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Partnership in health and partner patients – Guide

✍️ High Authority of Health (HAS), under the responsibility of the commission for the participation and engagement of individuals (CPEP), coordination Maryse Karrer, validation by the College of HAS.
1 July 2026 by
Partnership in health and partner patients – Guide
Daniel Oberlé - Pratiques en santé Oberlé
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🔦🔍💡 Partnership in health: HAS establishes a concrete framework to integrate partner patients into care, service organisation, training and research. #PartnershipInHealth #UserEngagement
🤝📘 Partner patients: a national guide to define their missions, secure their status and equip teams that want to co-construct the quality of care with users. #PartnerPatient #QualityOfCare



📌 This guide provides a clear and operational framework for integrating partner patients into care pathways, organisation, training and research, based on practices already deployed in France. It is directly useful to establishment management, primary care teams, CPTS, medico-social structures and user associations that want to formalise partner patient missions, secure the legal framework and equip their projects. An essential framework to articulate health democracy, quality of care and the empowerment of individuals, without getting lost in terminological debates.



Source :     📒 Partnership in health and partner patients – Guide
✍️ High Authority of Health (HAS), under the responsibility of the commission for the participation and engagement of individuals (CPEP), coordination Maryse Karrer, validation by the College of HAS.


📜🔗LINK to the source


1. ANALYTICAL SUMMARY

An expected framework in the face of the multiplication of unstandardised practices. For more than ten years, healthcare establishments have been using partner patients without a common framework, generating disparate names (expert patient, peer supporter, patient coach) and confusion with user representatives (UR) (p. 15-19). The HAS deliberately limits its scope to the organisational level (“meso”) of the partnership — care pathways, adaptation of services, training, research — excluding the individual care relationship and the development of public policies (p. 6-7). This choice responds to a strong expectation for legal security and recognition, expressed notably during the 4th International Colloquium in Lyon in 2024 (p. 5).

Operational tools that can be directly mobilised. The guide proposes three founding principles (co-decision, co-leadership, co-evaluation, p. 40), a 5-step “project mode” method (p. 41), a verification checklist (p. 46 and appendix p. 56), a standard commitment charter (appendix 1, p. 55) and four practical sheets detailing missions and field examples by area (pathways, service offerings, training, research, p. 57-79). It also directly addresses sensitive issues: professional secrecy, access to health data, sectarian drifts, proportionate and non-systematic training (p. 32-39).

2. KEY POINTS OF THE DOCUMENT

  1. The guide proposes an official distinction and a clear legal framework between partner patient (co-construction within a care team) and user representative (associative mandate in a regulated body), two statuses that do not overlap but can be held by the same person (p. 28-31).
  2. The HAS recommends mobilising at least two partner patients per project, to limit their isolation and strengthen their mutual support — a concrete point of vigilance too often ignored in pioneering initiatives (p. 32).
  3. The prior training of partner patients is not systematically necessary : it should be proportionate to the mission (more demanding in the care pathway or research, almost unnecessary in organisational improvement), with the exception of therapeutic education which legally requires 40 hours of training (p. 34-36).
  4. A check-list of 10 criteria (shared diagnosis, deliberative voice of partner patients, collectively validated conclusions, etc.) allows for continuous verification that an approach genuinely falls under partnership and not a “false pretence” or an alibi participation (p. 42-43, 46).
  5. The documented effects since 2020 cover five areas — clinical (reduction in errors and lengths of stay), psychosocial, organisational, professional (reduction in cognitive load and burnout) and on research (better relevance of protocols) — but remain largely based on qualitative studies, with randomised trials remaining rare (p. 47-52).

3. ACTION PATHWAYS FOR LOCAL ACTORS

  1. Use the partnership check-list (p. 46, reproduced in annex 2, p. 56) prior to any project to objectify whether the proposed approach genuinely falls under partnership or risks remaining symbolic.
  2. Rely on the standard engagement charter (annex 1, p. 55) to formalise from the outset the rules of public order (professional secrecy, non-access to shared health data, neutrality) between partner patients and professionals.
  3. Systematically request at least 2 partner patients per action or programme (p. 32), and organise a joint training of patients-professionals from the initiation of the project rather than separate training sessions (p. 36).
  4. Draw inspiration from the four attached practical sheets (p. 57-79) — notably the examples from the health centre of Saint-Martin-d'Hères (health café, speaking groups, p. 58-59) or the 4P pharmacists-patients project in Nouvelle-Aquitaine (p. 60-61) — to build a realistic territorial action, including in small structures.
  5. Anticipate the issue of recognition and valuation (VAE, RAE, volunteer certificates, mention in organisational charts) from the design phase rather than at the end of the project, to secure long-term commitment (p. 38-39, 45-46). Unmet need identified by the guide: the lack of a stabilised regulatory framework for the remuneration of partner patients remains identified as a persistent barrier (p. 39).

