Lisbon's São José Hospital Moves A&E Patients Waiting for a Ward Into a New 30-Bed Unit, With 34 Extra Staff

The general emergency department at Lisbon's Hospital de São José has had a new 30-bed observation unit since the start of this week, and 34 extra staff to run it, the Unidade Local de Saúde (ULS) São José, the public health unit that runs the hospital, announced on Thursday 5 November.

In a statement reported by the Lusa news agency, the ULS said it had hired three more doctors, 19 nurses, nine healthcare assistants and three administrative staff for the unit. With the expansion, the Urgência Geral Polivalente (the hospital's main 24-hour adult A&E) now has 14 observation rooms, up from five.

Beds for patients waiting to be admitted

The new beds are meant mainly for patients who have already been seen in A&E and are waiting for a place on a hospital ward. The board chairman, Miguel Paiva, told Lusa that the hospital found a space inside São José that could be refurbished and "created an inpatient area with 30 beds, precisely for those patients". He described it as "a complement to the observation room, while patients wait to be transferred to the wards of the various departments".

According to Paiva, 58 patients passed through the 30 beds in the unit's first three days. Four of them stayed on because they are social cases: patients who are medically ready to leave but have nowhere suitable to go.

The aim, he said, is to stop using the temporary modular structures put up during the Covid-19 pandemic to hold patients waiting for a ward bed. He admitted that closing them has been hard because of the volume of patients the ULS handles. The extra hiring, he said, means the space was not "just created" without the people to run it.

Months of pressure on the department

The new unit follows a difficult summer. In August, the head of the São José emergency department said he intended to step down if patients continued to go without "dignified treatment", pointing to a lack of resources to admit those who needed a bed, Lusa recalled. The department works as a Centro de Responsabilidade Integrado (an integrated responsibility centre, with dedicated teams and performance-linked pay), but Paiva said its results suffer when patients cannot be moved where they need to go. He added that the average hospital stay at the ULS has risen this year, and that the board is working to bring it down.

Separately, half of São José's surgery waiting list was past the legal maximum wait at the end of July, as we reported on 2 October. Under a rule we reported on 22 October, hospitals can call ward doctors into A&E when it is overwhelmed.

What residents should know

• Call first. The ULS asks patients to go to their health centre or call SNS 24 on 808 24 24 24 before coming to A&E. Patients referred by their family doctor or by SNS 24 are seen ahead of those who turn up without a referral, and they do not pay the taxa moderadora (the SNS user charge).
• Bring your documents. Your identity document (the ULS lists the Cartão de Cidadão), your SNS user card and any health-subsystem card.
• Visits. In the observation areas, visits run from 13:00 to 14:00 and 18:00 to 20:00, for 15 minutes per patient, hours that can change when A&E is busy. Relatives can get updates from the I-Urgência information desk.
• Check waiting times and which A&E units are open on the SNS waiting-times page and its list of emergency services.

Full guidance is on the ULS São José's emergency department page (in Portuguese).