Quelles solutions pour la garde en médecine générale? - KCE

KCE Reports 1771
o Decreaase
of GP homee
visits (and work kload) by recommmending
patientts
to consult the ooffice
(or ODC);
o Recruiitment
of “volunteer
GPs” from othe ers areas.
• Category 2 : Solutions that rrequire
financing measures m
o Budgeet
and organization
support to set up
ODC;
o (in commbination
with) Hoome
visits with dri iver;
o Social taxis for specific situations;
• Category 3 : Solutions that rrequire
changes in n law
o Revision
of the obligaation
to perform any home visit that is
requessted
by the patiennt
(day or night);
o New sstatus
of “volunteeer
GPs” who do not fill the conditiions
for
being licensed and accrredited;
o Cessaation
of the police requisitio on to suppress
this
•
suppleementary
workloadd
during AHS.
Category 4 : implementatiion
of the proje ect 1733 that coombines
emergencyy
medical aid andd
GPs AHS with a central dispatchhing
for
the triage. The responsibilityy
issues of this sys stem have to be ssolved.
8.2.1.2. Doccument
from thee
FAG
The FAG (Foruum
des Associatioons
de Généralis stes) groups the FFrench-
speaking GPs’ circles and asssociations.
This Forum F proposed 10 key
issues to suppoort
the reform of after-hours
in gene eral practice.
• Redefinition
of the term “dutty
period in GP”, i.e. i the continuity of care
in oppositioon
to answers to eemergency
situations;
• Revision of
the number minnimum
of GPs to mobilized/1000 ppatients:
today too mmany
physicians aare
mobilised during
the night.
• Definition oof
the maximum thhreshold
of recurr rence per year:
o Week-ends/public
holidays:
8 X 24h;
o Weekddays
15 X 13h.
• Abolition of
the obligation too
perform any hom me visit when reqquested
(ACIOD). It
is preferable to keep home visits for the few patients
that
need it. A change in this laww
should allow th he merge of areass
and a
decrease inn
the frequency of
duty periods.
Affter-Hours
Primaary
Care
• Triage of callls
under State’s responsibility (TAASRE)
: to allocatte
the
best solutioon
according to the patient’s
consultation, emergency service);
medical need (visit,
• Recruitment and license for GGPs
who help in thhe
organization off
AHS
(even if they are not set up in ttheir
own practicee);
• New calculattion
of the lump ssum
paid to GP ccircles
for duty periods.
The current ssystem
is based oon
the population density and penaalizes
rural areas;
• Support of thhe
ODC by the autthorities;
• Exceptional measures to bee
applied after faailure
of the preevious
solutions, affter
the advice of the FCGPC.
An example iis
an
agreement wwith
an emergenccy
department forr
AHS during the deep
night periodss.
• Specific meaasures
to ensure the GPs securitty
during duty peeriods
(e.g. driver).
8.2.2. Statemeents
from assocciations
of youngg
general
practitiooners
(Jong Dommus
and SSM-J) )
8.2.2.1. Stateements
from the Flemish associaation
Jong Domuus
Summary
Jong Domus is thhe
association of young GPs, a wwing
of Domus Meedica.
They made threee
concrete propossals
to keep the AHS as a challenging
and interesting GP’s
mission and to
combine it with the private life:
• Organization of an after-hourss
service during thhe
weeks’ nights bby
the
GP circles inn
all regions to limmit
the evening woorkload.
An agreeement
between geoographical
areas mmight
facilitate thee
organization of these
duty periods in particular in larrge
geographical aareas;
• Splitting up dduty
periods duringg
the week-ends:
o Minimumm
2 separated dayys
of 24 hours.
o When possible,
ODC is an efficient way to provide GP caare
to
the popuulation.
ODC alloow
more contactss
with patients annd
the
participaation
of less fit/older
GPs to the AHSS.
• AHS exemption
for pregnant
women, mainlyy
for home visitss
and
duties duringg
the nights.
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