The growing pains of the 2024/2025 Portugal's NHS telephone triage system national rollout
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Author(s)
Type
Journal Article
Abstract
In 2024, the Portuguese NHS introduced “Ligue Antes, Salve Vidas” (“Call Before
You Go, Save Lives”), making phone triage through the national SNS 24 line
compulsory prior to an Emergency Department (ED) visit in most NHS Local Health
Units. While the policy was rightfully concerned with improving timely access
to urgent care, it was quickly rolled out without a corresponding investment in
infrastructure. The phone triage system’s ability to meet growing call demand
was assessed using full population administrative data (January 2024–May
2025), applying a Holt–Winters model to project call volumes. These demand
forecasts were compared with a fixed benchmark of installed capacity, allowing
for the estimation of unmet demand and waiting times. The authors’ projections
show that, without structural reinforcement, the SNS 24 line will face persistent
overload, with up to 1 million unanswered calls during the 2025–26 winter
season. Unless structural adaptations are implemented, current gaps threaten
clinical safety, equity, and public trust. Robust policy options like AI-supported
triage, targeted workforce reinforcement, and enhanced transparency are critical
to ensure system resilience.
You Go, Save Lives”), making phone triage through the national SNS 24 line
compulsory prior to an Emergency Department (ED) visit in most NHS Local Health
Units. While the policy was rightfully concerned with improving timely access
to urgent care, it was quickly rolled out without a corresponding investment in
infrastructure. The phone triage system’s ability to meet growing call demand
was assessed using full population administrative data (January 2024–May
2025), applying a Holt–Winters model to project call volumes. These demand
forecasts were compared with a fixed benchmark of installed capacity, allowing
for the estimation of unmet demand and waiting times. The authors’ projections
show that, without structural reinforcement, the SNS 24 line will face persistent
overload, with up to 1 million unanswered calls during the 2025–26 winter
season. Unless structural adaptations are implemented, current gaps threaten
clinical safety, equity, and public trust. Robust policy options like AI-supported
triage, targeted workforce reinforcement, and enhanced transparency are critical
to ensure system resilience.
Date Issued
2025-10-15
Date Acceptance
2025-09-30
Citation
Frontiers in Public Health, 2025, 13
ISSN
2296-2565
Publisher
Frontiers Media S.A.
Journal / Book Title
Frontiers in Public Health
Volume
13
Copyright Statement
© 2025 Goiana-da-Silva, Amorim-Lopes, Correia, Pereira, Ribeiro, Tude-Graça, Pessoa-e-Costa, Cabral, Costa, Nunes, Ashrafian and Darzi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
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Publication Status
Published
Article Number
1694713
Date Publish Online
2025-10-15