In a context of profound reform of the nursing discipline, marked by the evolution of the legislative and regulatory framework, the National Union of Advanced Practice Nurses (UNIPA) requested an independent legal consultation carried out by Professor Joël Moret-Bailly, associate professor of law faculties, whose expertise in health law is recognized. This consultation provides structuring insight into the reform resulting from the law of June 27, 2025 and its implementing texts. Communiqué
The main legal lessons:
The reform establishes two distinct regimes of advanced nursing practice within the same normative setand not a single category intended to encompass all forms of exercise:
- The advanced practice regime known as full exercise (art. L. 4301-1 and L. 4301-2, I and II of the CSP) remains structured around a complete normative framework: dedicated state diploma, identified areas of intervention, expanded clinical skills, direct access specific to advanced practice and independent block of prescriptions.
- The so-called derogatory regime (art. L. 4301-2, III of the CSP) is based on methods specific to each specialty defined by decree of the Council of State. As the published texts stand, it has neither direct access specific to advanced practice, nor an autonomous prescription framework comparable to that of the first regime.
But also, the core profession, redefined around broader missions (consultation, nursing diagnosis, prescription, coordination, direct access in the specific role), constitutes the common framework of the discipline and benefits all nurses.
Specialty practice constitutes a particular mode of practicing the nursing profession, backed by additional training, a specific diploma and specialized skills corresponding to a specific field of intervention.
Finally, the introduction of the population approach to article L. 4301-1 of the CSP constitutes an open legislative authorization for the future, which the regulatory power has not yet fully grasped to date.
This analysis provides a stabilized legal reading at a time when professional debate benefits from relying on positive law.
It confirms that the advanced nursing practice of the first regime retains its own architecture, a structuring point for future regulatory work and monitoring committees.
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UNIPA press release of April 26, 2026.
