Ordinance and decree published

Two texts, an ordinance and a decree, were published in the Official Journal on October 24, confirming the promise made by the Minister of Health, Stéphanie Rist, in March 2026 to expand the role of advanced practice nurses (IPA) through direct access to the territorial health professional community (CPTS) in an experiment.

Experiment details

The experiment, set to begin on December 1, 2026, requires IPA participants to declare their involvement to the director of their Regional Health Agency, providing justification for their practice within a CPTS. They can do so up to six months before the end of the program.

Care process outlined

Within the framework of care, the professional refers the patient to their general practitioner if needed, or, if not available, to a doctor involved in the follow-up or practicing within the CPTS. After the consultation, a report on the care provided by the advanced practice nurse is sent to the doctor and integrated into the shared medical record or the patient's electronic file.

Evaluation responsibilities

The concerned regional health agencies are responsible for evaluating the experiment on their territories. The decree lists the status of care provided by IPA in CPTS, centralization of information relating to the quality of care (number of IPA participating in the experiment and patients received, average number of consultations and their reasons, number of files and any potential adverse effects).

Experiment locations

The experiment will be deployed in six departments: The Hérault; The Loiret; Martinique; Mayotte; The Val-d'Oise; and the Yonne. The experiment is scheduled to last five years.

Nurses' order reacts positively

The National Order of Nurses expressed its joy at the publication of these texts, stating that direct access to advanced practice nurses is a measure they have advocated for several years.

President's statement

The president of the order, Alain Desbouchages, said the texts fully recognize the skills of IPA and their ability to take care of patients autonomously and responsibly, in coordination with other health professionals.

Other related measures

These texts complete other measures that have expanded direct access, which, since January 20, 2025, and the publication of the decree setting its conditions, has made it possible "in several coordinated practice structures, including health establishments, health and social service establishments, health centers, health houses, as well as primary and specialized care teams."

Order's expectations

The Order estimates that the results of this experiment will prove that IPA represent "a concrete, safe and effective response to the health needs" of the population.

Rist law background

Direct access for IPA was one of the measures of the law aimed at improving access to care through trust in health professionals, called the Rist law because carried by the current Minister of Health, adopted in January 2023. This law allowed it under certain conditions, including the membership of IPA to a coordinated practice structure. The CPTS had then been excluded from the scope of the text.

Government goals

More broadly, direct access represents a factor of attractiveness for the profession, itself a real challenge for the government, which hopes to double the number of trained IPA as early as 2027.