The situation may seem paradoxical. Despite bed openings and several hires, the AP-HP (Assistance Publique – Hôpitaux de Paris) announced this Tuesday, January 14 that its deficit has widened in 2024 to reach 460.6 million euros. A deterioration of 62 million compared to 2023, but above all 166 million euros more than the sum planned in the overall multi-year financing plan.
A paradox because at the same time, the AP-HP experienced a relaunch of its activity after a Covid-19 pandemic which caused enormous harm to the establishment. “Between 2019 and the beginning of 2023, the AP-HP lost 12% of its nurses (i.e. 2,000 across all 38 hospitals) and we rose to 20% of closed beds,” reports France Inter this Tuesday morning its general director, Nicolas Revel. “It’s true that we suffered a shock in a fairly unprecedented way,” he concedes.
600 beds open between 2022 and 2024
Faced with this observation, an action plan was launched at the end of 2022. Entitled “30 levers for acting together”, its objective is “to attract and retain healthcare staff to allow a reopening of healthcare capacities”, indicates the AP-HP in a press release. And two years after the launch of this plan, the first are starting to be felt with the opening of 600 beds between October 2022 and October 2024.
“For two years, we have been going back on track. We started to reverse the trend in the summer of 2023 and we ended the year with a small rebound of 220 more nurses. Then 2024 was really a year of acceleration of this recovery since 950 additional nursing staff were added. So we’re a little more than halfway there,” announces Nicolas Revel.
“But what is key is that these people stay at the AP,” warns the director general. “We always have departures and there is no magic measure, nor a single lever. We must act on a whole series of elements that make up the daily life of caregivers. For example, we have made a huge effort on housing. Before, the AP-HP was able to allocate 500 to 600 housing units each year, we have increased to 1,200,” says Nicolas Revel. And to summarize: “We tried to focus on everything that pollutes the lives of caregivers. »
No white plan triggered
In its press release, the AP-HP announces that it wants to “continue the reconstitution of the workforce” begun two years ago, in particular by increasing more than 1,000 full-time equivalents (FTE). 815 FTEs of caregivers, including 600 nurses, 100 caregivers and 115 other caregivers who work in stressful professions are hoped for.
The AP-HP situation comes at a time when its hospitals are not immune to the flu epidemic. Nicolas Revel indicates that across all 17 emergency services, up to 250 patients found themselves on stretcher beds while waiting to be hospitalized, compared to around a hundred on a normal day. “Regarding the super intense flu, which lasted around twenty days, we managed to cope”, in particular thanks to the 600 new beds. “We have canceled some planned stays in medical departments. But we did not activate the white plan because fundamentally, it allows staff to be recalled from leave, and we did not need to do that. »
“But we also regularly see that the hospital is very quickly under pressure. The flu doesn't happen every 100 years. We remain extremely fragile,” he admits.
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