new ways of accessing the profession; the increase in the number of nurses in advanced practice (with the objective of 5,000 APNs in activity by the end of 2024) and the recognition before the end of 2023 of advanced practice for specialized nurses.
• Create a shock of attractiveness in the territories and facilitate the daily life of caregivers
Housing, transport, parking, security or even childcare, this is “to provide new and innovative solutions” at the territorial level, to facilitate the daily life of caregivers.
• Turn your back on the accounting logic and review the financing of the health system
“We are going to get away from the logic of supply and profitability, and better support the issues of public health, cooperation at the territorial level, prevention and responsibility vis-à-vis the populations. Our objective is clear: get out of “all T2A””, indicated the Minister of Health, specifying that the foundations of this development will be laid as of the next Social Security financing law. The project team responsible for building the target model “will be installed at the ministry in the coming days”.
• Guarantee that health is accessible to all
While improvements have made it possible to improve everyone’s access to certain types of care (dental care and hearing aids, for example), the Ministry intends to initiate a “deepening phase”: it is necessary to make the service provided better known, to update care baskets covered, opening up the scope to new products.
• Collectively assume a new ambition on prevention
For F. Braun, prevention must be “a marker of refoundation” of the health system. This will result in particular in the realization of prevention appointments, in particular for people furthest from health. In this register, “the mission entrusted to Philippe Denormandie, Alexandre Berkesse and Emilie Henry on the subject of health mediation and new forms of “going towards”” completes this ambition. Their recommendations are expected during this first semester.
• Make 2023 an important year for research and innovation
In connection with the Minister of Higher Education and Research, the Minister of Health carries “voluntary and resolute actions” to develop research. This supposes to “questioning the place of all players in the research ecosystem, simplifying procedures as much as possible, developing fundraising and increasing funding to accelerate fundamental research, clinical research and translational research at the same time. »
