The demographic medical deficit poses a problem in a number of regions in France, as the current demand for care is considerably higher than the supply. The situation in the north is unusual and the shortage ofservice providers causes major patient waiting times. On the other hand, the density of healthcare services in West-Flanders in Belgium is twice as high as in Nord-Pas de Calais.The partners set up a comprehensive healthcare offer in nephrology for the cross-border area. In collaboration with the Ypres network, they open an auto-dialysis centre (CAD) in Armentieres. They developperitoneal dialysis and prevention of chronic renal failure. The plan is also to broaden the cross-border healthcare offer for ophthalmology. In addition, this project creates a coherent framework to develop healthcare access in a given area, such as Thiérache. Achievements: The ZOAST MRTW-URSA action is a huge success. The tangible result of the action is that French and Belgian patients have access to cross-border care. There are no more administrative issues for the patients, nor for the hospitals.In spite of both partners wish to achieve a cross-border healthcare nephrology offer, the project did not materialise. Likewise, the ophthalmology project yielded limited results.The emergency drill, organised by the Jan Yperman and the Armentieres hospital, allowed French doctors to compare their procedures to their Belgian colleagues and their structure to the Belgian healthcare organisation.The actions organised for the exchange of professional practices went smoothly. Yet, due to the French nursing education reform, the traineeships at the Jan Yperman hospital could not be pursued.Both hospitals make efforts to inform their patients as well as possible through:- bilingual brochures;- information on the cooperation and the ZOAST convention.