Imagine a toolbox allowing hospital emergency services to get through the summer despite the shortage of personnel. This was the “flash mission” entrusted at the end of May by Prime Minister Elisabeth Borne to Dr François Braun. After a month of reflection, the report of the president of Samu-Urgences de France, presented Thursday June 30 at Matignon, lists 41 proposals. The executive will then decide on the measures it wishes to put in place.
The Braun report notably recommends accepting fewer patients and makes several proposals in this regard. Between 20 and 40% of people who come to the emergency room do not come under these services, notes the document now in the hands of the head of government. These patients come for what is called “bobology”. According to the conclusions of the “flash mission”, it will be necessary to set up a communication campaign to tell the French to call 15, the Samu before possibly moving. To do this, the report plans to increase the hiring of the people who receive these calls, the medical regulation assistants, and to better pay the regulating doctors.
The idea is to impose on patients a call to 15 before moving or to sort patients at the entrance to the emergency room or at the entrance to the service. And each time, if necessary, if it is not a serious emergency, send the sick to the city medicine or a medical center on duty. Doctors in town who agree to recover patients who have failed in hospital would receive an additional 15 euros per consultation. To relieve the hospital, the Braun report still recommends reimbursing telemedicine at 100% this summer.
Finally, downstream, within the hospital, the report evokes the problem of doctors who spend hours on the telephone looking for a bed in the various departments for their patients and the overcrowding of emergencies, patients who stay for hours on stretchers. For Dr. Braun, the solution would consist in setting up “bed management” in all hospitals, that is to say a service, an internal bed management unit.
The Braun report also suggests drawing inspiration from what is already being done in Bordeaux and Grenoble. In these two cities, the emergency services may have to close at night when the staff is insufficient, except for a vital emergency, and provided that a neighboring hospital can receive patients at night.
Another recommended measure: encourage doctors, nurses and caregivers to work more by paying them better this summer on the nights and weekends of July 14 and August 15. The government had already decided last month to better pay overtime.
Finally, the 60-page document suggests relying more on firefighters by deploying their vehicles to areas where there are not enough ambulances from the SAMU. The Samu could also send more reduced teams on the ground, only a paramedic and a nurse. Once there, these teams would enter into video communication with a doctor, or even, in certain situations, would simply do without a doctor.