Breaking down the barriers between practitioners in the community and in hospitals!

Communication problems between medical professionals in the community and in hospitals, with regard to patient management, are a long-standing issue. Today, there has been a general increase in awareness and a determination to overturn the status quo. We stand on the brink of real progress.

A major challenge

“For the FHF, improving relations between healthcare professionals in the community and in hospitals is a major challenge,” says Cédric Arcos, former Delegate General of the FHF (French hospital federation)1. “The stakes are high and it is essential that we succeed. We are doing all we can to foster relations with medical partners in the community, such as the URPS (regional union of healthcare professionals) and associations of young healthcare professionals.”To what end? “To bring together the patient’s treatment and care plan, based on the concept of graduated care,” indicates Cédric Arcos. And, within this transformational dynamic, hospitals must play their part in establishing a structure for good relations between practitioners in the community and hospital staff.

Costly and ineffective

There is an urgent need for profound change, as this separation between practitioners in the community and in hospitals has been identified as one of the major sources of several chronic failings of the French healthcare system. Indeed, it is the cause of many redundant procedures and far too many breakdowns in patient management. As far back as 2004, a report issued by the HAS (French national authority for health) on the cost of non-quality identified this weakness in the system. It is also a regularly recurring theme in reports by the French Court of Auditors on the cost of unnecessary healthcare acts.

Pressing demand from patients

Patients have made this issue one of their hobby horses. A major proportion of the suggestions that CancerAdom has recently published via its citizens’ booklet2 relates to improving relations between hospital staff and the practitioners in the community who take over the monitoring and treatment of cancer patients who are cared for at home. The separation between practitioners in hospitals and in the community adds a real layer of difficulty that patients could well do without when faced with a fight against cancer.

GHTs: a step in the right direction

So, how to proceed? Cédric Arcos thinks that the creation of GHTs (regional hospital consortia) will accelerate the implementation of solutions. Structured on a regional basis, GHTs have no alternative but to strengthen their collaboration with healthcare professionals in the community in order to deploy their medical projects. “Two-thirds of GHTs are on-board with the reinforcement of links with practitioners in the community as a strategic priority,” confirms the FHF Delegate General.

A recognised formula for success

Cédric Arcos has no doubts as to how to proceed: this issue should very definitely be addressed at local level and the input from national level should be strictly limited to the provision of effective and appropriate ICT (information and communication technology) tools. The solutions implemented should build on the systems that already exist and work in certain territories. In almost all successful cases, the same formula can be identified:

  • the problem is addressed by stakeholders in the field, with all parties willing and determined to take a step towards each other and modify their practices accordingly.
  • Real solutions are found to meet patients’ needs, with the implementation of an effective information system being a key factor.

Responses at Paris Healthcare Week

All of these issues had been addressed at the 2018 edition of Paris Healthcare Week. The event will offer an ideal opportunity to address this sort of problem, which combines the need to support cultural and professional changes and to find solutions to provide appropriate tools for organisational projects. There had been particular called for companies that publish and provide information systems to present existing tools and solutions. It remains only to establish the necessary connections. According to Cédric Arcos, “The only rule is that it is important not to multiply the systems in use, but rather to identify a set of tools appropriate to the task, designed by those working in the field, be they based in the community or in hospitals.”

1 Cédric Arcos was temporary FHF Delegate General at the time of the interview, and is now Deputy Director General of the Île-de-France regional council.

2 Cancer A Dom: “Citizens’ booklet of ideas – Making the transition to cancerology outpatient together – 10 suggestions”. Available for download (in French) at

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