Policy responses for Luxembourg - HSRM


Policy responses for Luxembourg

3.3 Maintaining essential services

On April 29, the Minister of Health announced that non-urgent medical activities would resume, albeit in an adapted format, from Monday 4 May 2020. It concerns all categories of doctors in the non-hospital and hospital sectors as well as certain liberal health professions such as nurses, midwives, physiotherapists and psychotherapists. Safety measures must continue to be respected. Consequently, all consultation appointments planned from next Monday on will be made via telephone during which the administrator or professional will carry out a COVID-19 screening. If symptoms are present, the patient will be referred to an advanced care centre or an emergency service. Patients should also continue to opt for teleconsultations, where depending on their state of health.

The advanced care centres will remain operational, with the exception of the area provided for non-COVID-19 patients which will be taken up by medical offices from 4 May. The opening hours will be adapted (i.e. 10:00-18:00 instead of 08:00-20:00). Likewise, the medico-dental emergency service and the new medical care systems in place in care homes will remain in place for the time being.
Similarly, access to care in hospitals will no longer be limited to acute or urgent care. Medical and surgical activities will be resumed according to several prioritisation criteria such as their interest in terms of public health, their impact on hospital resources and risk management and their impact on the downstream care pathway from acute care hospitals.

The resumption of activities will be organised in a coherent manner by each of the four hospitals, taking into account the existing infrastructural resources, equipment, medicines and human resources, while guaranteeing maximum safety for patients and healthcare professionals. The separation of COVID-19 and other patient flows will remain in place in order to protect patients and staff. The country's four emergency services will also maintain their separate patient care channels.

As of May 25, the three GP offices (maisons médicales de garde) in Luxembourg that cover out-of-hour care resume their regular activities. Patients (without COVID-19 infection) are asked to make an appointment by telephone.

Source: https://sante.public.lu/fr/actualites/2020/04/reprise-medicale/index.html

On March 18, the Government set up a new system for accessing primary care. All patients can now only consult their treating physician via telephone or teleconsultation. An e-consultation platform (eConsult, https://econsult.esante.lu/en/list/) has been set up and was launched the same day. This system has been set up in the context of the government’s strategy to prevent the transmission of the infection to vulnerable populations as well as to protect health professionals.  The treating physicians are obliged to refer patients towards the best possible care.

Alternatively, patients can visit (1) the advanced care centres (Centre de soins avancés - CSA) for a medical examination. A prescription is not necessary. The CSA can be visited in case of symptoms related to COVID-19 or for health problems not related to COVID-19, or (2) the hospital emergency departments in case of a serious health problem.

Since March 18, the government recommends that visits of hospital patients and residents in nursing homes are prohibited. Access can only be decided on the basis of a special authorisation issued by the management or directors. Activities of the senior clubs are suspended. Activities in daycare centres can be maintained. The same is true for care and assistance networks. Meals-on-wheels will be continued.