Doctors concerned with errors, omissions in new surgery system – Portugal Resident

The Portuguese Order of Physicians expressed concern today about the new National System for Access to Consultations and Surgery (SINACC) – highlighting errors and omissions that could undermine patients’ guaranteed access and clinical priority.

In a statement, the Order (OM), drawing on the opinions of various specialist colleges, considered that the risks justify a technical and clinical validation process before the model is rolled out across the board.

The Order had previously issued warnings about SINACC, which led the relevant ministry to extend the trial phase to all Health Service units, thereby postponing the implementation scheduled for August 1.

Today, the OM reiterated its concerns, emphasising that the new model must improve access, transparency and the responsiveness of the health service, “without compromising clinical safety, the traceability of the patient’s care pathway, regional equity or the sustainability of healthcare teams”.

“Any model that alters the patient pathway without prior technical validation risks creating problems greater than those it aims to solve,” said OM president Carlos Cortes, quoted in the statement.

According to the statement, the analysis carried out on the new model reveals “cross-cutting risks” – namely fee scales and nomenclatures that “do not adequately reflect clinical complexity” or the resources used in various areas, as well as reclassification rules and criteria for minor surgery that may undermine the traceability of the patient’s care pathway, guarantees of access and clinical priority.

The Order also highlights changes in the new model relating to additional service provision, team allocation and the funding of medical devices, which could reduce care capacity and prolong patient waiting times.

In order for the system to be rolled out and implemented nationwide, the Order argues that, amongst other matters, a “technical and clinical review of the tables” should be carried out, with the participation of the colleges of the Order of Physicians, including the College of Clinical Coding.

It also advocates that the model be implemented in phases, with pilot projects, training, a SINACC operational manual, contingency mechanisms and public monitoring of response times.

The OM also emphasises the need to prioritise clinical care and regional equity “above any purely productivity-based objective” and calls for further coding, audit and governance mechanisms to ensure “reliable, comparable and useful data for continuous improvement”.

“The Order of Physicians is not opposed to modernisation. What we demand is that this modernisation be carried out on a scientific basis, with clinical validation and with absolute respect for the patient’s care pathway,” the statement emphasises, adding that all opinions and recommendations have already been sent to the Ministry of Health and reiterating its willingness to engage in “joint technical work”.

Source: LUSA