Rescheduling of consultations in the NHS should be gradual and follow DGS rules

in News · 10-05-2020 11:32:00 · 1 Comments

The order that determines the centres and hospitals of the National Health Service (SNS) to reschedule scheduled consultations that were not carried out due to the covid-19 pandemic hs been published in Diário da Republic.

“The governing bodies of the primary and hospital health care providers of the NHS must ensure the identification and rescheduling of all programmed care activity not carried out due to the Covid-19 pandemic, reporting the plan and the recovery period to the respective Regional Administration of Health and the Central Administration of the Health System”, says the order signed by the Minister of Health, Marta Temido.

The same document, which came into force last Sunday, 3 May, determines that the performance of the suspended activity and the resumption of non-covid-19 consultations in SNS establishments and services “must be gradual, dynamic and ensure strict compliance with the rules and guidelines of the Directorate-General for Health (DGS) in terms of safety for users and health professionals, namely personal protective equipment, patient circuits, diagnostic tests and good clinical practices, in the different care areas”.

The order emphasizes that "the promptness of response necessary to an eventual increase in the incidence of SARS-CoV-2 infection" must be safeguarded.

“As long as the country's epidemiological situation justifies it, and especially during the state of calamity, the SNS establishments and services guarantee that assistance activities are carried out using non-face-to-face means,” he says.

According to the document, telehealth mechanisms should be used, namely telerraught, teleconsultation, telemonitoring and teleconsulting programmes, “except when this is not clinically appropriate or technically possible”.

Face-to-face consultations should be scheduled "with a delay in service hours, including at the weekend" and with an appointment to ensure that "users remain in health services only for the period strictly necessary".

The order also stresses that the Commission for Monitoring the National Response in Intensive Care Medicine must monitor the evolution of the availability of intensive care beds in the NHS hospital establishments, prepare recommendations for the response of the hospital to the local epidemiological situation and present a proposal for revision of the national referral network for intensive care in order to respond to current challenges.

The non-urgent assistance activity, as long as it did not imply risk of life for the users, had been suspended on 16 March, also through an order from the Minister of Health, which justified this measure with the necessary response to the covid-19 patients.

At the time, it was decided that when consultations were resumed, “the criteria of seniority and clinical priority” should be respected.


Re "telehealth mechanisms should be used, namely telerraught, teleconsultation, telemonitoring and teleconsulting programmes, “except when this is not clinically appropriate or technically possible”.

This is admirable in the era of online facilities like Skype, however my Health Centre in Sertã uses the SNS computer systems and their own SNS custom made tele-consulting facility has not worked since November 2019 [before COVID-19] and I have had 3 consultations which was to specifically use this facility, to no avail! When the visiting Specialist Consulting doctor made a further appointment, it was not possible to access my patient file and produce my test results etc on their computer system!.

4 visits were made without any results or diagnosis.

Perhaps the boffins at the University in Porto who have made their "app" to monitor COVID-19 patients could resolve the problems with the SNS computer systems in my Centro de Saúde ?

By Ronald from Beiras on 11-05-2020 11:00
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