4. ADDITIONAL REFERENCES

5. FREQUENTLY ASKED QUESTIONS (FAQ)

  1. Does this guide address the individual patient-caregiver relationship?
    No. The HAS explicitly excludes care partnership in the sense of the individual professional-patient relationship, as well as the participation of patients in the development of national health policies: only the organisational level ("meso") is covered (p. 6-7).
  2. What is the difference between a partner patient and a user representative (UR)?
    The UR is mandated by an accredited association to voice a collective opinion in regulated bodies (CDU, supervisory boards). The partner patient is a member of a care team and co-constructs concrete actions; they cannot sit in regulated bodies unless they are also a member of an accredited association (p. 28-31).
  3. How many partner patients should be involved in a project?
    The HAS recommends a minimum of two, in order to limit their isolation and allow for mutual support (p. 32).
  4. Must a partner patient be trained before they intervene?
    Not systematically. Training should be proportionate to the mission: almost unnecessary for a role focused on user experience, more necessary in the care pathway or research. Only therapeutic education for the patient legally requires 40 hours of training (p. 34-36).
  5. How to recognise or remunerate a partner patient?
    Two statuses coexist in current French law: employment/service provision (with contractual remuneration) and volunteering (with compensation/reimbursement of expenses). The HAS also refers to VAE, RAE, and VAPP schemes to value acquired experience (p. 38-39).
  6. How to prevent a "partnership" project from being just a facade?
    By checking for the presence of a shared diagnosis, a real deliberative voice of partner patients, a steering body including at least one patient, and collectively validated conclusions — criteria gathered in the guide's checklist (p. 42-43, 46, annex p. 56).
  7. Does health partnership have demonstrated effects?
    Yes, across five areas (clinical, psychosocial, organisational, professional, research), but the evidence mainly relies on qualitative studies and patient narratives; randomised trials remain rare six years after the HAS recommendation of 2020 (p. 47-52).

6. REWRITING IN EASY TO READ LANGUAGE

What is health partnership?

Health partnership is working together.

Patients and health professionals work together.

They share their knowledge.

The patient knows their illness from the inside.

The professional knows the care.

Together, they decide, they act, they evaluate.

Who is a partner patient?

A partner patient is part of a care team.

They have experienced an illness or disability.

They use their experience to help others.

They are not just a witness.

They participate in decisions.

This guide, what is it for?

This guide provides clear rules.

It helps hospitals and health centres.

It helps to create a real partnership.

Not a partnership for show.

5 important points to remember

  • At least 2 partner patients are needed in each project.
  • Partner patients are not always trained before they start.
  • There is a simple checklist to do it well.
  • The partner patient is different from the user representative.
  • The partner patient can be paid or voluntary.

The results of the partnership

The partnership helps patients.

The partnership helps professionals.

It improves the quality of care.

But more studies are still needed to prove it.

7. CROSS-SECTIONAL ANALYSIS — VALUES OF HEALTH PRACTICES

  • Literacy : the guide provides a simple and printable checklist (p. 46), but does not develop any easy-to-read tools or linguistic adaptations for the patients themselves.
  • Empowerment : the strengthening of patients' agency is presented as one of the two central objectives of the partnership, with documented effects on self-determination (p. 50-51).
  • Participation : the operation in "project mode" imposes co-construction from the shared diagnostic phase, even before the design of the action plan (p. 41).
  • Community health : the collective dimension is recognised through communities of practice among partner patients, but associative and community peer support is explicitly referred outside the scope of the guide (p. 20-21, 32).
  • Ethics : specific vigilance is established (professional secrecy, non-access to health data, neutrality and secularism), but the guide itself acknowledges that the ethical domain of the partnership remains poorly structured (p. 21-22, 36-37).
  • Human rights : self-determination and the refusal to impose a role of partner patient are affirmed as principles, without specific development on equity among vulnerable populations.
  • Intersectorality : the guide lists structured partnerships with hospital federations (FHF, FHP, FEHAP), Unicancer, universities, and IREPS (p. 12-13, 44-45).
  • Partnership : a formalised model charter is provided in the annex to frame the collaboration between patients and professionals (annex 1, p. 55).
  • Fight against discrimination : the subject is not addressed head-on; only the principle of public service neutrality is mentioned, without development on the non-judgment of discriminated populations (p. 37).

8. EVALUATION OF THE RELIABILITY OF THE RESOURCE

Scientific relevance : the guide is based on an updated literature review since 2020, hearings from hospital federations and associations, as well as the recognised theoretical model of Carman and Pomey (University of Montreal, p. 6). The HAS itself acknowledges a significant methodological limitation: randomised trials assessing the impact of partnership remain rare, with most data relying on qualitative studies, testimonies, or theses (p. 47, 52). The authors also highlight the risk of "symbolic partnership" (tokenism) documented in the critical literature (p. 47).

Operational relevance : very high. The guide provides tools that are directly transposable in the field (charter, checklist, mission tables by domain, eight testimonies of real experiences with contacts), making it a pragmatic resource rather than just a theoretical exposition.

🔍➕ For more information, see the articles referenced by "Health Practices" on the theme of health and work ➡️🔗

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