Portugal’s call-before-emergency model is changing how patients reach care
A regulator review found more SNS 24 use and fewer low-priority self-referrals to emergency departments, alongside long telephone waits and referral problems that still need attention.
Archived after its publication day. Search retains this original briefing for background and accountability.
Archived 31 August 2026Patients need to know both the intended route and the point at which a failed referral should be escalated instead of repeated indefinitely.
- SNS 24 is intended for acute or urgent problems without an immediate threat to life.
- The regulator found increased use of the line and more referrals to primary care.
- More than 90% of referred non-programmed primary-care consultations occurred within 24 hours in 2025.
- The review also found waits over 30 minutes and referrals that could not be completed.
What the review found
The Health Regulatory Authority examined the 'Call First, Save Lives' model across participating local health units. It found that the model changed access patterns: more calls to SNS 24, more routing to primary care and a relative reduction in people taking lower-priority problems directly to emergency departments.
The primary-care response was often quick. In 2025, more than nine in ten non-programmed consultations following referral took place within 24 hours. That supports the central idea that some acute problems can be handled safely outside a hospital emergency department.
The system still has friction
Call demand also increased waiting. The regulator recorded a marked rise in calls waiting more than 30 minutes and cases where a primary-care appointment could not be made because of technical constraints or was declined.
Complaints showed referrals to units that did not have real-time capacity. The regulator issued directions intended to improve coordination and ensure that prior referral does not become a barrier to timely care.
Which number to use
Call 112 for a life-threatening emergency, severe trauma or another situation requiring an immediate emergency response. SNS 24, on 808 24 24 24, is the route for acute or urgent symptoms without an immediate risk to life, where clinical triage can direct the next step.
A routine prescription, planned follow-up or long-running symptom normally belongs with primary care or the treating service. Choosing the route by clinical urgency is more reliable than choosing it by which door appears easiest to reach.
If the referral fails
Write down the call time, advice, referral destination and any case reference. If the destination says it cannot see the referral or has no capacity, explain that specific failure when contacting SNS 24 or the local health unit again.
If symptoms worsen, seek a new clinical assessment. The original triage decision was based on the symptoms reported at that time; it is not a permanent instruction to wait regardless of change.
What you can do now.
- 01
Save 112 and SNS 24 separately in your phone.
- 02
Describe symptoms and timing accurately during triage.
- 03
Record the referral details before ending the call.
- 04
Escalate a failed route or worsening condition promptly.
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