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Health systems in transition
Portugal
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Further, some measures have been recently approved to improve patient
choice across NHS hospitals. Since May 2016, NHS users can be referred to
a hospital outside their residence area, as long as waiting times for a given
procedure or outpatient consultation are shorter than in their residential area
(Decision No. 6170-A/2016, of 9 May 2016). The brand new NHS website
(
https://www.sns.gov.pt )was launched in February 2016 and provides
information on waiting times regarding outpatient consultations for several
specialties. The NHS users are now able to analyse together with their GP with
their GP the best option in order to receive timely treatment in an NHS hospital.
The GP, in agreement with the patient’s best interest, will refer the patient for
the first time to any of the NHS hospitals where there is the specialty concerned,
by using criteria of geographical proximity and average response times for the
relevant consultation.
In primary care, the reform enacted in 2007 was pursued, although at a
slower pace. Therefore, the goal of expanding FHUs and including all NHS
users in a GP patient list was not achieved. In 2008, primary health care units
were reorganized under groups of health care centres (ACES), with the aim of
increasing efficiency and enforcing health policies and strategies at the local
and regional levels. Given the emergency services overuse by the population, a
number of measures were taken to promote patients’ use of primary health care
and alleviate emergency rooms at NHS hospitals, including hiring new GPs,
expanding FHUs and facilitating access to primary health care (by expanding
the number of NHS users registered with a GP).
In February 2016, the Ministry of Health launched the “Strategic Plan for
Primary Healthcare Reform” to reprioritize the 2005 Primary Healthcare
Reform and expand the number of NHS users enrolled in a GP patient list. For
this purpose, the Ministry of Health has facilitated retired physicians to return
to the NHS.
The Plan also comprises a number of measures regarding primary health
care contracting in terms of selected indicators. The Plan is intended to create
a global reference framework of indicators for primary health care in a range
of areas. There are no major changes to the 2005 Primary Healthcare Reform,
which aims to improve the quality of primary healthcare provision mainly
through expanding FHUs and interlinking to hospital care. Recently, the
Ministry of Health has established a maximum number of FHUs to transit
from a remuneration model without financial incentives (model A) to one with
financial incentives (model B) during 2016 (Dispatch No. 6739-A/2016, of
20 May 2016).