The reform of ambulance duty and urgent medical transport which has been implemented in the department since July 1, 2022, establishes several principles:
- The target objective of a delay of 30 minutes between the request for urgent medical transport from the SAMU and arrival at the patient's point of care,
- The emergency medical transport association (ATSU) is entrusted with clarified missions in terms of the operational organization of guard duty and urgent medical transport,
- The departmental specifications are expanded to determine the organizational arrangements not only for guard duty but also for the entire response of medical transport companies to SAMU requests,
- It becomes possible for urgent medical transport to ensure transport to city care or when an emergency exit occurs,
The reorganization of on-call duty aims to optimize the response of medical transport companies to SAMU requests by positioning daytime on-call resources across all 3 on-call sectors so as to limit the number of ambulance shortages.
After two years of implementation, it turns out that the ambulance on-call system does not make it possible to reduce the number of deficiencies during the day, given the intervention requests from SAMU-Centre 15.
The lack of availability of private companies to respond to SAMU requests in addition to the guard vehicle also contributes to maintaining the number of deficiencies at a high level.
Also on an experimental basis over a period of 1 year, from February 17, 2025, the ARS wishes to be able to act in partnership with the partners concerned so that a response to requests from SAMU47-Centre 15, under satisfactory conditions, can be brought to the entire department.
In the Lot-et-Garonne department, current legislation (article R 6312-30 of the public health code) does not allow for additional marketing authorization. In fact, the department of Lot-et-Garonne exceeds the vehicle quota determined by order of the Director General of the ARS of Nouvelle Aquitaine dated March 25, 2021, by 44 vehicles.
Also, in order to improve the response of medical transport to urgent medical aid, it is proposed to set up “non-quota” ambulance vehicles throughout the department.
The possibility is offered to medical transport companies wishing more particularly to respond to urgent medical aid within the framework of articles R 6312-12 and R 6312-30 of the public health code to have an ASSU type ambulance “out of quota” .
The use of these vehicles will be dedicated exclusively and continuously to urgent medical aid, under the regulation of SAMU47-Centre 15 in the Lot-et-Garonne department.
These vehicles are made available to the SAMU and cannot under any circumstances be used for transport on medical prescription, secondary transport or even inter-hospital transfers unless requested by SAMU 47 with specification of the mission intervention number.
The vehicle will be flocked with the additional notice: “ATSU” followed by the allocation number.
Companies wishing to respond to the call for applications must meet the conditions of the specifications (see appendix 1), defined by the ATSU and the SAMU47, the objective of which is to:
- Maintain a low level of deficiency in Lot et Garonne
- Provide a more favorable response to SAMU47-Centre 15 during calls to medical transport companies.
- Ensure a better adequacy of existing resources in order to ensure the fairest possible support depending on the nature of the requests.
Commissioning authorizations will be issued, on an experimental basis, for a renewable period of one year.
A 6-month evaluation of the implementation will be carried out.
The Nouvelle Aquitaine Regional Health Agency does not provide specific financial support for medical transport companies as part of this call for applications.
Application file
Requests may be submitted by a company with approval to provide medical transport in the Lot-et-Garonne department and already participating in the ambulance on-call system as organized in the department.
Companies must provide proof of staff holding the State Ambulance Diploma (or CCA) in sufficient numbers and at least equal to 1.5 times the number of ambulances including the non-quota vehicle and meet the conditions of the specifications, attached in appendix 1.
Requests must be submitted using the standard form sent electronically to:
specifying in subject « Candidature ambulance Hors quota » .
