Gondomar: wrong information took him to two hospitals
Still in February this year, another user complained to ERS that she contacted the SNS24 Line, via cell phone, because her husband had cut his arm. As he says: “I explained to the nurse who attended to me that the cut needed stitches and she sent me to the Care Center that operates at Hospital da Prelada” (Santa Casa da Misericórdia unit, in Porto, in agreement with the SNS).
“My area of residence is Gondomar”, he explains further. But it was. And after waiting for around 30 minutes with her husband, they were seen by a doctor who told them that “they don’t do sutures there and that the SNS24 Line knows this, as they have already sent several patients with identical problems and they informed them of this”, reports the user.
The doctor “wrote a letter and sent us to the Hospital de Santo António, in Porto, where we should have gone straight away if the SNS24 Line had done what it was supposed to”, describes the user. ERS reminds the SPMS, which manages the SNS24 Line, and the Executive Management, that the information about the type of care provided by each unit, even those that are not part of the SNS, must be correct, to avoid wrong referrals.
Lisbon and Tagus Valley: From hospital to hospital because of Orthopedics
Also at the beginning of this year, ERS received the case of a user who had a bicycle accident, in Lisbon, in front of the Pulido Valente Hospital, and who went to his health center because he had “the phalanx of his left hand deformed and in a lot of pain”. There, they told him they couldn’t do anything and advised him to call the SNS24 Line.
“I called at 6:00 pm, reported the accident and that I was in a lot of pain in my hand. At 6:17 pm they called me to inform me that I should go to the Hospital de Santa Maria, I took the Metro and when I arrived at the Emergency Department I withdrew the ticket for triage care. When I was called, the nurse informed me that on Friday night there is no orthopedics service and that I had to go to the Hospital São José”, but that I had to call back. new for the SNS24 Line.
“I called again at 7:20 pm, informed him again about the accident and what had happened at the hospital” where they sent him. In Santa Maria, they did not solve the problem and the SNS24 Line redirected him as if he had not already been referred and waiting in another unit. “I went by Metro, got my ticket again, waited and the treatment only ended at 11pm”. A delay of time that would have been unnecessary if the user had been routed correctly. ERS highlights in its report that “alternative care or referral to another health unit must be done in a way that provides a timely response to the user”.
Lisbon and Tagus Valley: Child sent to center with doctors on strike
A mother called the SNS24 Line at 9:00 am because her seven-year-old son had a cough and fever. The support line scheduled him for an appointment at 6:28 pm at the Service Center in Odivelas. “I arrive 30 minutes early and I am denied the service scheduled on the SNS24 Line, because there were no doctors, they were on strike, but with open doors”, he tells ERS.
This mother had to call the SNS24 Line again, where she was told “that the health center would have to send me to another unit”, she reports. She went back there, but they sent her back to Line SNS24. “My son had a fever of 40 and spent the day waiting for the appointment scheduled by Line SNS24, to a place where there were no doctors because they were on strike. Didn’t you know about this?”
The mother then went to the emergency room in Santa Maria, where she was “waiting for hours”. In its report, ERS recalls several times that the information given by units to Line SNS24 needs permanent updating, to avoid incorrect routing.
Viana do Castelo: 15-month-old baby without care because he is not referenced
Another mother enters the emergency room at Viana do Castelo Hospital with her 15-month-old baby, in November 2024. “It was 00:51. My daughter had had a fever since the day before and was crying with her hand next to her right ear.” A behavior that had worsened in the last few hours. In September, she had an ear infection, so, given the signs, she says: “I went directly to the emergency room, not knowing that it was mandatory to call the SNS24 Line in advance. I’m not even surprised, when I got there, we were refused service because we hadn’t been referred by the Line. In disbelief, I called, thinking that, and since we were already at the door of the emergency room, they would confirm the service there.”
But, after the telephone screening, the operator informed her of a different decision: “Since my daughter did not meet the criteria to be admitted in an emergency context, she had to be referred for consultation at the Melgaço health center. I couldn’t answer anything other than: Melgaço? Do you know where Melgaço is? It’s almost in Spain. I’m from Lanheses, I’ll get to Porto sooner.” To which the operator replied that he had to go to “access my area of residence”. “Sorry, this can only be a joke. I had a 15-month-old baby crying in my arms and with a fever and I had to travel 84 kilometers, an hour and a half, to Melgaço, when I was at the door of an emergency room?”
Another case that the ERS says violates the Constitution, the Charter of User Rights and Duties and even the rules that regulate the Ligue Antes, Salve Vidas program. Therefore, it is recommended that SPMS and ULS inform their professionals of these rules so as not to make inappropriate decisions. “No patient can be denied healthcare assistance.”
Alcobaça: From Porto de Mós to Coimbra because of an X-ray
Last year, on a day in December, at 9:00 am, a user went to his health center – which is, as he says, “600 meters from my house”, near Juncal -, with his son, so that his knee, which was swollen, could be checked. “He was in a lot of pain”, but when they arrived at the center they told him he had to call SNS24. He called, but instead of sending him there, they sent us to Alcobaça Hospital, as he was an athlete and had to undergo an X-ray.
He was. But when he arrived, he says, “they informed us that we had to go to the Porto de Mós health center”. “We went, but when we arrived they redirected us to the health center at our residence.” The user didn’t want to believe it when he got there. “The doctor sent us to the Pediatric Hospital of Coimbra, due to the fact that he was a child and had to undergo tests. With all this, we had already covered more than 80 kilometers and still had another 115 to go until Coimbra.”
ERS reinforces that the information provided to users must be “correct”.
Porto: Fees wrongly charged to users
In January of this year, a user from Porto called Line SNS24 and was referred to the Hospital de São João. However, when he arrived there, he was not admitted, because, he says in the complaint sent to ERS: “They informed me that from the 1st to the 15th of each month, from 7:30 pm there is no ophthalmology emergency” – during this fortnight the emergency room operates at the Hospital de Santo António, at night.
After receiving the information, they told him to call SNS24 again. Called. “But they kept telling me to go to São João. I went back to the office for admission and the employee, impatient, said again that there was no ophthalmology emergency, indignant at the fact that I was putting her work at risk.”
The user also says that “a person responsible for the service who was watching what happened came to tell me the same thing and asked me to show her the SNS24 message”. He showed it, but they told him to go to Santo António. The user asked for proof of what they were telling him, but was denied. He then went to Santo António, where they admitted him, but they told him that they could not accept the SNS24 message because it referred to São João, so he had to pay an emergency fee. If you wanted to be exempt, you would have to call Line SNS24 again so that the route could be made to Santo António.
This case was not the only one to reach the ERS, but it was this one that the Health regulator used to make it very clear in its evaluation report for the Ligue Antes, Salve Vidas program that there are units that are charging fees to users incorrectly.
ERS reminds health units that it is illegal to charge a fee to a patient already referred by SNS24, even if they have gone to another hospital. If this happened, it was because the patient received the wrong information. “It is only permissible to charge certain amounts to users with the aim of moderating the consumption of health care, as pursued by user fees and provided that access to such care is not prohibited for economic reasons, nor are situations of exemption and the expense of paying legally provided for user fees put into question”.