A new phase of the SNS organization – SNS

ULS and USF are essential to ensuring quality and timely health care for the population.

The first day of 2024 is marked by the start of a new phase of the organizational reform of the National Health Service (SNS), namely through the expansion of the Local Health Units (ULS) to cover the entire national territory and the universalization of the Family Health Units (USF) Model B.

The expansion of ULS across the country, based on the SNS on this organizational model, facilitates people's journey through the health system by integrating hospital centres, hospitals, health center clusters (ACeS) and the national network into a single continuous care department in a given geographical area.

This integration enables SNS to respond, streamline processes, increase coordination between teams of health professionals, focus expertise and pathways between different levels of care, increase management independence, and maximize access and efficiency of the NHS.

Within the framework of the restructuring of the SNS, 31 new ULS were created, in addition to the existing 8, and preparations are being made for the extinction of more than fifty entities, whose responsibilities have now been transferred to the ULS.

ULS makes it possible to respond to the needs of citizens, giving priority to proximity, optimization of resources, continuity and integration of care, in prevention, in the plan of care, in the provision of treatment and care, and in recovery and rehabilitation.

The ULS vision allows us to look at health beyond the “boundaries” of the hospital, valuing primary health care and integrating other institutions in the local community, namely municipalities, parish councils, schools and private institutions of social solidarity, giving meaning to the idea that health is a good for all and for all, building a sustainable society.

At the same time, in the course of measures aimed at increasing and improving access to health, in the field of primary health care, the popularization of the USF leads to an increase in the number of people who have a family doctor and appreciate the professionals in these health units.

222 new USF-Bs will now be created, allowing 51 municipalities to have, for the first time, a USF-B. In total, there will be 570 USF-B units in operation, in 154 of the continent's 278 municipalities, achieving a historic milestone in the primary health care reform that began in 2006.

A total of 212 USF-A and 10 USF-A – traditional health centers – were converted to USF-B, which converted to the new model, with the potential to employ family doctors for more than 300,000 users and the pay impact of more than 3,500 of healthcare professionals, including doctors, nurses and clinical secretaries, now receive incentives linked to their teams' performance in monitoring users.

This action represents an important advance in reform of primary care in the NHS and advances the path towards the universalization of a model that ensures a modern and close response to users.

In 2024, the remaining USF-A forces will transition to Model B, with retroactive effects through January, considering an overall performance rating equal to or greater than 60% in the 2023 assessment.

The increase in the health and well-being needs of the population, associated with aging and the burden of disease, as well as their increasing demands and expectations, requires that SNSs continue to increase access and efficiency in health care provision by promoting organizational models that promote the integrated management of primary and hospital care, thereby Ensures focus on people.

The expansion of the ULS and the popularization of the USF are a crucial path towards the rehabilitation of the SNS and ensuring quality and timely healthcare for the population, always with the aim of improving the country's health and well-being indicators.

39 local health units (31 new and 8 existing)

