Faced with the exceptional heatwave affecting the country, Prime Minister Sébastien Lecornu chose Tuesday June 23 to activate the Orsan plan (for Organization of Health System Response), a system designed to prepare and coordinate the various stakeholders in order to deal with an exceptional health situation.
The Prime Minister indicated that he had taken this decision in consultation with the Minister of Health, Stéphanie Rist, “in the face of the heavy demand on emergency services and emergency services linked to the heat wave”. “This decision will make it possible to strengthen medical regulation capacities, to mobilize the personnel necessary for the operation of the hospital, to guarantee full coordination between community medicine, hospitals, clinics and nursing homes, and to adapt activities if the situation requires it,” he assured.
In fact, from Monday, calls to the Samu jumped from 30% to 40% and visits to the emergency room recorded an increase of 10% to 20%. If health services are holding up for the moment, thanks to a good distribution of patients between emergencies and community medicine, the continuation of the heatwave until Thursday – at least – could complicate things.
While 58 departments are placed on heatwave red vigilance and 31 others in orange this Tuesday, emergency services expect to see a strong influx of patients from Wednesday, with symptoms which will have appeared after several days of heatwave. People aged over 65 are on the front line – particularly women – and can report long-term problems with diabetes, heart or kidney failure or even decompensations. While the heat killed some 5,700 people last year in France in 2025, caution is required.
Mobilization of all health services
The activation of the Orsan plan at level 2 out of 4, requested by Sébastien Lecornu, will make it possible to organize the ramp-up of the health system to meet these exceptional needs. This type of plan is triggered at the regional level, by decision of the director of the regional health agency (ARS), in order to mobilize all health structures in the face of an exceptional event.
This involves establishing care pathways for victims of this event, while ensuring the continuity of routine care. There are several components of the Orsan system, dedicated to different situations: accidents with numerous victims, epidemics and pandemics, nuclear, radiological, biological or chemical risks, or even climatic events such as heatwaves, episodes of extreme cold or pollution.
Unison organization of health services
Concretely, when an Orsan plan is triggered, the players in the health system organize themselves in unison. At level 1, all health services are put on alert, hospitals increase their reception capacities in anticipation of greater influx, nursing homes activate their blue plans (monitoring and reinforced care of residents), Samu adapts its workforce.
During the second phase (level 2), the one which will be implemented in France, hospital tensions are monitored even more closely, hospitals can postpone certain non-urgent activities, general practitioners must expect to be more requested by the Samu, other medical-social establishments are also preparing to take care of patients.
At level 3, in the event of a major crisis, patient transfers are organized, deprogramming is broader, and exceptional reinforcements are mobilized. The fourth phase organizes the gradual return to normal after the major crisis situation.
A first due to the heatwave
The Orsan plan should not be confused with the Orsec plan, launched by the prefecture to coordinate assistance and relief services to the population. Activated in several departments a few days ago, such as in Loire-Atlantique, in Sarthe or even in Creuse, the Orsec plan makes it possible in particular to strengthen the surveillance and support of vulnerable people: distribution of health instructions, telephone calls, follow-up visits, opening of air-conditioned or cooled places, adaptation measures for public places (crèches, schools, etc.).
All State services, communities, social operators, associations and solidarity actors are then mobilized.
If the Orsec plan is regularly triggered during episodes of extreme heat (as was the case in July 2025, when 16 departments were placed on heatwave red alert), the activation of the Orsan plan at the national level due to the heatwave is a first.
This system, developed in 2016, is part of the National Heatwave Plan, put in place in 2004, following the exceptional heatwave of August 2003, which caused nearly 15,000 additional deaths in France, compared to an ordinary summer.
