Nurses Will Take the SNS 24 Calls Routed Into Portugal's 112 Dispatch Centres, and INEM Will Not Say When It Starts

Nurses will take over answering and triaging the calls that Portugal's SNS 24 health line passes to the emergency dispatch centres, a job pre-hospital emergency technicians have done for years. The Instituto Nacional de Emergência Médica (National Institute of Medical Emergency), or INEM, confirmed the change to Lusa on Thursday.

"A new model will be implemented for answering calls forwarded by the SNS 24 line to the Centros de Orientação de Doentes Urgentes (Urgent Patient Guidance Centres), which will now bring nurses into this answering and triage circuit," the institute said. Those centres, known by their initials CODU, are where 112 medical calls land.

What changes, and what does not

Until now those calls were answered and triaged by técnicos de emergência pré-hospitalar (pre-hospital emergency technicians), working to algorithms set by INEM. That group is not leaving the dispatch centres, and the institute went out of its way to say they have done the job "for several years" and "have a fundamental role in the CODU."

The nurses moving into the role have been trained in the Manchester Triage system, which INEM has been rolling out inside the CODU over recent months, under the new statute signed last July. The change, it says, promotes "greater differentiation and complementarity between the competences of the different professionals." Nurses are not new there: they have worked in the CODU since November 2024, supporting field teams and receiving patient data. INEM employs 237 nurses and says it intends to keep recruiting.

What it would not give is a date. The model starts "shortly," once the necessary technical changes are in place. That is notable, because the Ordem dos Enfermeiros (Order of Nurses) told the public on 18 August that nurses would begin taking part in CODU triage from 1 September. Thursday's statement came two days after that date with no start day attached.

The return leg of a switch made in January

On 2 January 2026, INEM replaced its old call handling with five priority levels modelled on hospital triage:

• Emergente (imminent risk to life): immediate response.
• Muito urgente (high clinical risk): first resource on scene within 18 minutes.
• Urgente: basic life support within 60 minutes.
• Pouco urgente: basic life support within 120 minutes.
• Não urgente: no emergency resource, and the call is transferred straight to SNS 24.

So since January the least urgent 112 calls have been pushed down to SNS 24; from now on, the calls SNS 24 pushes back up to 112 will be met by a nurse. The two lines hand work to each other in both directions, and a clinician now sits at the receiving end of the upward leg.

A contested reorganisation

The Ordem dos Enfermeiros used its August statement to reject the charge that the new model strips resources from the system, resting its case on two figures: maximum priority incidents are around 10 percent of INEM's calls, and in the first half of 2026, 90 percent of immediate life support activations also involved a second ambulance, mobilising two transport-capable vehicles for one patient. "Safety does not depend on sending the largest possible number of vehicles," its president, Luís Filipe Barreira, said, "but on the right team arriving, with the right skills, in the shortest time."

INEM's pre-hospital technicians read the same reorganisation differently. They have strike days set for 14 and 28 September, after talks at the Health Ministry on 26 August ended without agreement.

What this means for expats

• The numbers do not change. 112 for an emergency, 808 24 24 24 for SNS 24. What changes is who picks up when SNS 24 decides your case belongs with the emergency service.
• Expect clinical questions, and answer precisely. Manchester Triage works from symptoms, onset and vital signs, and the priority you are given now carries a defined response time.
• Write down what you are told. Since January, callers receive the priority level, the estimated arrival time and the referral before the call ends.
• Call back if the picture changes. A lower priority is not permanent; INEM asks people to ring again if symptoms shift or a new one appears.
• Say early if your Portuguese is limited, at the start of the call rather than partway through a symptom description.

The reorganisation is being sold as a way to send the right team rather than the most vehicles, and on the order's own numbers there is a real inefficiency to attack. Whether it works will show up in one place: the interval between a call being answered and the first resource reaching the patient, measured against the five response times INEM set for itself in January. Those figures exist. The test is whether the institute publishes them.