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Understanding Portugal NHS Policies and Strategy


Understanding Portugal NHS Policies and Strategy

Policy and Planning

So What?

It is important innovators recognise the difference between the National Health System and the National Health Plan:
National Health System (NHS) was created in Portugal in 1979 and guaranteed “universal, general and free” healthcare. All residents in Portugal have access to health care provided by the NHS, financed mainly through taxation 0.
National Health Plan (NHP) “is a value-based and action-orientated instrument, designed to be adapted to national, regional and local specificities. It takes a broad view of health, and is very extensive in its scope and coverage” 0.

The health targets for 2020, in accordance with the National Health Plan in force, are 0:
a) reduce premature mortality (≤70 years) to below 20%;
b) increase healthy life expectancy at age 65 by 30%;
c) reduce the prevalence of smoking in the population aged ≥ 15 years and eliminate exposure to environmental smoke;
d) to control the incidence and prevalence of overweight and obesity in the children and school population, limiting growth to 2020.

The Principles

The Principles and values of the National Health Plan 0 are transparency and accountability that allow the agents to be trusted and valued, as well as for the system to develop by learning. In addition, the following stand out:
− the involvement and participation of all stakeholders in the processes of health creation;
− reducing health inequalities as a basis for promoting equity and social justice;
− integration and continuity of care provided to citizens;
− a health system with timely response to needs, making the best possible use of the resources available in order to avoid waste;
− sustainability, in order to preserve these values for the future, in which it can be combined: a healthy population; resilient communities that can have a good informal network care; policies and practices well integrated into other social and economic policies and practices; a well-designed and people-centred health care system, adjusted to its goals, efficient, and which has adequate, qualified and team-based human resources for integrated health care provision.

The implementation of the National Health Plan is based on seven guiding principles that are also a challenge, which is 0:
− Disease Prevention and Control;
− Promotion and Protection of Health;
− Intersectoral collaboration;
− Citizen empowerment;
− Promotion of healthy environments;
− Dissemination and implementation of good practices;
− Strengthening Global Health.

For more information on the seven guiding principles, you can consult the National Health Plan 0.

Quality and Performance

The National Strategy for Quality in Health, approved by Portuguese Decree-law n.o 5613/2015 0, published in Diário da República, identifies the obligation of health institutions and professionals to ensure that the health care they provide to citizens meets quality criteria.

Providing information to the public on the performance of institutions (hospitals, local health units, regional health administrations and their groupings of health centres and other services) improves the transparency of health information about quality and safe healthcare delivery services, including public accountability, as well as simple, objective and decoded disclosure of information.

The Portuguese Dispatch n.o 5613/2015 determines that 0, 0:
1. The Central Administration of the Health System, I. P (CAHS) publishes quarterly, on its website, the quality indicators of the entities of the NHS, according to the table attached to this order. At the end of each quarter, the information relating to the previous quarter is disclosed.
2. The data to be disclosed originate in the monthly report sent to the CAHS by the entities and services referred to in the previous number.
3. The entities covered by this order shall ensure the timely provision to the CAHS of the information necessary to comply with this provision and shall also publicise it on their websites.
4. The CAHS and the General Directorate for Health shall, every six months, evaluate the need to revise the disclosed indicators and, whenever necessary, by prior and superior approval, issue, through normative circulars, guidelines on this subject to the entities involved.

So What?

Understanding the quality metrics that underpin any healthcare market are important in understanding how your product will help players deliver better care.
The indicators for monitoring the quality of the entities of the NHS are 0, 0:
− Preventive Interventions;
− Volume and Use;
− Security;
− Pediatric.

Each of the indicators mentioned above is subdivided into several categories. To access them, you can consult the Portuguese Dispatch n.o 5613/2015 0, and the site of NHS – Indicators for Quality 0 (for Portuguese speakers).

Key Organisations

Health Regulatory Agency (HRA)
The Health Regulatory Agency (HRA) is an independent body, responsible for the regulation and supervision of the activity and operation of all healthcare facilities, public, private and social of any type (hospitals, clinics, individual offices, dentists, complementary diagnostic and therapeutic means) located in the continental territory.

The objectives of HRA regulatory activity are as follows:

  • Ensure compliance with the exercise requirements by healthcare providers;
  • Ensure compliance with the criteria for access to healthcare;
  • Guarantee the legitimate interests and rights of users;
  • Ensure the legality and transparency of economic relations between all agents;
  • Defend competition in segments open to the market and collaborate with the Competition Authority.

HRA’s main activities are:

  • Registration and licensing of operators;
  • Handling complaints;
  • Investigation: investigation proceedings and infringement proceedings;
  • Sanctioning: admonitions, fines, suspension of establishments;
  • Issuance of instructions and recommendations;
  • Inspection actions;
  • Quality assessment: National Health Assessment System;
  • Preparation of studies and opinions.

With regard to the regulation of health professions, the existing professional orders in Portugal are the Order of Nurses, the Order of Pharmacists, the Order of Doctors, the Order of Dentists, the Order of Psychologists and the Order of Nutritionists.
The regulatory functions of professional orders are as follows:

  • Validation and guarantee of professional certification;
  • Supervision of clinical practice;
  • Training and continuous assessment of professionals;
  • Definition and control of professional ethics;
  • Disciplinary power over professionals.

National Authority for Medicines and Health Products (INFARMED)
INFARMED, National Authority for Medicines and Health Products, under the supervision of the Ministry of Health, is the regulatory authority regulates and controls medicinal products for human use, health products, including medical devices and cosmetic and body care products 0.

INFARMED main task is to ensure the quality, safety and efficacy of medicinal products, and health products, preventing the risks arising from there ensuring the highest standards of public health and interests of the consumer 0.

The areas of intervention by the INFARMED related to medical devices are 0:
– Research, evaluation, registration, monitoring and supervision of health products (evaluation of clinical research, evaluation and registration of medical devices, health product reporting and market supervision activities).
– Monitoring of adverse drug reactions through pharmacovigilance and surveillance and monitoring of the use of health products (collection and evaluation of adverse drug reactions or incidents with medical devices as well as any useful information relating to the use of medicinal products and health products).


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