The National Union of Health Insurance Funds (Uncam), the three representative organizations of liberal nurses (the National Federation of Nurses (FNI), the National Union of Independent Nurses (SNIIL) and Convergence Infirmière (CI), signed amendment 11 to the national nurses’ convention. In this context, nurses in advanced practice also see their role reinforced, with expanded direct access, a significant upgrade of their consultations and relaxed monitoring methods. Overall this agreement tangibly reflects the evolution and recognition of the role and skills of nurses.
The Minister of Health, Families, Autonomy and People with Disabilities welcomes the successful conclusion of conventional negotiations between Health Insurance and representatives of independent nurses. This agreement marks a major step in recognizing the role of nurses and in adapting our health system to the growing needs of the population.
Following on from the law of June 27, 2025 relating to the nursing profession, this agreement provides for concrete progress around three priorities: revalorize the core of the profession, recognize the rise in skills and improve access to care throughout the territory.
The agreement thus marks a progressive revaluation of technical acts (AMI/AMX), with an overall increase close to 10%, responding to strong expectations from the profession and contributing to strengthening the attractiveness of liberal practice, in particular for daily care.
It also marks a significant development in nursing skills, with the creation of nursing consultations deployed between 2026 and 2028, valued at 20 euros. These new consultations will make it possible in particular to support patients suffering from chronic illnesses, to secure the initiation of treatments and to strengthen prevention actions. The establishment of the referent nurse will complete this dynamic by offering the most vulnerable patients a clearly identified local contact, in conjunction with the attending physician.
In terms of access to care, the agreement facilitates direct access to nurses and broadens their scope of intervention, particularly for the management of certain wounds, both acute and chronic, with a value adapted to the level of complexity. It is also developing new modes of practice, in particular for unscheduled care, in order to provide faster responses that are more adapted to the needs of patients, throughout the territory (see box).
Particular effort is being made on the most complex situations, with an evolution of the nursing care assessment (BSI), refocused and better valued for the most dependent patients, as well as the creation of new monitoring acts to better cover intermediate needs.
Advanced practice nurses also see their role strengthened, with expanded direct access, a significant upgrade of their consultations and more flexible monitoring methods, allowing them to contribute more to the care of patients, particularly those suffering from chronic pathologies.
L'Union Nationale des Infirmiers en Pratique Avancée (Unipa) salue "l’adoption d’un modèle construit à partir des retours de nos adhérents. Il permet enfin le remboursement de l’accès direct, reconnaît davantage les spécificités de l’exercice en pratique avancée et introduit une meilleure valorisation des différents modes d’exercice, notamment dans les parcours complexes.
La valorisation de l’accès direct est sensiblement supérieure, mais elle repose sur une succession de trois consultations, là où le parcours orienté atteint un niveau de reconnaissance proche en deux consultations. Cette structuration, plus exigeante en nombre d’actes, ne reflète pas pleinement l’expertise mobilisée dès le premier recours.
L’écart entre la consultation infirmière et celle de pratique avancée demeure fixé à un euro. À ce niveau, il ne traduit ni l’ampleur des compétences mobilisées, ni le niveau de formation, ni les responsabilités exercées, alors même qu’un positionnement médian avait été envisagé.
Cette analyse ne s’inscrit pas dans une logique d’opposition entre professionnels. Elle vise à promouvoir un cadre cohérent et lisible, dans lequel chaque infirmier trouve pleinement sa place, avec une reconnaissance à la hauteur de ses missions.
Désormais, nous attendons, que ce modèle soit éprouvé sur le terrain, avec un objectif clair de viabilité pour l’ensemble des IPA, en particulier en exercice libéral. L’Unipa sera attentive aux premiers retours chiffrés afin d’objectiver les ajustements nécessaires"."
Finally, the agreement provides for a more balanced framework for the use of replacements, in order to guarantee continuity and quality of care, while taking into account territorial realities.
Through this agreement of nearly 500 million euros deployed over 2026-2029, public authoritiesin conjunction with the nurses’ representatives, reaffirm their commitment to a health system that is more accessible, more coordinated and closer to patients, while fully recognizing the daily commitment of private nurses.
Stéphanie Rist, Minister of Health, Families, Autonomy and Persons with Disabilities: “This nursing negotiation constitutes a new stage in the reform of the nursing profession, by concretizing the revaluation of the care provided by nurses. This agreement tangibly reflects the evolution and recognition of their role and skills, throughout the territory. There is still much to do, but it is collectively that we will meet this challenge. I thank Health Insurance and the nurses’ representatives for the quality of this conventional, demanding but essential dialogue. »
Press release, Ministry of Health, March 31, 2026
