Four years after its creation, the CPTS “Presqu’îles en mer” in Morbihan registered its dissolution on 1er January 2024, the two structures that made up this small community stopped standing on their own two legs.
Last December, the National Federation of Territorial Professional Health Communities (CPTS) reported continued progress with the number of 791 structures in the network in France, of which 498 have already officially contracted with public authorities. But if, every week, the projects are put together, the dissolution of the CPTS in Brittany on 1er January still shows that everything is not so simple. However, the story started well. Created in 2019 and called “Presqu’îles en Mer”, the community includes 180 professionals and was the result of the merger of two integrated exercise structures, one in Belle-Île and the other, on the continent, on the territory of Quiberon. Initially under an association format specific to the region – the Breton Interprofessional Federations (FBI) – they started to carry out projects on access to care and prevention, even for Belle-Eloise, about ten years ago.
“Historically, we created FBI-MARE to bring together all the health professionals on the island, says Dr Pierre-Yves Le Floch, general practitioner and former member of the office of the recently dissolved CPTS. It then adopted the legal structure of CISA (Interprofessional Society for Ambulatory Care, Editor’s Note) as a multi-site health center to be able to benefit from public funding to carry out the project. A coordinator is appointed and actions are being carried out: therapeutic education workshops on painful spines, addiction treatment courses, memory workshops or physical activities for the elderly, as well as a section on ongoing care. Doctors of MSP, who are located in the hospital premises, can also intervene in the establishment. A well-established establishment that also makes it possible to meet the rush of tourists during the season. Then, the strategic approach of the government towards the creation of the CPTS convinced the professionals to initiate themselves to integrate the two small islands of Houat and Hoedic in their territory of intervention and above all to be able to work with their colleagues. the peninsula. Quiberon Island. “We thought that this would make it possible to listen better by the public authorities and, for example, to open the way for a somewhat broader permanence of care” Dr Le Floch explains.
Disputes between professionals
The logic is almost identical on the continent, even though, in Quiberon, the MSP was formed slightly earlier than the CPTS. “In Brittany, it is the Geco Lib Association, launched by the Regional Union of Health Professionals (URPS) doctors and joined by others, which supports the development of CPTS, we thought it was interesting for us to partner with Belle-Île. structure rather than integrating a pre-existing aura” Testifies Dr Jean-Philippe Moitier, General Practitioner in Quiberon and last President of the CPTS. At the same time, MSP works with real nurses and sets up projects specifically in the field of addiction. As in many regions, the Covid crisis has given CPTS more resources, especially through the rapid establishment of vaccination centres. But infighting between professionals, presidential changes and different working habits mean the mayonnaise doesn’t really catch on. “The projects we tried to undertake together were a bit vague” Dr. Knows Moitier. “Initially we were very enthusiastic, Remembers Dr Le Floch. But when we started looking at the laws, it quickly became complicated. But if we are supported, there is a lot of bureaucratic and administrative work, all things that are not our job. It was a bit naive and not very well prepared.”
Duplicate effect
Some of these difficulties with the Breton structure were noted last June by Dr. “CPTS Tour de France” led by Marie-Hélène Sarton (MG France), Albert Lautmann (CPM de l’Essonne) and Hugo Gilardi (ARS Hautes-Alpes) reported. D-France). Following their interviews with professionals involved in various CPTS, they maintain that “Afraid of the logic of progressive multiplication of objectives, indicators, actions to be deployed, without adequate prioritization and without overarching consultation and co-creation” The dissolution of the CTPS Presqu’îles, which today is not without its administrative difficulties (coordinator’s departure, return of funds to the ARS, etc.), also highlights the difficulties…
