French Public Health Code
In forceI - Establishments belonging to or associated with a regional hospital grouping may create inter-establishment clinical or medico-technical clusters.
II - The head of the inter-institution cluster is appointed from among the practitioners practising in one of the establishments that are part of or associated with the group, after obtaining the opinion of the medical commissions of the establishments that are part of the group concerned, by a joint decision of the chairman of the strategic committee and the chairman of the group medical commission, as well as the director of the medical training and research unit or, if there are several units, the chairman of the medical education coordination committee, if one of the establishments is a university hospital centre.
When the head of the inter-institution division is an armed forces practitioner, he or she is appointed by a joint decision of the director of the supporting institution, the chairman of the group medical commission and the Minister of Defence.
After informing the regional hospital grouping's strategic committee, the director of the support establishment and the inter-establishment division head sign a division contract, under the conditions set out in article R. 6146-8.
III - The inter-institutional department head has functional authority over the medical, nursing, administrative and management teams in the inter-institutional department.
He/she organises the operation of the unit and the allocation of human resources according to the needs and locations of the activity and taking into account the unit's projected objectives, the professional ethics of each practitioner and the missions and responsibilities of the services, functional units, departments or other structures provided for in the unit project. This organisation takes account of staff appointments in each establishment and is consistent with the shared medical project.
The division head organises internal consultation and encourages dialogue with the division's staff.
He or she may be assisted by one or more members of staff working in one of the establishments belonging to or associated with the consortium, whose appointment he or she proposes to the director of the supporting establishment, after informing the president of the medical college or the consortium medical commission. If the cluster includes an obstetrics unit, one of these members of staff is a midwife.
If one of the members of staff is a professional from the armed forces health service, he or she is appointed by a joint decision of the director of the support establishment and the Minister of Defence.
IV - The cluster project defines, on the basis of the cluster contract, the missions and responsibilities entrusted to the internal structures, services or functional units and the organisation implemented to achieve the objectives assigned to the cluster. It provides for the development of their field of activity, as well as the resources and organisation that this entails.
The department head draws up a departmental project within three months of his appointment. He/she will involve the department heads and health managers in this process.
V.-The inter-institutional unit is represented on the medical committees of each of the institutions involved in its creation and on the equivalent body when an army hospital is associated with the group.
VI - The duties of the inter-institutional division head may be terminated in the interests of the service by a joint decision of the president of the strategic committee and the president of the grouping medical commission, and after obtaining the opinion of the director of the medical training and research unit or, if there are several units, the president of the medical education coordination committee, if one of the institutions is a university hospital centre.
When the head of the inter-institutional division is an armed forces practitioner, the decision to terminate his duties is taken under the conditions set out in the first paragraph of this VI jointly by the Minister for Defence, the chairman of the strategic committee and the chairman of the group medical commission. However, in the interests of the public hospital service or to meet the specific needs of defence, the Minister for Defence alone, or the chair of the strategic committee and the chair of the group medical commission jointly, may terminate the appointment directly.
