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Preparing for Summer: Care Structures and Tension in Val-de-Marne – AP-HP Update

They are ten around the table and, of course, no one has a crystal ball. Impossible this Wednesday to know how the care structures of Val-de-Marne, and in particular the emergencies, will spend the summer. It is also difficult to know the concrete impact of future temperatures, especially on the elderly. Still, summer is a source of tension, and they can still be anticipated. This is the meaning of the meeting which took place this Wednesday in a room of the Samu, at the Henri-Mondor hospital of the AP-HP in Créteil.

“Of course we are not the first tourist destination, but it is possible that there are a few more patients”, contextualizes the departmental head of the Regional Health Agency (ARS), Éric Véchard. On one side of the beds that can close, carers on leave. On the other, patients who continue to arrive, particularly in the emergency room.

On the workforce side, the Samu 94 “is complete”

With Health Insurance, the ARS brought together the territorial health players on Wednesday: Samu, Sami, Council of the Order of Physicians, association of liberal doctors. In the Val-de-Marne, the dialogue between these different actors is presented as a “historic” trademark. This is the case for example with this other departmental specificity, the Sami, these medical centers on duty which celebrated their 20th anniversary last year and remain open this summer. There are twelve in Val-de-Marne, which represented 92,000 patient visits last year.

As for Samu 94, we consider that the next two months are looking relatively good. “Compared to last year, we have 8% fewer calls,” explains the medical director, Éric Lecarpentier. There are still a few guards to be provided in August but there is “no foreseeable dramatic situation” for the summer, he reassures. Especially since the staff of Samu 94 “is complete”. What “guide patients by avoiding emergencies”, he continues.

Créteil, this Wednesday. In the Val-de-Marne, the dialogue between these different actors is presented as a “historic” trademark.

Last summer throughout the Ile-de-France region, there was a “sustained demand for care among people aged 75 and over”, we say to ARS Île-de-France. “However, we know that for an elderly person, going to the emergency room can be deleterious,” further recalls Éric Véchard.

This more effective referral of patients is possible in particular thanks to the SAS, the healthcare access service, registered in 2019 in the Pact for the overhaul of emergencies. Accessible in five of the eight Ile-de-France departments (in Val-de-Marne, Paris, Yvelines, Seine-et-Marne, Essonne, and being rolled out in Hauts-de-Seine, Seine -Saint-Denis and Val-d’Oise), it gives access to urgent care and unscheduled care, thanks to the regulation carried out by general practitioners. Its activity “takes place here in Mondor”, explains Charles Binetruy, general practitioner and coordinator of the association which organizes the general medicine component of the Samu.

City doctors mobilized to “lend a hand”

“On the territory, city doctors have always been invited to lend a hand,” recalls Éric Lecarpentier. “Three of the people present today are members of the Council of the Order”, slips its secretary general Éric Gibert. Coordinator of Sami 94, Jean-Noël Lépront recalls that “Val-de-Marne is a medical desert”. He is also the president of the CPTS de Champigny (territorial professional health community), which organizes care in a territory. There are now nine in the department, covering 60% of the population.

“The bet of Health Insurance is that of the CPTS, explains Sandrine Roque of CPAM 94, director in charge of support and the offer of care, because it gives visibility over several years. “For the Caisse, “the great novelty is the coordinated exercise modes”, which should make it possible to avoid leaving patients on the floor. The objective being all year round, summer and winter, “to avoid giving up treatment”, insists Éric Véchard.

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