French Public Health Code
In forcePublic health establishments are free to define their internal organisation in order to carry out their missions, subject to the provisions of this chapter.
The director and the chairman of the establishment's medical commission shall jointly define the organisation of the establishment into centres of activity in accordance with the establishment's medical project, after consulting, in university hospital centres, the director of the medical training and research unit.
The centres of activity are made up, on the one hand, of services, departments and functional units or any other structures for the care of patients by medical, nursing or medico-technical teams and, on the other hand, of the services, units, departments or medico-technical structures associated with them. In university hospital centres, the clinical and medico-technical clusters are called "university hospital clusters".
For clinical or medico-technical clusters, the cluster head is appointed by a joint decision of the director of the hospital and the chairman of the hospital medical commission, and, in university hospital centres, by a joint decision of the director of the hospital, the chairman of the hospital medical commission and the director of the medical training and research unit or, where there are several units, the chairman of the medical education coordination committee.
If the head of department is an armed forces practitioner, the decision to appoint is taken jointly by the director, the chairman of the hospital medical committee and the Minister of Defence.
The term of office of the heads of department is set by decree. They may be reappointed under the same conditions.
Practitioners mentioned in article L. 6151-1 and in 1°, 2° and 3° of article L. 6152-1, as well as army practitioners, are eligible to perform the duties of head of clinical or medico-technical unit.
The Director signs a cluster contract with the cluster head, setting out the cluster's objectives and resources.
In the case of clinical and medico-technical clusters, the president of the establishment's medical commission and the director of the establishment jointly sign the contract.
In university hospital clusters, the contract is signed jointly by the chair of the hospital medical committee, the director of the hospital and the director of the medical training and research unit or, where there are several units, the chair of the medical education committee coordination committee.
The practitioner in charge of a clinical or medico-technical unit implements the institution's policy in order to achieve the objectives set for the unit. Without prejudice to the first paragraph of article L. 6146-1-1, he/she organises, with the medical, nursing, administrative and management teams in the unit, over which he/she has functional authority, the operation of the unit and the allocation of human resources according to the needs of the activity and taking into account the unit's projected objectives, while respecting the professional ethics of each practitioner and the missions and responsibilities of the services, functional units, departments or other structures, as set out in the unit project. In the performance of his or her duties, he or she may be assisted by one or more members of staff, whose appointment he or she proposes to the Director of the hospital. If the unit includes an obstetrics unit, one of these assistants shall be a midwife.
Without prejudice to the penultimate paragraph of article L. 6146-1-1, the head of the department, in close collaboration with the senior health executive, promotes internal cooperation between the services, departments, units and structures that make up the department.
The main principles of the organisation of the hospital into clusters and the rules governing their operation are set out in the hospital's internal regulations.