• Alto Ave ULS: Hospital da Senhora da Oliveira Guimarães with ACeS do Alto Ave – Guimarães/Vezela/Terras de Pasto and Health Center Celorico de Pasto.
• ULS Barcelos/Esposende: Hospital Santa María Mayor – Barcelos with ACeS do Cávado III – Barcelos / Esposende.
• Braga ULS: Braga Hospital with ACeS in Cavado I – Braga and Cavado II – Geres/Cabrera.
• ULS from Povoa de Varzim / Vila do Conde: Póvoa de Varzim/Vila do Conde Hospital Center with ACeS in Greater Porto Area IV – Póvoa de Varzim/Vila do Conde.
• ULS do Medio Ave: Médio Ave Hospital Center with ACeS in the greater Porto area I – Santo Tirso/Trofa and Ave – Famalicão.
• Tameja e Souza ULS: Centro Hospitalar do Tâmega e Sousa with ACeS in Tâmega I – Baixo Tâmega, except for the Health Center in Celorico de Basto, Tâmega II – Vale do Sousa Norte and Tâmega III – Vale do Sousa Sul.
• Gaia/Espino ULS: Hospital Center Vila Nova de Gaia/Espinho with ACeS in Porto VII Grand – Gaia and Porto VIII Grand – Espinho/Gaya.
• ULS from Terrace os Montes and Alto Douro: Hospital Center of Tras os Montes and Alto Douro with ACeS in Tras os Montes – Alto Tamega and Barroso, in Douro I – Marau and Douro Norte and Douro II – Douro Sul.
• ULS of Entre d'Oro and Voga: Entre o Douro e Vouga Hospital Center with ACeS for Entre Douro e Vouga I – Feira e Arouca and Entre Douro e Vouga II – Aveiro Norte.
• ULS Sao Joao: São João University Hospital Center with ACeS in Porto Metropolitan Area III – Maya/Valongo and Porto Metropolitan City VI – Porto Oriental.
• Santo Antonio ULS: Centro Hospitalar Universitário de Santo António with ACeS in Porto Major II – Gondomar and Porto Major V – Porto Oeste.
• ULS from Baixo Mondego: District Hospital of Figueira da Foz with health centers in Figueira da Foz, Sorey, and Montmor-o-Felho.
• Cova da Pera ULS: University Hospital Center Cova da Beira with ACeS in Cova da Beira.
• ULS from Physio Dow LaVoice: Tondela Viseu Hospital Center, with ACeS in Dao Lavois.
• Leiria District ULS: Leiria Hospital Center in collaboration with ACeS in Pinhal Litoral, and health centers in Ourem, Fatima, Alcobasa and Nazaré.
• Coimbra ULS: Hospital and University Center of Coimbra, Hospital Arcibispo João Crisostomo – Cantanhede, Center for Rehabilitation Medicine of the Central Region – Rofisco Paes, with ACeS in Pinhal Interior Norte and Health Centers in Cantanhede, Silas, Eras, Fernão Magalhães, Norton de Matos, Santa Clara, São Martinho do Bispo, Condexa a Nova, Milhada, Mira, Mortagua and Pinakova.
• ULS in the Aveiro area: Hospital Center do Baixo Foja and Hospital Dr. Francisco Zagallo – Ovar with ACeS do Baixo Foja.
• Amadora/Sintra ULS: Hospital Professor Dotor Fernando Fonseca with ACeS in Amadora and Sintra.
• Almada Sexal ULS: Hospital Garcia de Orta with ACeS Almada-Sixel.
• LISERIA ULS: Santarém District Hospital with ACeS Lezíria.
• Estuary of Tagus ULS: Hospital Vila Franca de Zira, with ACeS Esttuário do Tejo.
• ULS by Loris Odefelas: Hospital Loures with ACeS Loures-Odivelas, excluding Sakavim Health Centre.
• Santa Maria ULS: Centro Hospitalar Universitário de Lisboa Norte with ACeS Lisboa Norte and Mafra Health Centre.
• ULS Sao Jose: University Hospital Center in the center of Lisbon, the Psychiatric Hospital Center of Lisbon and the Dr. Gama Pinto Ophthalmology Institute, with ACeS in the center of Lisbon and the Sacavim Health Center.
• ULS in Oeste: Centro Hospitalar do Oeste with ACeS Oeste Sul, excluding Mafra Health Center and Bombarral, Caldas da Rainha, Óbidos and Peniche Health Centres.
• Middle Tagus ULS: Medio Tejo Hospital Center with health centers in Abrantes, Alcañina, Constancia, Entroncamento, Ferreira do Zizere, Macau, Sardole, Torres Novas, Tomar, Vila Nova da Barquinha and Villa de King.
• Arrabida ULS: Setubal Hospital Center with ACeS da Arrábida.
• West Lisbon ULS: Western Lisbon Hospital Center with ACeS Western Lisbon, Oeiras and Cascais.
• Arco Ribereño ULS: Centro Hospitalier Barreiro-Montejo with ACeS Arco Ribereño.
• Central Alentejo ULS: Hospital Espirito Santo de Évora with ACeS do Alentejo Central.
• Algarve ULS: Algarve University Hospital Center with ACeS Algarve I – Central, Algarve II – Barlavento and Algarve III – Sotavento.
• Eight ULS exist: Matosinhos (1999), Guarda (2008), Baixo Alentejo (2008), Alto Minho (2008), Castelo Branco (2010), Nordeste (2011), and Litoral Alentejano (2012). ULS Norte Alentejano (2007) is now called ULS Alto Alentejo and is part of the Public Health Laboratory of Alto Alentejo.

January 1, 2024