Access to physiotherapists, nurses, and opticians now easier in france

THE RULES WILL BE TRIALLED FOR FIVE YEARS People in France will soon be able to access care from physiotherapists, nurses, and opticians more easily, in a bid to facilitate healthcare -

especially in areas that lack doctors. The new access rules were confirmed on June 28 with three decrees in the Journal Officiel. They will come into force from August 29 (two months after

the decrees’ publication). Patients with an official long-term condition (affection longue durée, ALD) will be able to see a nurse without a GP prescription, physiotherapists will be able to

see a patient for eight weeks without a GP prescription, while opticians will be able to adapt some existing prescriptions without the patient having to see a specialist again. The rules

come amid multiple government measures to make access to healthcare easier, especially in areas where there is a lack of GPs or it is difficult to find an appointment. Read also: Seven

questions about ‘medical deserts’ in France Read also: Eight facts to understand France’s issue of ‘medical deserts’ PHYSIOTHERAPISTS The rules will apply to physiotherapists working in

hospitals, clinics, social or medico-social establishments, and/or in a multi-professional health centre, to treat patients on a direct access basis, without a medical prescription. For a

five-year trial basis, this will be permitted for:  There are some conditions, and the patient’s GP will still be involved in some capacity, for example: * Physiotherapists must refer

"patients to their GP or, failing that, to another doctor if a diagnosis or medical opinion is required”, the text states.  * In addition, physiotherapists will have to write “an

initial assessment and a report on the care provided” in the patient's shared medical file, and this to the patient and their GP. The five-year trial of these rules will take place in

the following 14 departments in mainland France:  * Deux-Sèvres, Côtes d'Armor, Haute-Corse, Loiret, Mayotte, Meurthe-et-Moselle, Nord, Rhône, Seine-Maritime, Tarn, Var, Vendée, Yonne,

and Yvelines. The overseas territories of Martinique and La Réunion are also included. You can find a list of participating physiotherapists in each of the departments on the Agence

régionale de santé (ARS) website. Read also: How can I find out which parts of France are lacking doctors?  The Conseil national de l'ordre des masseurs-kinésithérapeutes (CNOMK, the

national council of physiotherapists) has welcomed the rules.  “It is becoming increasingly difficult to access physiotherapists without a doctor's prescription,” said the CNOMK in a

statement. It has been calling for easier access for years. "Patients who consult a physiotherapist frequently ask for an assessment, an opinion or advice on certain pathologies

[already],” it said. “Setting up this trial means enshrining in law what 106,000 physiotherapists have always been doing in practice.” Read also: Make sense of… Physiotherapists (kiné) and

osteopaths in France  PATIENTS WITH LONG-TERM CONDITIONS AND NURSES The decrees also aim to make it easier for patients with an officially-recognised long-term condition (affection de longue

durée - ALD) to access nurse care. In a statement, the Ministry of Health said the aim was to “strengthen the role of nurses in care pathways and promote the quality of care for

patients". The referral nurse will be responsible for:  * Prevention work  * Follow-up  * Further referrals  The nurse will work closely with the patient’s GP and usual pharmacist.  ALD

patients aged 16 or over will be able to nominate their chosen referral nurse to the state health body Assurance maladie. If the patient is under 16, a parent or guardian must agree.

Patients can change their nominated nurse at any time by making a new declaration to the Assurance maladie. Self-employed nurses have long called for this rule, but some doctors say it could

offer unsafe ‘competition’ with GPs. Another decree is expected to be published imminently, which would give advanced practice nurses the authority to write prescriptions, and authorise

them to work in wound and scar care. Read also: Chronic illnesses, language barriers and French health bureaucracy  OPTICIANS The third decree states that opticians - under some conditions -

will be authorised to adapt an existing ophthalmologist or orthoptist prescription when issuing corrective glasses or contact lenses. This means that patients will not need to revisit an

ophthalmologist or orthoptist in order to get new glasses or lenses. The optician must have the written agreement of the prescriber, who will have 10 working days in which to inform the

optician of his decision. After this deadline, the absence of a response will be equivalent to acceptance.