Quelles solutions pour la garde en médecine générale? - KCE

KCE Reports 1771
sanctioning coompetences,
this code is only considered as a
practices guideline»
and doees
not foresee in provisions re
teleconsultationn.
3.4.3. Respoonsabilities
and liabilities of the involved actors
• General liaability
rules
On the Criminal
/ Penal level: artticle
422bis of the Penal Code ;
On the Civil level
: article 1382 of
the Civil Code
• The Act of 31st March 2010 on no fault liabilit ty
In case the connditions
of this actt
are fulfilled, the victim has the rig
indemnification by the Fund for
Medical Accide ents without the
prove the physician’s
fault.
• Royal Decrree
n° 78
Only a competent
person with the necessary qualifications q
can
perform acts oof
healthcare. If this is not the case, c these acts
considered as illegal
acts of heallthcare.
• Act of 22ndd
august 2002 : The
patients’ rights s act
The patient seeeking
for telephoonic
contact with
also rely on thiss
act.
3.4.4. Adaptation of thhe
current legal
In accordance wwith
article 11 of the Royal Decree
therapeutic annd
diagnostic freeedom
and ther
physicians to ddiagnose
and to perform acts of
The legislationn
must not be aadapted.
Howeve
guidance on wwhich
medical inteerventions
can b
would be useful.
If nurses wouldd
perform teleconnsultations
legisla
as to the definittion
of their compeetences.
3.4.5. Issuess
to consider in case of impleme
The issues menntioned
for scenarrio
3 also apply he
to a comparabble
level as live consultations sh
Therefore a tecchnical
support ssuch
as for insta
conversations sshould
be consideered.
It is not clear hoow
phone consultaations
should be f
21
a «best
egarding
ght to an
need to
n legally
will be
a health practitiooner
can
framework
e n° 78 physicianss
have a
efore it is posssible
for
healthcare by telephone.
er it is clear thaat
some
e handled by thee
phone
ation should be aamended
entation
ere. Quality assurrance
up
hould to be guaranteed.
nce the recordingg
of the
financed/reimburssed.
Affter-Hours
Primaary
Care
KKeypoints
– Legislation
DDepending
on thhe
scenario, chaanges
to the currrent
legal frameework
aare
needed
• Scenario 1 : unique call number
with triage : in this case the 1733
system and iits
modalities should
be integrateed
in legislation and
in particular:
o The existence
of protocools
underpinningg
the decisions too
be
taken forr
the follow-up of
the patient’s caall,
o The definnition
of the legaal
status of the teelephonists,
o Their training
and education,
o Guidancce
should be provvided
on the inteerpretation
of artt.
9
RD n° 788
regarding the dduty
to visit patieents
at home durring
after-houurs
periods,
o A definittion
of a uniform start and end timme
of the after-hours
service wwould
be opportuune
.
• Scenario 2: ssystematic
refereence
to a hospitaal
nearby during the
night or mergge
of GP circles
o If merginng
of GP circles aareas:
the legislaation
should be
adapted to align the requuired
number of GPs on call to thhe
expectedd
number of callss.
o If systemmatic
reference too
hospital: The triage
system shoould
be includded
in the legislaation
and in casee
the emergency
system is
being outsourcced
to the 1733 ssystem,
legislatioon
should bbe
amended as fooreseen
in scenaario
1
• Scenario 3: CConsultation
by nnurses:
AAdditional
qualiffications
and lissts
of acts (currrently
performeed
by
pphysicians
only) should be integgrated
in the exxisting
list of nuurses’
ccompetences.
• Scenario 4: PPhone
consultatiions:
Iff
nurses would peerform
consultations
by phone, the legislation shouldd
be
aamended
as to thee
definition of their
competences.
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