Everything you need to know about Territorial Health Councils: missions, role and operation
Territorial Health Councils (CTS) will play a crucial role in local health governance by 2025, particularly in the Châteaubriant region and the Loire-Atlantique department.
These bodies bring together public stakeholders, professionals, and citizens to effectively address the health needs of the population in close collaboration with local authorities. Understanding their operation and missions is essential to grasping how health democracy is built at the local level and how a health policy tailored to the territory is developed.
Since their creation in 2016 by the law modernizing our healthcare system, CTSs have evolved to become key players in organizing care pathways and coordinating health and social service partners. They actively contribute to the implementation of the regional health plan initiated by the Regional Health Agency and ensure close monitoring of local initiatives. In the Châteaubriant-Derval inter-municipal community, for example, they represent a vital lever for aligning public policies with the concrete concerns of residents. This momentum is part of a national context strengthened by institutional partnerships involving the Ministry of Health and Prevention, the High Authority for Health, and Public Health France.
The central role of the Territorial Health Councils: a body of local health democracy.
The Territorial Health Councils (CTS) embody local democracy in healthcare. Through their diverse composition, bringing together healthcare professionals, user associations, local authorities, and state representatives, they ensure in-depth consultation on all health issues affecting the region. In Loire-Atlantique, particularly in the Châteaubriant area, they facilitate dialogue between local stakeholders and the Regional Health Agency (ARS), ensuring that national policies are implemented as closely as possible to real needs.
- By 2025, the primary mission of the CTS is to foster the development of shared territorial expertise. They analyze various issues, ranging from access to care to specific challenges related to mental health. This collaborative work is organized around thematic groups and specialized committees, such as those focused on mental health, thus reflecting a comprehensive approach to the determinants of health.
- Key Missions of the Territorial Health Councils
- Active Participation in the Development and Monitoring of the Regional Health Project (PRS): The Territorial Health Councils are involved in defining priorities and evaluating actions to optimize the organization of care pathways.
- Shared Territorial Analysis and Diagnosis: They contribute to the collection and analysis of local health data to accurately identify needs. Partnership Dialogue: The Territorial Health Councils promote coordination between healthcare facilities, social care providers, associations, and local authorities, thereby strengthening integrated governance.
Concrete Proposals and Recommendations: They can submit opinions and proposals to the Director General of the Regional Health Agency to adapt policies and improve access to care.
| For example, in the area of mental health, often underestimated in some rural areas like the Pays de la Mée, the Châteaubriant Territorial Health Council works in synergy with local stakeholders to develop a relevant territorial project, thus helping to remove barriers to access to mental health care. | Mission | |
|---|---|---|
| Description | Local Example (Châteaubriant) | Regional Health Plan (PRS) Development |
| Define and monitor the regional health project | Adapt primary care for rural areas | Territorial assessment |
| Collection and analysis of local data | Identification of dental care gaps | Dialogue and coordination |
| Brings together health and social care stakeholders | Organization of regular exchanges on mental health | Recommendations |
Sur le meme sujet
Formulation of proposals to the Regional Health Agency (ARS)
Proposal to strengthen teleconsultation services
Composition and operation: a balance between institutional and citizen stakeholders
- The operation of the Territorial Health Councils is based on a rigorous composition guaranteeing the representation of all stakeholders involved in local health. In 2025, the term of office is five years, renewable once, which ensures continuity in projects and actions undertaken. A diversity of voices is essential to guarantee a participatory approach and democratic governance.
- Structure of the Territorial Health Councils
- Membership groups:
- Healthcare professionals and providers (hospitals, clinics, doctors, social and medical facilities)
- Patient users and patient associations
- Local authorities and their groupings (such as representatives of the Châteaubriant-Derval Community of Communes)
- State representatives and social security organizations
- Qualified individuals from the territory
- Healthcare professionals and providers (hospitals, clinics, doctors, social and medical facilities)
- Patient users and patient associations
- Local authorities and their associations (such as representatives of the Châteaubriant–Derval Community of Communes) State representatives and social security organizations
- Qualified individuals from the region Additional bodies:
plenary assembly, executive board, specialized thematic committees (particularly mental health and user feedback).
| Election procedures: | Some members are appointed by recognized federative bodies such as the French Hospital Federation or the National Union of Health Professionals, while others are directly elected or appointed through a call for applications. | This rigorous structure allows for a balance between different interests and facilitates collective decision-making. In Châteaubriant, for example, this model promotes better coordination between public health policies implemented by the Regional Health Agency and initiatives developed by local elected officials and community organizations. This shared governance is an essential driving force for addressing the specific health challenges of the Loire-Atlantique department. |
|---|---|---|
| College | Representatives | |
| Example of a role | Professionals and service providers | Hospital teams, general practitioners, social service establishments |
| Define care priorities and coordination | Users and associations | Patients, families, user associations |
| Ensure that expectations and needs are taken into account | Local authorities | Municipal councils, inter-municipal authorities |
| Promote local public health policies | State and social organizations | Prefecture, Social Security |
Sur le meme sujet
Regulatory monitoring and funding
Qualified individuals
Public health experts, academics
- Provide an independent and scientific perspective The concrete contributions of the CTS (Local Health Teams) to local health in the Pays de la Mée and Loire-Atlantique regions
- The Territorial Health Councils (CTS) take concrete action at the heart of the region, helping to adapt healthcare services to the specific geographical and social needs of the population. In the Châteaubriant area and its surroundings, they address a variety of issues: medical deserts, access to specialized care, prevention of health inequalities, and support for mental health.
