Portugal's Continuing-Care Network Has Lost 264 Beds Since January, Triple Last Year's Closures, Its Providers Say

More than 750 beds have closed in Portugal's network of continuing-care units over the past five years, and more than 260 of them closed this year alone, three times as many as in 2025. The figures come from the Associação Nacional dos Cuidados Continuados (ANCC), which represents the providers, and were released on Wednesday on the day its president was due to be received at the Presidency of the Republic.

Continuing-care units are where patients go when they are too unwell to go home but no longer need an acute hospital bed: people recovering from a stroke or a fracture, or needing long-term nursing and rehabilitation. Most are run by Misericórdias and other social institutions under contract to the state, which pays a fixed daily price per bed.

The count, year by year

According to the ANCC's data, 264 beds have closed outright since January. Another 72 were closed in what the network calls consolidation, where a unit shuts beds but reinforces its home-care teams instead, and 15 were reclassified into a different type of care. The association also lists 55 beds it has been unable to verify.

The earlier years were far quieter: 220 closures across 2021 and 2022, 87 in 2023, 88 in 2024 and 90 in 2025, when a further 43 were consolidated into home care. Counting closures, consolidations and reclassifications together, the association puts the total since 2021 at almost 880.

The ANCC president, José Bourdain, does not accept that consolidation is a neutral swap. "In my opinion, a bed that is closed cannot be replaced by home support. They are different things," he told the Lusa news agency. "Usually, someone who needs to be admitted does not go home, they go into inpatient care." Beds lost to consolidation, he said, "are beds that, in practice, close".

Frozen prices, missing recovery-fund beds

Bourdain blames chronic underfunding. Annual price updates from successive governments, he said, have not kept pace with the institutions' costs, above all wages. "There is a history of several years of either frozen prices or ridiculous price rises. The units reach a limit where they cannot take any more and they close the door."

He was equally critical of the recovery and resilience plan (PRR), which was supposed to expand the network. The original target was 5,500 new beds, but only 4,446 went to tender, so 1,054 were dropped at the outset. About 400 have gone ahead in the Centro region and 2,000 were approved in the Norte, which he put at roughly half of the initial goals. In Lisboa e Vale do Tejo, 1,457 beds were approved and only just over 100 have gone ahead. The new beds that did open, he said, "do not make up for the ones that closed. Instead of improving, it got worse."

Where the patients wait

The closures land on a network that was already short. At the end of August, the waiting list for a continuing-care bed reached 3,195 people, the highest in the decade the SNS has published it. Patients waiting for a place often stay in hospital meanwhile, occupying acute beds that emergency departments then cannot use.

The ANCC has also rejected the health minister's suggestion of a charge for patients who refuse a continuing-care place when one is offered. Its meeting in Belém on Wednesday is the latest attempt to get the pricing question onto the agenda before the 2027 state budget is presented next month.