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Non-scheduled CareE-CARE SNPNCT07862699

Coordinated Primary Care Team to Access and Regulate Unscheduled Care

An observational study of Non-scheduled Care, run by Centre Hospitalier Universitaire de Nīmes at 2 sites in France.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Unscheduled care is care "that does not constitute a life-threatening emergency but for which treatment by a healthcare professional is desirable within 48 hours" and 80% of general practitioners organize their schedules to provide unscheduled care each day. Read more about this study

Who is it for?
Any age
Conditions the study is for
Non-scheduled Care
How many people
3,000 participants
Where
2 sitesFrance
Study dates
Oct 2026to Dec 2026
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • Child, Adult, Older adult

Study population: All patients, whether minor or adult, presenting at La Source Urgent Care Center to request unscheduled care.

Who may be able to join

  • Any patient, whether minor or adult, who comes to the La Source Urgent Care Center to request unscheduled care. Note that patients who have a request for unscheduled care and who present at La Source Urgent Care Center but who are "outside the target population" will not be seen at the coordinated Structure for Unscheduled care but will still be included in the study, and their proportion will be reported.

Who cannot join

  • None

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

France2 sites
  • Nîmes University Hospital

    Nîmes, Gard, 30900

    Anissa MEGZARI, +334.66.68.67.52, drc@chu-nimes.fr

  • MSPU La Source 68, rue du charron,

    Vergèze, GARD, 30310

    Mélanie BADIN, +336 27 38 20 41, melanie.badin@umontpellier.fr

Other trials in France

About this study

Official title: Coordinated Primary Care Team to Access and Regulate Unscheduled Care, a Comparative Before-and-after Longitudinal Cohort Study.

Unscheduled care is care "that does not constitute a life-threatening emergency but for which treatment by a healthcare professional is desirable within 48 hours" and 80% of general practitioners organize their schedules to provide unscheduled care each day. In Multidisciplinary Health Centers, 58% of general practitioners report that they systematically address requests for unscheduled care through a collective response to these requests.

Despite this, difficulties in accessing healthcare are worsening and according to a survey by France Asso Santé, 44% of French people report that they have already foregone healthcare due to excessively long waiting times, and in 2025, 80% reported having foregone care at least once, with 67% claiming this is due to excessively long waiting times for appointments.

Read more

The literature shows that it is linked to two main factors: precarious living conditions (financial barriers) and limited healthcare availability, which reinforce one another, as people living in poor conditions are three times more likely to forego care than others.Indeed, in areas underserved by general practitioners, this risk becomes more than eight times higher than that of the rest of the population.

Nationwide, the density of general practitioners was 153 GPs per 100,000 residents in 2012 and 140 per 100,000 in 2021; it is expected to continue declining over the next decade. GPs work work an average of 55 hours per week and, as their number is declining, it is essential to reorganize primary care services.Regarding non-emergency care, in 2019 17% of French people reported that they had sought emergency room care because no doctors were available (according to a survey by France Asso Santé). Many visits to the emergency room could be avoided because they fall under the purview of community-based care. This misuse appears to be linked to several factors, including the lack of availability of appropriate primary care and the greater financial accessibility of third-party payment, which is consistent with the factors leading to forgoing care. In Occitanie, the 2024 ORU report found that 20% of emergency department visits could potentially be handled by primary care. Changes in the organization of community health services are gradually emerging, notably thanks to task delegation and the creation of coordinated care structures but this has not been sufficient to prevent a deterioration in access to community-based care. The medical team at the La Source MSPU is well aware of this public health issue and the inequality in access to care for all. In light of this, the MSPU proposes to organize a primary care team to manage access to and coordinate unscheduled care services within the organization. This innovative structure is referred to as the Coordinated Structure for Unscheduled Care (SC-SNP). A walk-in consultation window is open every morning from Monday through Friday to address requests for unplanned care. This system mobilizes a dedicated primary care team consisting of a medical assistant, a registered nurse, and a general practitioner.

Read the detailed description

Unscheduled care refers to care "that does not constitute a life-threatening emergency but for which treatment by a healthcare professional is desirable within 48 hours" (1).

Eighty percent of general practitioners organize their schedules to provide unscheduled care on a daily basis. In Multidisciplinary Health Centers (MHCs), 58% of general practitioners report that they systematically address requests for unscheduled care through a collective response to these requests. Despite these efforts, difficulties in accessing healthcare are worsening: in 2019, 44% of French people reported having already foregone healthcare due to excessively long wait times, according to a survey by France Asso Santé, and by 2025, 80% of French people reported having foregone care at least once, with 67% citing excessively long wait times for appointments as the reason. Forgoing healthcare is a reality in France, and the literature shows that it is linked to two main factors: precarious living conditions (financial barriers) and limited healthcare availability, which reinforce one another, since people living in poor conditions are three times more likely to forgo care than others but in an area underserved by general practitioners, this risk becomes more than eight times higher than that of the rest of the population.

