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Access to care
You can more easily access an advanced practice nurse for your medical follow-up
Publié le 29 janvier 2025 - Directorate for Legal and Administrative Information (Prime Minister)
An Advanced Practice Nurse (APN) can regularly monitor your health, especially if you have a stable chronic condition or cancer. A decree issued in Official Journal January 21, 2025, allows you to go directly to a API for your follow-up, without first going through a doctor. This direct access is conditioned by the method of exercise of the API.
Advanced practice nurses (APNs) are involved in the overall management of patients; they support doctors in the care of patients with certain pathologies. They may in particular:
- perform technical, clinical and para-clinical surveillance procedures;
- order further examinations and renew or adapt medical treatments;
- carry out education, prevention and screening activities.
As of January 22, 2025, you can go directly to an API for your medical follow-up, without first going through a doctor. As part of this process, the Advanced Practice Nurse you are about to see should practice:
- as an employee in a public or private health institution or in a medical-social institution or service (Ehpad, nursing home, etc.);
- as a liberal API in a coordinated exercise structure (nursing home, health center, primary care team, or specialty care team).
However, you cannot consult directly with a liberal IPA that does not operate within a coordinated exercise structure. In this situation, you must first go see a doctor. The latter defines a diagnostic procedure and therapeutic choices, then it can entrust your medical follow-up to a liberal IPA not working within this type of structure.
Please note
Decree of 20 January 2025 broadens the scope of limitation for APIs, including the primary prescription of medical devices and medicinal products subject to compulsory medical prescription. An order must specify the list of medical devices and drugs involved and the scope of that prescription.
Reminder
The law of 26 January 2016 on the modernization of our health system laid down the legal framework for advanced practice for medical assistants. APIs have broader competencies than nurses. Their duties are thus at the junction between the nursing and medical exercises. When their scope is reached, they should refer a patient back to the treating physician (if there is no treating physician, they should refer the patient to a physician or appropriate facility).
Advanced practice nurses may include take action in the following areas :
- Stabilized chronic and polypathologies common in primary care;
- oncology and hematooncology;
- chronic kidney disease, dialysis, kidney transplantation;
- psychiatry and mental health;
- emergencies, under certain conditions.
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