SNS 24 Has Issued 1.5 Million Illness Self-Declarations Since 2023 — and Q1 2026 Is Running at 1,790 Per Day

The Serviços Partilhados do Ministério da Saúde (SPMS) marked the third anniversary of the SNS 24 illness self-declaration service on Thursday with a release confirming that the digital baixa now runs at industrial scale: 1,424,665 declarations issued between 1 May 2023 and 31 March 2026, an average of roughly 1,350 a day across the full three-year window, and a markedly higher 1,790 a day across the first quarter of 2026 alone. Around 284,000 users have already exhausted their two-per-year entitlement at some point during the period.

The SPMS figures, distributed via the Lusa wire and picked up by Público, ECO, Observador and Diário de Notícias, are the first comprehensive snapshot of how a single 2023 reform has reshaped how Portuguese workers — and the foreign workers and posted residents who use the SNS — handle short illness absences.

The numbers, year by year

The SPMS release breaks the volume into four buckets:

• 1 May to 31 December 2023: 264,039 self-declarations across the first eight months of the service
• 2024 (full year): 462,284 self-declarations
• 2025 (full year): 539,251 self-declarations
• 1 January to 31 March 2026: 159,091 self-declarations — about 1,790 per day, the highest sustained rate the service has ever recorded

The seasonality is exactly what you would expect from a respiratory-illness corridor. The three highest-volume months on record are January 2025 (67,300), December 2025 (65,919) and January 2026 (64,334) — flu season, in other words. The lowest-volume months are June 2023 (25,365) and August 2024 (27,463), when the country is on holiday and acute respiratory illness is rare.

The 284,000-user figure that hits the two-per-year ceiling is also worth pulling out: that is not 284,000 distinct people across the full three-year window, but the running total of users who reached the annual cap at any point. The cap resets each calendar year, so a heavy user can in theory exhaust it in three different years and be counted three times.

How the system actually works

The autodeclaração de doença was created by Portaria 132/2023 and entered into force on 1 May 2023. Any worker aged 16 or over can issue a declaration through the SNS 24 portal, the SNS 24 app or the 808 24 24 24 phone line, certifying "under compromise of honour" that they are unfit for work for up to three consecutive days. The cap is two declarations per calendar year, so a worker can self-justify a maximum of six (non-consecutive) days of illness absence each year. Declarations must be requested within five days of the first day of absence.

The service does not require contact with a médico de família and does not require attendance at a Centro de Saúde — that is the entire point. The Ministry of Health's own framing in the SPMS release was that the measure was designed to "simplify access to illness justification" and free SNS resources from short-duration cases that do not need clinical attention. The Ministry of Labour, Solidarity and Social Security signed off on the labour-side acceptance. Employers must accept the declaration on the same legal footing as a Certificado de Incapacidade Temporária (CIT) issued by a doctor.

The catch — and it is a meaningful one — is that the autodeclaração justifies the absence but does not pay for it. As with the CIT, the first three days of any illness absence are unpaid by the employer; Segurança Social only begins to pay subsídio de doença from the fourth day, and only when a CIT is issued by a doctor. A self-declaration on its own therefore costs the worker their pay for the days covered.

The pattern: a labour-cost story, not a clinical one

The 2026 acceleration to 1,790 declarations a day is the part of the dataset that will reach the Ministério das Finanças. The full-year 2025 average was about 1,477 a day. Q1 2026 is running 21% higher than that, and the January 2026 peak alone (64,334) is 21% above the equivalent month a year before. There is no obvious public-health explanation for the size of that step change — the 2025-26 flu season has not been called unusually severe by the DGS — which leaves the more uncomfortable read that more workers are simply learning the system exists.

That is, in fact, the line the Government has been quietly pushing back on. Pacote Laboral provisions tabled in late 2025 include language that would let employers require a clinical confirmation after a second self-declaration in a calendar year, and the Ministério da Solidariedade has been signalling for months that the rules around short illness absences are likely to tighten. The CGTP general strike called for 3 June against the Pacote Laboral has the autodeclaração rules as one of its named flashpoints.

What this means for expats

• You are eligible if you work in Portugal under a Portuguese contract. Eligibility is tied to age (16+) and to having an SNS user number, not to nationality. Foreign workers with a número de utente — which any legal resident has, including holders of D7, D8, Tech Visa, Golden Visa and dependent residence permits — can issue a self-declaration through the SNS 24 app.
• Set up SNS 24 access before you need it. The app login uses Chave Móvel Digital or NIF + SNS user number. If you have not registered Chave Móvel Digital yet, the moment you are sick is the wrong moment to start. Register at autenticacao.gov.pt while you are well.
• Read your contract before you use a self-declaration. The autodeclaração legally justifies the absence but does not entitle you to pay for the days covered. Many Portuguese employment contracts top up the first three days of illness above the legal minimum — your employer's HR may treat self-declarations differently from CITs. Check.
• Keep the cap in mind. Two declarations per calendar year — six days total — is a low ceiling for anyone with school-age children or chronic conditions. If you exceed it, you need a CIT from a doctor, which means a Centro de Saúde or private GP visit. Plan for the bottleneck.
• The rules are likely to tighten in 2026. The Pacote Laboral provisions before Parliament include language that would let employers demand a doctor's confirmation after a second declaration. If passed, that changes the practical value of the system. We will track the bill through the Comissão de Trabalho votes.

The three-year scoreboard hides a more interesting story than the headline number suggests. The 1.5 million figure is large but proportionate — Portugal has 4.9 million dependent workers, so the average rate is well under one self-declaration per worker per year. The 21% Q1 2026 step change is a different signal: if it persists into Q2, the Government's instinct to tighten the rules will harden, and the Pacote Laboral fight in Parliament will become a fight about who pays for short absences. For workers who have come to rely on the autodeclaração — Portuguese and foreign alike — it is worth getting the registration sorted while the system still runs the way it does.