- Examples of actions carried out by the Territorial Health Councils: Combating medical deserts:
- Implementing programs to encourage healthcare professionals to set up practices in rural areas, through aid coordinated with the National Health Insurance Fund. Promoting mental health:
Creating partnerships between hospital services, local associations, and local authorities to improve mental health care and prevention, particularly through dedicated working groups.
| Establishing territorial support platforms: | Coordinating healthcare pathways, especially for patients with complex needs, thus facilitating better care. | |
|---|---|---|
| Participation in Local Health Contracts: | Co-construction with local authorities and the Regional Health Agency (ARS) to define local priorities for prevention and health promotion. | Concrete impact on the ground: In Châteaubriant, a recent study revealed a significant improvement in access to care thanks to the coordination facilitated by the Local Health Contracts with the French Hospital Federation and Public Health France. These improvements are particularly anticipated in the areas of palliative care and the management of chronic illnesses. |
| Issue | Action taken | |
| Result | Medical desertification | Assistance with setting up practices and support for professionals |
| 15% increase in general practitioners in rural areas | Mental health | Creation of working groups and partnerships with associations |
Improved organization of mental health care pathways
Sur le meme sujet
Coordination of care pathways
Establishment of localized support platforms
Streamlining of complex care pathways
- Local prevention Development of Local Health Contracts
- Strengthening of targeted public health initiatives This role of coordination and strategic planning gives the Territorial Health Councils (CTS) an essential dimension for addressing the growing challenges of the healthcare system, exacerbated by demographic changes and social inequalities present in the Pays de la Mée region and the Châteaubriant-Derval inter-municipal community.
- The operational stages and institutional relationships of the Territorial Health Councils The operation of the CTS follows a precise framework that promotes coherence of actions at the local level while ensuring strong links with institutional partners in the healthcare system. By 2025, exchanges between the Territorial Health Centers (CTS), the Ministry of Health and Prevention, the Regional Health Agency, the High Authority for Health, and the National Health Insurance Fund will be ongoing and structured.
- CTS Intervention Process
| Territorial Assessment: Data collection and exchanges between members to clearly identify priority needs in relation to the local population. | Definition of Priorities: Development of proposals defined by committees according to themes. | |
|---|---|---|
| Adoption of Opinions and Recommendations: The plenary assembly approves the proposals, which will then be submitted to the Regional Health Agency and local authorities. | ||
| Implementation and Monitoring: Stakeholders ensure the implementation of the measures and oversee their evaluation. | The quality of the partnership between the Regional Health Teams (CTS) and the various stakeholders is crucial. The link with the National Medical Council, for example, provides an additional guarantee that the recommendations reflect professional realities. Similarly, the French Hospital Federation (FHF) plays a role in the appointment of members and in the development of integrated hospital initiatives. | |
| Stage | Description | Key Partners |
| Diagnosis | Detailed assessment of local healthcare needs | Regional Health Agency (ARS), Public Health France, patient associations |
Prioritization
Debate and definition of strategic directions
Local authorities, healthcare professionals
Validation
- Vote in plenary session and external opinions
- Regional Health Agency (ARS), Ministry of Health and Prevention
- Implementation
- Execution and monitoring of actions on the ground
National Health Insurance Fund, social security organizations
| This operating method ensures an adaptable and coordinated response to local health challenges and reflects the commitment to establishing shared governance, rooted in the realities of territories such as Châteaubriant. Community Engagement and Future Prospects for Territorial Health Councils | Citizen involvement is central to the Territorial Health Council model. Their ongoing participation in public debates, through user associations or regular consultations, contributes to a greater understanding of health issues. In the Pays de la Mée region, this dynamic fosters, in particular, more inclusive care, where issues of vulnerability and isolation are not overlooked. | Methods of Citizen Participation |
|---|---|---|
| Formal representation of users in a dedicated body, guaranteeing their voice in all strategic decisions. | Organization of participatory workshops and open public forums, aimed at identifying expectations and barriers to accessing healthcare. | Regular exchanges with local authorities, such as the Association of Mayors of France, to integrate health into all local policies. |
| Publication of reports accessible to the general public outlining the progress and proposals of the Regional Health Coordination Centers (CTS). | In 2025, the CTS plan to expand their scope of action, notably through the digitalization of consultations and the implementation of predictive analysis tools for healthcare needs. These innovations will be accompanied by greater transparency and improved data sharing, in order to drive an increasingly tailored and agile health policy. | |
| Aspect | Initiative | Expected Benefits |
| Citizen Participation | Workshops and Public Forums | Better Addressing Real Needs |
Transparency
Regular Publication of Reports
Strengthening Local Trust
Digitalization
Implementation of Digital Consultation Tools
Streamlining Communication and Data Collection
Predictive Analysis
Use of Artificial Intelligence to Anticipate Needs
More Targeted Preventive Actions
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