Overview
- The Bundestag approved the Notfallreform on Thursday, October 15, giving parliamentary backing to a law that overhauls how patients enter emergency care.
- The central measures require a unified, software‑supported first medical assessment by phone, video or on‑site, digital coupling of emergency numbers 112 and 116117, and the creation of roughly 750 integrated emergency centres (INZ) at hospitals to route patients to the right setting.
- The reform lets Rettungsdienst teams treat patients on scene or deliver them to notdienstpraxen instead of automatically transporting them to hospital and reclassifies emergency rescue as a statutory health‑insurance service so on‑site care becomes billable.
- Major hurdles remain before the law takes effect in 2027: the Bundesrat review and Länder must pick INZ sites, national IT links must be built, financing for prehospital ‘Vorhalte’ costs must be settled, and unions and rescue organisations are protesting the funding terms.
- Local pilot projects offer proof of concept: München Klinik’s ZNA20++ reported a 57% fall in ambulance rejections and an empty ED waiting room while treating more patients, and the government cites potential annual savings of about €1.2 billion and 1.2 million avoided ED visits if steering works at scale.