"We have to act on the issue of the referral of patients to the emergency services and here I am referring to the issue of blue and green cases [where bracelets are assigned]. This is a topic discussed in many places, but always postponed because it is an unpopular topic," said the executive director of the SNS, Fernando Araújo, at the opening of the first edition of the "SNS Summit", which is taking place in the Aula Magna of the Santa Maria Hospital in Lisbon.
But, he assured, that the Executive Board of the SNS "will take up this issue, which needs to be addressed. It is a topic that will certainly be discussed. It's a topic that is no longer able to be postponed."
Addressing an audience with clinical directors, doctors, nurses, among others, Fernando Araújo stressed that it is an area that will be deepened and that the executive direction will "take the measures that have to be taken to be able to change this system."
According to the official, Portugal has "an exaggerated consumption" of health care in terms of acute illness, and it is necessary to "be able to influence and change this process and likewise also give training and training on the management of health pathways."
"The emergency door cannot be the first place where people think to go when they have some acute pathology in clinical terms and that the responsibility falls on us," he said.
In his opinion, it is necessary to find "other doors before emergency" to respond to less urgent situations, with primary health care being fundamental.
"We have, fortunately, teams of professionals, doctors, nurses, but also nutritionists, psychologists, and others, who are exceptional teams, with enormous capacity, and we have to be able to organise ourselves to give a response to the less severe acute diseases in a different way," he said.
On the other hand, he argued, there is also "a path that has to be done" in terms of the management of hospital beds and the average length of hospital stay.
"It is not possible for us to continue to have patients in the emergency room corridor with empty beds inside the hospital. And that's a change that has to be achieved", he said.
The executive director said that a team from the European Commission that is helping Portugal in terms of planning the situation, by its calculations, if the average hospitalisation delay was similar to the best hospital in each group, there would be more than 2,000 beds per day in the country.
The specialty of Emergency Medicine, which was not approved by the Medical Association, was another matter defended by Fernando Araújo, considering it to be "an important measure" and that the Executive Board will "surely pursue" it in order to create conditions for it to be possible.
Alluding to metropolitan emergencies, he said that it is something that is being implemented in the country, "sometimes with difficulties, with limitations, but with concrete results", being a path that he said would be followed.
In a video message, the president of the Order of Nurses, Ana Rita Cavaco, defended that "the current model of access centered on the hospital is deeply wrong or outdated."
"And if this is true in theoretical terms it is even more evident in the day-to-day life of a country with evident social cleavages and also obvious regional asymmetries. This means, among other things, that it is essential to implement a true reform of primary and home health care that values the teamwork of all the professionals involved, destroying farms and yards, "said Ana Rita Cavaco.
Also in a video message, the president of the Medical Association, Carlos Cortes, focused his intervention on the discharge of patients who often already have their clinical problem solved and who are waiting for a care response, considering it to be one of the main challenges they have to address to solve the problems of emergencies.
"It is important not to forget that in the midst of all these changes, in the midst of all these difficulties, we have to think and always focus our attention on the person," he said.
National Health Service wants to change referral system for non-urgent cases
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