NRW Plan: Number 116 117 to better guide patients - North Rhine-Westphalia's bold plan to transform outpatient healthcare access
North Rhine-Westphalia has unveiled a major reform plan to modernise outpatient healthcare. The proposals aim to ease pressure on doctors, cut bureaucracy, and improve patient access. Health Minister Karl-Josef Laumann called the initiative an 'important impetus' for nationwide discussions on reforming primary care.
The state's plan centres on transforming the existing 116 117 hotline into a central health platform. This system would assess urgency, direct patients to the right type of practice, and make binding decisions to speed up care. Calls to the hotline have surged in recent years: official figures show requests rising from 250,000 in 2021 to over 450,000 in 2025, with non-urgent queries—such as appointment bookings—jumping from 40% to 55%.
Primary care practices would take on a stronger coordinating role under the proposals. They would assess, treat, and refer patients to specialists when necessary. Medical assistants would also gain new responsibilities, including handling minor illnesses. The reforms seek to reduce paperwork by introducing standardised forms, long-term prescriptions, and more digital processes.
Despite the changes, patients would keep their right to choose their own doctor. However, implementing the guidance system would require federal legislation. The plans come as the region faces a workforce challenge: around 40,000 practices currently provide outpatient care, but a third of doctors are over 65 and nearing retirement.
The reform package targets long-standing issues in outpatient care, from rising demand to administrative overload. If adopted, the changes could reshape how patients access services and how practices operate. The state now awaits federal support to turn the proposals into law.