Nationwide, the density of general practitioners (GPs) was 153 GPs per 100,000 residents in 2012 and 140 per 100,000 in 2021; it is expected to continue declining over the next decade. With general practitioners working an average of 55 hours per week and a declining population, the reorganization of primary care services is a necessity. The challenges facing primary care services have repercussions throughout the entire healthcare system: regarding non-emergency care, 17% of French people reported in 2019 that they had sought emergency room care because no doctor was available, according to a survey by France Asso Santé. The HCAAM report from 2022 notes that "many visits to the emergency room could be avoided because they fall under the purview of community-based care"; this misuse appears to be linked to several factors, including the lack of availability of appropriate primary care and the greater financial accessibility of the SAU (third-party payment), which is consistent with the factors leading to forgoing care. In Occitanie, the 2024 ORU report found that 20% of emergency department visits could potentially be handled by primary care.

The effectiveness and efficiency of primary health care have been demonstrated internationally, as has its ability to reduce social inequalities in health, particularly through interventions in primary care. In 2018, in the Declaration of Astana, the World Health Organization (WHO) affirmed that Primary Health Care is "the cornerstone of a sustainable health system with a view to universal health coverage." In France, to reduce the forgoing of care and the incidence of health-related social issues, it would be necessary to reorganize the French healthcare system around primary care, which is currently only minimally organized, planned, and regulated.Changes in the organization of community health services are beginning to emerge, notably through the expansion of task delegation and the creation of coordinated care structures (MHCs, Territorial Professional Health Communities (CPTS)), but this has not been sufficient to prevent a deterioration in access to community-based care. This is the conclusion reached by the High Council for the Future of Health Insurance (HCAAM) in its 2022 report on primary care, "Organization of Community-Based Care: Ensuring Access to Quality Care for All," in which it emphasizes the need "to expand and accelerate these transformations, but also,to find short-term solutions to guarantee adequate access to care everywhere.".

The medical team at the La Source MSPU is well aware of this public health issue and the inequality in access to care for all. In light of this, the MSPU proposes to organize a primary care team to manage access to and coordinate unscheduled care services within the organization. This innovative structure is referred to as the Coordinated Structure for Unscheduled Care (SC-SNP). A walk-in consultation window is open every morning from Monday through Friday to address requests for unplanned care. This system mobilizes a dedicated primary care team consisting of a medical assistant, a registered nurse, and a general practitioner.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of consultations per hour for walk-in care BEFORE implementing the Controlled Structure for Unscheduled Care at the La Source MSPU

    The aim is to compare the number of consultations per hour for walk-in care before and after the implementation of the Controlled Structure for Unscheduled Care at the La Source MSPU, over a 6-month period.

    Measured: Baseline

  2. Number of consultations per hour for walk-in care AFTER implementing the Controlled Structure for Unscheduled Care at the La Source MSPU

    The aim is to compare the number of consultations per hour for walk-in care before and after the implementation of the Controlled Structure for Unscheduled Care at the La Source MSPU, over a 6-month period.

    Measured: After 6 months

Secondary outcomes (18)
  1. Proportion of requests for unscheduled care according to reason

    Quantitative

    Measured: After 6 months

  2. Proportion of requests for unscheduled care by category : medical referral by the controlled structure for unscheduled care

    The aim is to estimate the proportion of responses by category (medical referral by the controlled structure for unscheduled care, paramedical referral by the controlled structure for unscheduled care, consultation within < 48 hours, < 7 days, > 7 days) and the proportion of responses per qualification

    Measured: After 6 months

  3. Proportion of requests for unscheduled care by category : paramedical referral by the controlled structure for unscheduled care

    The aim is to estimate the proportion of responses by category (medical referral by the controlled structure for unscheduled care, paramedical referral by the controlled structure for unscheduled care, consultation within < 48 hours, < 7 days, > 7 days) and the proportion of responses per qualification

    Measured: After 6 months

  4. Proportion of requests for unscheduled care by category : medical referral by the controlled structure for unscheduled care within 48 hours

    The aim is to estimate the proportion of responses by category (medical referral by the controlled structure for unscheduled care, paramedical referral by the controlled structure for unscheduled care, consultation within < 48 hours, < 7 days, > 7 days) and the proportion of responses per qualification

    Measured: After 6 months

  5. Proportion of requests for unscheduled care by category : medical referral by the controlled structure for unscheduled care within < 7 days

    The aim is to estimate the proportion of responses by category (medical referral by the controlled structure for unscheduled care, paramedical referral by the controlled structure for unscheduled care, consultation within < 48 hours, < 7 days, > 7 days) and the proportion of responses per qualification

    Measured: After 6 months

  6. Proportion of requests for unscheduled care by category : medical referral by the controlled structure for unscheduled care > 7 days

    The aim is to estimate the proportion of responses by category (medical referral by the controlled structure for unscheduled care, paramedical referral by the controlled structure for unscheduled care, consultation within < 48 hours, < 7 days, > 7 days) and the proportion of responses per qualification

    Measured: After 6 months

  7. Patient satisfaction adapted version of the University of Sheffield's Main Survey Questionnaire

    The aim is to assess the satisfaction of patients seen at the controlled structured for unscheduled care regarding their care journey and treatment using an adapted version of the University of Sheffield's Main Survey Questionnaire (MSQ).

