HAS Certification 2025: What the 6th-Cycle Framework Changes

A new certification cycle opened in 2025 for French health-care establishments. The Haute Autorité de santé (HAS), France’s independent public health authority, published a revised framework applicable to visits conducted from September 2025. This is neither an overhaul nor a light touch-up: the overall structure holds, but the content tightens and the bar moves.

Here is what matters when preparing for a visit.

A tightened framework, in three chapters

The backbone does not move. The framework remains organised into three chapters, three angles of observation on the same establishment:

• the patient — what they understand, consent to, experience and avoid;
• the care teams — how they coordinate, document and secure;
• the establishment — its governance, quality strategy and risk management.

What changes is the grain. The 6th cycle shows a reduced and rebalanced set of objectives: twelve objectives, four per chapter. The old imbalance between chapters — one heavily loaded, another thinner — gives way to a symmetry that makes the text easier to read.

Below them sit one hundred and eighteen criteria, spread across three levels of requirement: imperative criteria, standard criteria, and a small contingent of so-called advanced criteria, which reward the most committed establishments without being expected of all.

Each criterion comes with evaluation elements, in a tightened number, which simplifies the averaging and, above all, makes the framework more legible for front-line teams. This practical point is underrated: a criterion a ward manager can explain to their team in thirty seconds stands a far better chance of being applied than one that needs translating.

The real shift: twenty-one imperative criteria

This is the change with the heaviest consequences. The number of imperative criteria rises from seventeen to twenty-one.

An imperative criterion expresses a requirement the HAS deems non-negotiable for patient safety. It does not offset: good results elsewhere do not make up for failing one. Mechanically, that is where the gap opens between a favourable decision and certification subject to conditions.

Four more imperative criteria means four subjects that switch from a logic of progress to a logic of threshold. For a quality director, the operational consequence is immediate: you must rebuild the list of imperative criteria applying to your scope and steer it separately, outside the general quality plan. We set out that method in our article on the imperative criteria of HAS certification.

What does not change — and that is good news

The HAS was explicit about continuity: the organisation of the visits and the four decision levels are unchanged.

The decisions remain: establishment certified with distinction, certified, certified subject to conditions, not certified. The visit methods — patient tracer, pathway tracer, targeted tracer, system audit, observation — remain those teams trained on in the previous cycle. The Calista platform continues to carry exchanges between the HAS and the establishment.

In other words, an establishment that came through the previous cycle well is not starting from scratch. The investment in tracer-method training still holds; it is the content of the framework that needs revising, not the way to prepare for it. We describe those methods in detail in our guide on preparing for the HAS certification visit.

Three stated priorities

The HAS presented this 6th cycle around three ambitions: strengthening requirements on key issues, adapting to public-health priorities, and making patients full partners.

The third deserves a comment. Making the patient a partner is not just handing out a satisfaction questionnaire at discharge. It means checking that they understood what was proposed, that they were able to decide, that they know whom to turn to if something goes wrong, and that user representatives have a real place in the establishment’s bodies. These things are observable — and they are observed, notably during patient tracers, where the expert visitor may speak to the patient directly.

It is probably the point on which the gap is widest between what establishments state and what teams see on the ground.

What the research says about this kind of scheme

It is worth keeping a clear-eyed view of what hospital certification produces. The systematic review by Hussein, Pavlova, Ghalwash and Groot, published in 2021 in BMC Health Services Research from seventy-six empirical studies, finds a consistent positive effect of hospital accreditation on safety culture, on process-related measures and on efficiency — but mixed results on mortality and on patient satisfaction (see the study).

That nuance has a practical translation. What certification most reliably shifts are processes and team culture — precisely what is built continuously, not what can be recovered in three months. A tightened, more legible framework works in that direction: it is easier to fold into day-to-day steering than a list nobody reads between two visits.

Where to start, concretely

Four moves, in order:

1. Obtain the official framework version applicable to your visit from the HAS. Summaries and commentary — this one included — do not replace the text.
2. Map the twenty-one imperative criteria across your scope, and name an owner for each.
3. Revise your internal training materials on tracer methods: the method does not change, but what has to be documented does.
4. Check your certification scope if you are multi-site or part of a territorial hospital grouping. This is settled beforehand, never during the visit.

Take action

The 6th-cycle framework is shorter and more legible than the last: that is an opportunity to fold it into routine steering rather than treat it as a preparation file. Start with the twenty-one imperative criteria, name an owner for each, and run internal patient tracers without waiting for the visit to be announced. For the whole scheme — legal obligation, visit methods, decision levels, cycle — see our guide to HAS certification of health-care establishments.