In a set of more than 40 recommendations prepared by more than 30 experts from various health fields, the document, which Lusa had access to, indicates that in addition to reducing wait times, the development of protocols and mechanisms referrals would improve care delivery and patient satisfaction.
Experts also point out that previous surveys have shown that GPs and family doctors “do not always feel confident about which tests to order their patients before referring them to specialist hospital appointments”.
“The same survey also showed that medical specialists consider that the patients they receive do not always bring the necessary tests for a first appointment,” they add.
The work was carried out as part of the Partnership for Health Systems Sustainability and Resilience (PHSSR), a global collaboration established in 2020 by the London School of Economics and Political Science, the World Economic Forum and AstraZeneca.
In Portugal, the diagnosis of the sustainability and resilience of the health system was coordinated by Mónica Oliveira, of the Instituto Superior Técnico, and Aida Isabel Tavares, of the Instituto Superior de Economia e Gestão, of the University of Lisbon.
The 43 recommendations are divided into several areas: governance, financing, human resources, drugs and other health technologies, prevention and health care, population health and environmental sustainability.
Speaking to Lusa, Mónica Oliveira underlined, in the area of governance, the message of the need to “promote the autonomy and responsibility of the administrations of health establishments, so that they can make decisions and not depend too much on other interlocutors in the health system".
In the field of governance, the experts insist on the end of captures in the field of Health by the Ministry of Finance, considering that "they affect the autonomy and management capacity of hospital administrations".
At this level, they argue that the state should place more trust in public managers, with a “responsibility that flows from it”.
They also say that it is necessary to "form a structure that pilots the integration of the supply of care provided at the different levels and by the different sectors (public, private and social)", noting that the Board of Directors of the SNS – recently created – only coordinates the public service response.
"There are private and social sector entities that provide health care, some of which are contracted / contracted with the SNS", underline the experts, defending the need for "supervision at the highest level", to achieve a “more efficiently, avoiding gaps”. and duplication”.
Speaking to Lusa, the study coordinator underlined the importance of continuity in the delivery of health care, emphasizing the need for coordination: "we have systems that sometimes complement each other, but sometimes compete”.
“It was very clear that there needs to be planning to understand the role of the public, private and social sectors,” he added.
At this level, the expert group – which involves specialists such as the former Minister of Health Adalberto Campos Fernandes, Maria do Céu Machado, who was High Commissioner for Health and led Infarmed between 2017 and 2019, the former Director General of Health Constantino Sakellarides, the President of the Central Administration of the Health System (ACSS), Vitor Herdeiro, among others – also recommends better intersectoral articulation between health and social security to ensure the continuity of care.
"The definition of a care pathway that considers the person as a whole, with their health needs and social support, appears to be an essential objective for improving the quality of life of health users and their caregivers, with undeniable health gains,” they suggest. .
End political appointments of leaders of care providers, appoint only on the basis of competence, promote partnerships and collaborations in the delivery of care between the public, private and social sectors and separate the roles of the state from financing, delivery, regulation and control, are other recommendations.
The work coordinator underlined the “very strong support of a very large panel of experts”, made up of specialists from the industrial, private, social and public sectors, covering a wide political and ideological spectrum.
SW // ZO