Satisfaction With Portugal's Primary Care Reform Falls to 26 Percent Among Family Health Unit Coordinators, and Every Unit Surveyed Had an IT Outage
Satisfaction among USF coordinators fell from 31.9 to 26 percent, USF-AN's annual survey finds. 85.7 percent of units are owed incentives, and 91.1 percent had three or more IT outages in a year, with 98.7 percent saying care suffered.
Only 26 percent of the people who run Portugal's family health units say they are satisfied with the state of primary care reform, down from 31.9 percent a year earlier. Dissatisfaction rose from 43.7 percent to 46.8 percent. The figures come from the 16th edition of "O Momento Atual da Reforma dos Cuidados de Saúde Primários em Portugal 2025/2026", the annual survey of the Associação Nacional de Unidades de Saúde Familiar (USF-AN). It was presented on Friday at the association's national meeting in Gondomar, near Porto, according to RTP.
The association says 541 coordinators answered, 76 percent of the 712 units operating when the survey ran from 19 June to 4 August 2026. The fall ends a recovery from the low point of 2022/23, when the series shows just 8.1 percent satisfied. In the first edition, in 2009/10, the figure was 59.8 percent. Coordinators still rate their own units well: 74.9 percent are satisfied with how their USF has worked, though that is 5.7 points lower than last year.
What a USF is
SNS family doctors work from a centro de saúde, a public health centre. Inside it, care is delivered either by a USF (unidade de saúde familiar), a team of doctors, nurses and clinical secretaries who formed voluntarily and organise their own work, or by a UCSP, the older model that the report says is still in use. Under Decreto-Lei n.º 103/2023, the entry-level model A was phased out and the performance-linked pay and incentives of model B were extended to USF staff generally. Model C, which Público describes as privately managed health centres, began in August 2026; only 15.4 percent of coordinators back it and 49.2 percent oppose it.
Incentives earned but not paid
A unit that meets its quality targets earns "institutional incentives". Under Article 35 of the decree-law, this money pays for staff training, conferences, research, equipment and better facilities for staff and patients. The report finds that 85.7 percent of USFs are owed incentives or cannot yet use them, and 63.6 percent were told that money earned in 2025 would only be made available in 2026. The units sit inside Unidades Locais de Saúde (ULS), regional bodies that also run the hospitals. USF-AN president André Biscaia told Lusa that some ULS spend the money on other investments.
IT failures and what they mean for patients
Every unit that answered had at least one IT outage in the year, and 91.1 percent had three or more. Some 15.7 percent waited more than a day for access to come back, and 98.7 percent said the failures affected the quality of care, the highest figure in the series. The report says an outage limits access to the patient record, hospital information, electronic prescribing and test results. Satisfaction with eVacinas, the vaccination system, fell from 61.9 percent to 43.7 percent. Biscaia told Lusa that in the middle of the flu vaccination campaign nurses are sometimes vaccinating without being sure of a person's history.
For patients, a repeat prescription, a test result or a consultation can be held up on a day the system is down; the report says people sometimes get poorer care in those conditions, or none. A list of your current medicines and vaccines can help. Three in four coordinators (76 percent) also say the size of their patient lists limits timely access, at a time when the SNS is still working to give every patient a family doctor. The report asks for a contingency plan in every unit, including a way to prepare prescription renewals offline and issue them once systems return.
