Portugal's New System for Hospital Appointments and Surgery Lists Is Pushed Back to January, as the Health Minister Expects Waiting Lists to Grow

Portugal's new national system for managing hospital appointments and planned surgery will go live in January 2027, Health Minister Ana Paula Martins said on Friday 30 October. The Sistema Nacional de Acesso a Consulta e Cirurgia, or SINACC (National System for Access to Consultations and Surgery), was due to start on 1 August but was suspended after the Ordem dos Médicos (Medical Association) objected to parts of its rules.

"Whatever is not right, in the ordinances or the orders, will be changed," the minister said at Santa Maria hospital in Lisbon, according to Lusa as carried by RTP and Observador. Asked about rising surgery lists, she said they will keep growing, RTP reported.

What the law already says

SINACC was created by Decreto-Lei 12/2026 of 22 January. It ends the Sistema Integrado de Gestão de Inscritos para Cirurgia, SIGIC (Integrated Surgery Waiting List System), in place since 2004, and puts first hospital specialist appointments, surgery and other planned procedures in one national system. Its operating rules are in Portaria 135/2026/1 of 31 March, which says the start date for each part will be fixed by a ministerial order. We found no such order in the Diário da República, so January rests for now on the minister's word.

Under those rules:

• Referrals for a first hospital appointment must be electronic and complete, and cannot go to two hospitals at once.
• Patients will be able to see their registration, clinical priority and place in the queue in their personal area on SNS 24 or in the SNS app.
• If no date is booked by a "critical point" set in the system, the case can be sent to another public, social or private provider, with the patient's consent. The system can assign one, or the patient can pick one with capacity. Refusing keeps your place on the list.
• Unjustified absences can lead to removal from the list.

Waiting time limits are already in force

The new maximum guaranteed response times (TMRG) took effect on 2 April under Portaria 137/2026/1. A first hospital appointment referred by a health centre must take place within 30, 60 or 120 days, depending on priority. Planned surgery has a limit of 30 days if priority and 180 days otherwise. For cancer the limits are 30 and 60 days, and for heart disease 30 and 90 days. At the end of July, 30.5 percent of people waiting for surgery were already past the legal limit.

What is still being changed

The Medical Association's main objection was that small procedures no longer go on the surgery list, which it said could hide patients still waiting. In a note on 17 August the ministry said no necessary procedure would go unregistered and agreed to review the definition of minor surgery in a working group that includes the Association. It said SINACC would go live only once a safe transition was assured. No amended rules have been published.

What patients should do now

Until SINACC goes live, the existing rules apply. If you are on a surgery list and receive a transfer note or surgery voucher (vale cirurgia) offering another hospital, follow the instructions and deadlines in it. For a first appointment, the free choice of hospital that has applied to health centre referrals since 2016 still stands, so ask your family doctor about it.

Keep your phone number and address up to date with your health centre: the new rules allow removal from a list if you repeatedly cannot be reached. Waiting times by hospital can be checked on the SNS waiting times portal (tempos.min-saude.pt). Complaints can go to the complaints book, the hospital's patient office or the health regulator, the ERS.