Driving a VSL in France: what the job is and how to qualify

Where the VSL sits in French health law

Article L6312-1 of the Public Health Code defines patient transport as carrying a sick, injured or pregnant person for care or diagnosis, on a doctor’s prescription or in a medical emergency, in a vehicle specially adapted for it. The regulatory chapter sorts road vehicles into four categories: A for the emergency care ambulance, B for the rescue vehicle for asphyxia cases, C for the standard ambulance and D for the light patient car, the VSL. A ministerial order sets the equipment standards for each.

So a VSL carries seated patients, on prescription, in a fitted car owned by a patient-transport company. It is neither a taxi nor a VTC (private hire car): it never picks up passengers in the street, takes no commercial bookings and does not set its own prices.

One crew member since 16 August 2026

Decree no. 2026-787 of 13 August 2026 rewrote article R6312-10, which sets crew sizes. The version in force since 16 August 2026 reads as follows:

Point 1 of article R6312-7 covers holders of the State ambulance diploma; point 2 covers firefighters trained in emergency rescue. Point 3 groups other people, notably regulated health professionals and holders of certain first-aid certificates. Every crew member, whatever the vehicle, needs a category B licence and a certificate issued by the prefecture after a medical examination under articles R221-10 and R221-11 of the Highway Code.

The short route: ambulance assistant

The order of 11 April 2022 created two courses: the State ambulance diploma and the ambulance assistant course. Its article 2 allows the assistant to drive the VSL and the ambulance, and to act as the qualified ambulancier’s crewmate inside the ambulance. To work, an assistant needs:

• a valid driving licence that is past its probationary period;
• the prefecture’s certificate of fitness to drive an ambulance, issued after a medical examination;
• a medical certificate stating no contraindication, plus proof of the vaccinations required by law;
• the 70-hour course certificate, including a skills assessment;
• the emergency care certificate level 2 (AFGSU 2), a hospital-standard first-aid qualification.

The course covers hygiene, professional values, working with the team and with patients, ergonomics, and safe handling when moving patients. It is taught in an ambulance training institute (IFA). The institute may refuse the certificate if the trainee’s skills are not enough to do the job, in which case it must give its reasons in writing. All of it is in French, so a solid level of spoken French is a practical must. The calculator at the top of the page tells you what you may drive with your qualification and how many course hours remain.

Assistant or diploma holder: what the VSL changes

Before the August 2026 decree, the assistant’s role mattered mostly inside ambulances, where crews mixed both profiles. A VSL carries a single crew member, which makes it the job where an assistant works with the most independence: driving, greeting the patient, helping them in and out, checking the transport form and running the day’s round.

The State diploma remains the gateway to patient care. It takes 801 hours, 556 in the institute and 245 on placements, after selection on file and interview. An assistant with a few months’ work behind them gets shortcuts: the ambulance training page sets out the hours and the becoming an ambulance worker page compares both routes.

Who employs VSL drivers

Patient-transport companies, in almost every case. Article L6312-2 requires anyone carrying out patient transport to be approved beforehand by the director general of the regional health agency (ARS, agence régionale de santé), with reasons given for any refusal. Article L6312-4 adds that, in each département, putting a patient-transport vehicle into service needs that director’s authorisation. Those two locks are why you cannot set up as a VSL driver the way you can as a VTC driver.

Founding your own company is possible but it is a different project: approval, vehicle authorisations, premises, staff and equipment standards. For a driver starting out, the realistic path is an employment contract with an approved firm.

Who rides in a VSL, according to the health insurance fund

Neither the driver nor the company chooses the vehicle: the doctor prescribes the transport suited to the patient’s health and independence. According to Ameli, the national health insurance website, in a page updated on 30 September 2026, seated professional transport, by VSL or approved taxi, is prescribed when a patient needs a walking aid such as crutches or a frame, help from another person, or special hygiene precautions. The ambulance is kept for patients who must travel lying down or half-seated, or under the watch of a qualified person.

In practice, VSL drivers take people with limited mobility to dialysis, chemotherapy, consultations or home after a hospital stay. Helping the patient matters as much as the driving.

VSL or approved taxi: two neighbouring jobs

Both carry the same seated patients, but the drivers fall under different law. The VSL driver works in patient transport: ARS approval of the company, an ambulance diploma or assistant qualification. The driver of a taxi conventionné (a taxi approved by the health insurance fund) is still a taxi driver: a professional card obtained through the chamber of trades exam, a taxi licence, then an agreement with the local fund based on the decision of 13 February 2025. That second path is described in the becoming a taxi driver guide.

The difference shows in how you are paid, too. The VSL driver is an employee on the ambulance pay scale. The approved taxi driver is often self-employed and lives on fares, as the taxi or VTC comparison explains.

Pay: the ambulance scale and the minimum wage

Employees of patient-transport companies come under the road transport collective agreement, with minimum rates set by amendment no. 8 of 6 May 2025. It sets three ambulance levels, at €11.89, €11.90 and €12.79 an hour, and does not say which one applies to VSL drivers. In 2026 the hourly Smic is €12.31, so the first two levels are lifted to it. The ambulance pay page works out the monthly gross from your hours and Sundays.

Five steps to your first round

1. Check your licence: category B, probation over. A licence from outside the EU may first need exchanging for a French one.
2. Have the medical examination and get the prefecture’s ambulance driving certificate.
3. Bring vaccinations up to date and obtain the medical certificate.
4. Take the 70-hour assistant course and AFGSU 2 at an ambulance training institute.
5. Apply to an approved patient-transport firm and ask in writing which pay level your contract uses.

Institutes set their own fees, so ask for a written quote and look into funding before you enrol. We do not name or recommend any institute.