    Patient satisfaction: overall satisfaction measured by a composite score derived from the MSQ, with each item (response time, wait time, staff attitude, overall satisfaction) assessed using Likert scales.

    Measured: Between September 2026 and March 2027

  8. Reported care pathways of patients not treated by the Controlled Structure for Urgent Care : calls to a Health Care Access Service

    Description of the reported care pathways of patients if not treated by the Controlled Structure for Urgent Care (calls to a Health Care Access Service, visits to an unscheduled care center, visits to the emergency department, visits to the MMG, or refusal of care). Quantitative

    Measured: Between September 2026 and March 2027

  9. Reported care pathways of patients not treated by the Controlled Structure for Urgent Care : visits to an unscheduled care center

    Description of the reported care pathways of patients if not treated by the Controlled Structure for Urgent Care (calls to a Health Care Access Service, visits to an unscheduled care center, visits to the emergency department, visits to the MMG, or refusal of care). Quantitative

    Measured: Between September 2026 and March 2027

  10. Reported care pathways of patients not treated by the Controlled Structure for Urgent Care : visits to the emergency department

    Description of the reported care pathways of patients if not treated by the Controlled Structure for Urgent Care (calls to a Health Care Access Service, visits to an unscheduled care center, visits to the emergency department, visits to the MMG, or refusal of care). Quantitative

    Measured: Between September 2026 and March 2027

  11. Reported care pathways of patients not treated by the Controlled Structure for Urgent Care : visits to the on-call Medical Center

    Description of the reported care pathways of patients if not treated by the Controlled Structure for Urgent Care (calls to a Health Care Access Service, visits to an unscheduled care center, visits to the emergency department, visits to the MMG, or refusal of care). Quantitative

    Measured: Between September 2026 and March 2027

  12. Reported care pathways of patients not treated by the Controlled Structure for Urgent Care : Refusal of care

    Description of the reported care pathways of patients if not treated by the Controlled Structure for Urgent Care (calls to a Health Care Access Service, visits to an unscheduled care center, visits to the emergency department, visits to the MMG, or refusal of care). Quantitative

    Measured: Between September 2026 and March 2027

  13. Cost of general practice visits for patients admitted for unscheduled care from the healthcare system's perspective

    The economic impact of the Controlled Structure for Urgent Care will be assessed from the perspective of the healthcare system through a cost-minimization study over a 1-day time horizon.

    Measured: One day

  14. Cost of visits to the emergency department avoided for patients admitted for unscheduled care from the healthcare system's perspective

    The economic impact of the Controlled Structure for Urgent Care will be assessed from the perspective of the healthcare system through a cost-minimization study over a 1-day time horizon.

    Measured: One day

  15. Cost of visits to the on-call medical center avoided for patients admitted for unscheduled care from the healthcare system's perspective

    The economic impact of the Controlled Structure for Urgent Care will be assessed from the perspective of the healthcare system through a cost-minimization study over a 1-day time horizon.

    Measured: One day

  16. Cost of visits to unscheduled care centers avoided for patients admitted for unscheduled care from the healthcare system's perspective

    The economic impact of the Controlled Structure for Urgent Care will be assessed from the perspective of the healthcare system through a cost-minimization study over a 1-day time horizon.

    Measured: One day

  17. Economic viability of the programme assessed from the perspective of the La Source Primary Care Center : Amount paid for on-site nursing shifts

    The economic viability of the program will be assessed from the perspective of the La Source Primary Care Center:

    • Amount paid for on-site nursing shifts
    • Number of unscheduled care-type consultations conducted and rates applied.

    Measured: Between September 2026 and December 2026

  18. Economic viability of the programme assessed from the perspective of the La Source Primary Care Center : Number of unscheduled care-type consultations

    The economic viability of the program will be assessed from the perspective of the La Source Primary Care Center:

    • Amount paid for on-site nursing shifts
    • Number of unscheduled care-type consultations conducted and rates applied.

    Measured: Between September 2026 and December 2026

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Oct 2026
  2. Study startOct 2026 (estimated)
  3. Primary completionNov 2026 (estimated)
  4. Study completionDec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Other
Enrolment
3,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07862699
Sponsor's protocol ID
LOCAL/2026/MB-01
Acronym
E-CARE SNP
Status last verified
Sep 2026
First submitted
29 Sep 2026
Last updated
7 Oct 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

An observational study of Non-scheduled Care, run by Centre Hospitalier Universitaire de Nīmes at 2 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 7 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Mélanie BADIN, Dr. (+336 27 38 20 41, melanie.badin@umontpellier.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of consultations per hour for walk-in care BEFORE implementing the Controlled Structure for Unscheduled Care at the La Source MSPU (time frame: Baseline). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Oct 2026.

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