The new Global Handbook (QGR) of the National Health Service (SNS) anticipates maintaining the level of family doctor coverage at 85.3% of the population until 2028, when the total number of healthcare workers is expected to exceed 160 thousand.
These figures are part of the SNS's QGR for the three-year period 2026–2028, which was published in the Official Gazette and establishes strategic and financial guidelines for Local Health Units (ULS) for this period.
Although published only today, the decree by the Minister of Finance, Joaquim Miranda Sarmento, and the Minister of Health, Ana Paula Martins, came into effect on January 1st of this year.
According to the document defining the SNS's strategic framework, the percentage of users with an assigned family doctor is expected to remain unchanged—85.37%—in 2026, 2027, and 2028, corresponding to the 2024 level.
Regarding operational indicators, the QGR indicates an increase in medical consultations within the SNS: from approximately 47.7 million in the current year to over 48.7 million by 2028. The government also plans for the number of surgical operations to grow from about 799 thousand in 2026 to nearly 832 thousand in 2028, while emergency room visits are projected to decrease from 4.5 million to 4.2 million over the same period.
The QGR also forecasts growth in the SNS staff: the number of workers will increase from 157 thousand to over 160 thousand by 2028, compared to about 151 thousand in the public health system in 2024.
Financially, the document projects total SNS expenditures of 19.714 billion euros in 2028, which is 1.216 billion euros more than the 18.498 billion euros in the current year. It is also noted that the public health system's debt should decrease during this three-year period: from 891 million euros in 2026 to 807 million in 2027 and 785 million in 2028.
The decree from the Ministries of Finance and Health stipulates that total SNS spending on personnel, cost of goods sold and consumed materials, and external services must 'correspond to a gradual reduction in growth rates over the three-year period 2026–2028.'
In terms of human resources, it is stated that SNS units must be provided with the necessary specialists, allowing for new recruitment through permanent employment contracts, which collectively could provide an increase of up to 1.4% in the number of workers in 2026 compared to the data as of December 31, 2025.
The SNS QGR serves as a three-year planning tool, forming the basis for the Local Health Units' Organizational Development Plans (PDO)—a kind of contract program through which each unit defines its planned activities and the necessary resources to support them.
The approval and publication of the relevant decree occurred after the Order of Nurses warned about the availability of about three thousand new nurses ready to enter the labor market, while various SNS departments continued to report specialist shortages and were unable to hire staff. The head of the Order of Nurses, Luís Filipe Barreira, called for urgent intervention from the Minister of Health.
On Thursday, the CEO of the SNS, Álvaro Almeida, told journalists at Matosinhos Hospital that the approval of the Global Handbook depended on the Ministry of Finance.