In the event of emergencies and accidents, patients in Germany should receive more targeted and better care in the future. After years of preparatory work, the Bundestag in Berlin decided to reform emergency care - an overview:
How did the reform come about?
In the plenary session, Federal Health Minister Carsten Linnemann (CDU) expressly thanks his predecessors Jens Spahn (CDU) and Karl Lauterbach (SPD), who initiated and developed the reform. Emergency rooms across the country have been overcrowded for years. Lauterbach had already promised a complete overhaul of emergency care in Germany in July 2024. Lauterbach said at the time that every third person in an emergency room would be better off in a practice. Better management should help combat the long waits and stress among staff. The reform should come into force at the beginning of 2025. But then the premature end of the traffic light government at the time intervened.
What can you do if you need help quickly?
As before, those seeking help can dial the uniform medical emergency number 116117 or the emergency number 112. The numbers and the processes behind them should be better integrated. “In the future, in the event of a health emergency, it will no longer make a difference which of the two numbers those seeking help call,” explains the head of the replacement health insurance association vdek, Ulrike Elsner, “they go through the same initial telephone assessment and are specifically directed to the appropriate level of care.”
For acute cases, telephone or video-supported care will be available around the clock on 116117, and outreach if necessary. Above all, all callers and those seeking help should receive an initial professional assessment on site. It should be determined what help someone needs. Linnemann: "Depending on the urgency, the patients are then referred to a doctor's office, an emergency service practice or the emergency room of a clinic - with or without emergency services, depending on the severity."
What are Integrated Emergency Centers?
They are another core part of the reform. Where do those seeking help go next - to the emergency room or a nearby emergency service? In these centers, which are docked to clinics, patients should be shown what to do next after the initial assessment. During consultation hours they should be able to be directed to a cooperative practice, otherwise also to an emergency service practice at the center. “With this emergency signpost, patients always get to the right place,” says Linnemann.
“The emergency rooms will be relieved and in the future can concentrate on cases that really need quick help.” Emergency services would no longer be unnecessarily tied up so often and emergency rooms would be relieved of avoidable treatment cases.
What role does digitalization play?
A big one, because the acute control centers of the statutory health insurance associations and the rescue control centers are to be further developed digitally into health control systems. It's about the processes behind the telephone numbers and counters. Every request for help should be forwarded on the basis of coordinated query systems and binding responsibility agreements with all data already collected. If necessary, the guidance system should also be able to direct people to palliative or social psychiatric services, for example. Help and conservation of emergency care resources should go hand in hand.
What should change in medical emergency rescue?
In the emergency services, the sharing of costs has long been considered a grievance. Now emergency rescue should be anchored in the law as a benefit in kind from statutory health insurance. Emergency management, on-site care and transport are recognized as parts of treatment “and the transport order is no longer financed by health insurance companies alone,” as the ministry emphasizes. Today, according to the government, there are too many and expensive “wrong trips”.
How do health insurance companies and associations react?
Elsner, head of the health insurance association, is relieved after years of preparation: “It’s done.” In addition to the actual reform, she also welcomed a regulation that was introduced at short notice, according to which doctors in practices should report more appointments to the appointment service points 116117 from next year. “This is the only way they can fulfill their task,” says Elsner, who represents health insurance companies such as TK and Barmer. A look at the costs also shows the need for action: expenditure on the emergency services rose from 4.4 billion euros in 2013 to 8.1 billion euros in 2025. “With the reform we can achieve efficient emergency care without placing additional burdens on those paying contributions with unnecessary costs,” said Elsner.
In the Bundestag, in addition to the coalition, the Greens also voted for the reform. The AfD and the Left abstained. Like several speakers from the opposition in the plenary session, the German Patient Protection Foundation also reminds people of the limited human resources in clinics and practices. “Weekends, public holidays and night hours remain times of crisis,” says board member Eugen Brysch. "Two population groups have it particularly difficult. These include the very old and people with language barriers." The accessibility of private practices remains completely unresolved. The association board also criticizes the lack of short-term appointments.
