There are ten of them around the table, and of course no one has a crystal ball. Impossible this Wednesday to know how the care structures in Val-de-Marne, and especially the emergencies, will spend the summer. It is also difficult to know the specific impact of future temperatures, especially on the elderly. Still, summer is a source of tension, and they can still be expected. This is the meaning of the meeting, which took place on Wednesday in a room in 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 head of department of the Regional Health Agency (ARS), Éric Véchard. On one side of the beds, which can be closed, carers are on leave. On the other hand, patients who continue to arrive, especially in the emergency room.
On the workforce side, Samu 94 is “complete”
With Health Insurance, ARS gathered on Wednesday the territorial health actors: Samu, Sami, Council of the Order of Physicians, association of liberal doctors. In Val-de-Marne, the dialogue between these different actors is presented as a “historical” trademark. This is e.g. the case of this other departmental specialty, the Sami, these medical centers on call, 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 estimate that the next two months look relatively good. “Compared to last year, we have 8% fewer calls,” explains the medical director, Éric Lecarpentier. There are still a few shifts to be made available in August, but there is “no predictable dramatic situation” for the summer, he reassures. Especially since the staff at Samu 94 “is complete”. What “guides patients in avoiding emergencies,” he continues.
Last summer throughout the Ile-de-France region, there was a “sustained demand for care among people aged 75 and over”, we tell ARS Île-de-France. “But we know that going to the emergency room can be harmful for an elderly person,” recalls Éric Véchard further.
This more efficient referral of patients is possible, in particular, thanks to SAS, the health access service, registered in 2019 in the covenant for the review of emergency situations. Available 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 provides access to emergency 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 Samu.
The city’s doctors mobilized to “give a hand”
“In the area, the city’s doctors have always been invited to lend a hand,” recalls Éric Lecarpentier. “Three of the people present today are members of the council of order”, says its general secretary Éric Gibert. Coordinator of Sami 94, Jean-Noël Lépront recalls that “Val-de-Marne is a medical desert”. He is also president of the CPTS de Champigny (territorial professional health society), which organizes care in an area. There are now nine in the department, covering 60% of the population.
“The effort of the health insurance is the effort of the CPTS,” explains Sandrine Roque from CPAM 94, director responsible for support and provision of care, because it provides visibility over several years. “For the Caisse, “the big news is the coordinated forms of training”, which should make it possible to avoid leaving patients on the floor. The goal is all year round, summer and winter, “to avoid abandoning treatment”, insists Éric Véchard.
