Projections for early 2026 anticipate up to 900,000 call attempts per month for the SNS 24 line, potentially leaving almost 300,000 calls unanswered in a single month.
“These numbers add up to more than a million unanswered calls throughout the winter and are a conservative estimate, given that we assume the mandatory phone triage will not be implemented in the 12 local health units that have not yet joined the program, serving a population of approximately 2.5 million users,” the authors state.
The risk of the SNS 24 line’s breakdown is attributed to the increased functionalities assigned by the government without proportional reinforcement of human and technological resources.
“While the policy was concerned with increasing access to emergency care, the line was implemented quickly without corresponding investment in infrastructure,” critique the authors, including health economist Eduardo Costa and Ara Darzi, the physician who reformed the UK’s NHS.
The authors assert that the line “has been operating above its capacity for more than two years” and attribute the partial failure of the service to delayed access.
“The response time for any received call should not exceed 15 seconds, yet (…) a significant number of calls have not met this key performance indicator since the start of real operation,” they state.
Examples from September 2024, before the nationwide implementation of the “Call Before, Save Lives” project—which filters who should or should not go to hospital emergencies and increased demand for triage services—show that “wait times approached the target,” with an average answer time of 23.16 seconds.
Recent activity numbers confirmed by researchers indicate that between June and September, the line answered over 1.6 million calls, a growth of approximately 56%, equating to 600,000 more calls.
More than half of these calls (58%) were answered in less than two minutes, 6% in up to five minutes, and 15% in up to 15 minutes.
The operator, Altice, confirms that the increase in call volumes is well above initial contract estimates.
Both the Shared Services of the Ministry of Health (SPMS) and Altice assure they are working on solutions.
“The operator has made sustained investments, in coordination with SPMS, in team organization and capacity building, technological modernization, and optimization of service circuits to enhance overall efficiency,” an SPMS source stated.
Altice highlights that “500 new professionals are enrolled for training in October alone.”
According to the Expresso, there are currently 3,200 professionals working at the SNS 24 line, which responded to 4.3 million contacts between January and September.
Last month, the Secretary of State for Health Management, Francisco Rocha Gonçalves, assured that the SNS 24 line (808 24 24 24) was prepared for the winter and said the operator would “adapt the technology” and “use Artificial Intelligence.”
