Mandatory Urgency Referrals in Portugal: How 'Call First, Save Lives' Will Change Healthcare Access

Mandatory Referrals in Emergency Services

Starting this Thursday, referrals for emergency services become mandatory at local health units in Santa Maria, São José, and Lisboa-Ocidental. Under the project “Call First, Save Lives”, patients will now need to be referred by the SNS24 line, health centers, or the National Institute of Medical Emergency (INEM).

In non-urgent pre-assessed cases, consultations will be scheduled at health centers within a maximum of 48 hours. Those who arrive at a hospital emergency department without prior contact with SNS24 will find a phone at the entrance for triage.

Objectives of the 'Call First, Save Lives' Project

The “Call First, Save Lives” initiative aims to ease the pressure on hospital emergency services, which was already operational in 22 local health units (ULS). By February 2025, it will be implemented in eight additional ULS, covering 85% of the country’s units.

In just a year and a half, this system has successfully diverted around 350,000 patients from hospital emergency rooms. Between May 2023 and the past Monday, of approximately 670,000 patients who called the SNS24 service, over 280,000 were directed to health centers. Additionally, about 70,000 patients were advised to take care of themselves at home.

Feedback from Health Officials

João Gamelas, clinical director for hospital health care at Lisboa-Ocidental, emphasized the importance of better coordination between hospitals and primary health care. The director of the central emergency department at Santa Maria Hospital expressed hope that patients will embrace this referral system.

João Gouveia also remarked that this system is a significant advantage, as it allows emergency departments to focus on treating more serious cases, reducing waiting times for patients with less critical needs.

Current Challenges and Future Plans

As the health services prepare for a particularly challenging season, António Gandra d’Almeida noted that ULS are implementing contingency plans, including increasing bed capacity and ensuring emergency service schedules remain full. Current average waiting times in general emergency services are reported to be over six hours in various hospitals, which is far above the recommended one-hour wait for urgent cases.

Government Initiatives

The Minister of Health, Ana Paula Martins, has warned of potential constraints during the holiday season and is working on expediting the hiring of more doctors. The SNS24 line will also introduce teleconsultation services to improve access for patients, particularly those without family doctors.