Quelles solutions pour la garde en médecine générale? - KCE

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• Studies als
the numbe
areas and
ageing of t
• Researche
the GPs p
option supp
8.2. Append
8.2.1. Synth
GP Ci
The Working G
document 115 so highlight a more
acute problem m in some specificc
areas;
er of active GPs iin
after-hours ser rvice decreases inn
some
this trend could be more marked
in the future wwith
the
he GP and the lacck
of setting up of f young GPs.
es also suggest ssolutions
for the fu uture and analysed
how
perceive them. Inn
particular the setting
up of ODCC
is an
ported by several researchers.
dices: statements
of professio onal associatioons
hesis note of the working group “after-hours” “
(Feederal
ircles Council)
Group on after-houurs
service (AHS)
proposed a connsensus
baased
on the opinioons
formerly expre essed by Domus Medica
and by the Foruum
des Associatioons
de Médecins Généralistes.
G
The documentt
underlines the importance of the GP circles in the
organization off
AHS and the neeed
for efficient collaborations witth
local
hospital and eemergency
servicces.
The main principles and soolutions
proposed are thhe
following ones: :
• To create OODCs:
o Mean (not aim) to optimmise
the organization
of GP AHS;
o Needss
financial supportt;
o Managgement
by the GPP
circles.
• To encourage
the patiennt’s
transfer (ve ersus GP homee
visit):
organizatioon
of affordablee
transport by
campaignss;
the authorities, public
• To include a minimum of 133
GPs when orga anising duty perioods
in a
given area;
• To include specific regulations
in the GP circle
rules in relation to duty
periods: in particular decisioons
with regard to t exemptions shoould
be
carefully exxamined;
• To follow the current Authorities’
projects in
relation to uniqque
call
number and
triage;
• To guaranttee
the GP’s safetty
during duty per riods;
Affter-Hours
Primaary
Care
KCE Reportss
171
• To heighten public awareness
in relation to thhe
correct use off
duty
services;
• To find alternnatives
to the requuisitioning
of GPs on duty by the poolice;
• To consider mmeasures
to allevviate
duty periods during the deep nnight;
• To increase the fees for connsultations
and visits
during after- hours
periods.
Some proposalss
require changees
in the legislaation.
If all avaailable
solutions are nott
successful, it iss
suggested that exceptional measures
should be submittted
by the GP Cirrcle
to the Ministeer
after approval bby
the
Federal Council.
The consensus ddocument
of the working group oon
AHS relies e. g. on
statements formeerly
issued by thee
Flemish (Domuss
Medica) and Freench-
speaking (Forumm
des Associations
de Médecins
Généralistes) ) GP
associations. Theese
statements are
summarised below.
8.2.1.1. Docuument
from Dommus
medica
Domus Medica iss
a Flemish organization
of GPs, comprising a scieentific
and a scientific wwings.
The officiall
document stressses
the GPs obliggation
to ensure the coontinuity
of care and the after-hoours
services. Domus
Medica is opposeed
to the abolitionn
of GPs’ AHS, altthough
they outlinne
the
necessity to facilitate
and suppoort
this mission in the future. Domus
Medica promotess
the GP circless’
role in the affter-hours
issuess
and
proposes a list of f solutions classifieed
in 4 categoriess:
• Category 1 : Solutions that do not require any pparticular
measuree
o Merging of geographic arreas
(mainly durinng
the night) leading
to
a decreaase
of the AHS reecurrence
and a greater
workload foor
the
GPs on duty;
o Time slot
of 12 hours providing time
activitiess
during the WE;
for family and ssocial
o Revisionn
of the age limitss
to avoid discrimmination
(GP who work
during wweekdays
can alsoo
work during the WE);
o More seeverity
as regardss
exemptions froom
duty services.
The
feasibility
of a part-timee
participation in the AHS shoulld
be
considerred;