The National Institute of Medical Emergency (INEM) in Portugal is set to undergo a comprehensive reform initiated by the government, slated to begin in January. A key aspect of this transformation is the elimination of INEM’s ambulances.
The government plans to focus INEM professionals solely on receiving emergency calls and dispatching aid, as detailed in a report by an Independent Technical Commission. Ambulances will instead be managed by firefighters and private rescue teams.
The Changes
The pre-hospital rescue network will now be based on basic life support care, including an external automatic defibrillation program, contracted to public, private, social, or other external entities.
The reform aims for rapid response by firefighters and private entities for initial assessment and stabilization. Subsequent rescue phases, including immediate life support (SIV) and advanced life support (SAV), will be activated as needed. These teams, consisting of an emergency technician and a nurse, will operate from dedicated vehicles to provide advanced care in more serious cases.
These teams will be stationed in National Health Service units, which will enhance and attract careers in this area.
Moreover, the processing of emergency calls is set for modifications. The government intends for the 122 call centers, managed by the PSP, to be located closer to Urgent Patients’ Guidance Centers (CODU) and the SNS24 line.
The goal is not to consolidate these centers into one unified hub but to ensure shared triage mechanisms and standardized communication.
INEM will become the sole entity responsible for training assistance technicians, and there is also a push for broader public education, potentially introducing basic life support training in schools.
New INEM Organic Law by End of January 2026
The government announced over the weekend its intention to advance the new INEM Organic Law by January 2026, seeking input from parliamentary political parties, particularly the Socialist Party (PS).
In a statement, the Ministry of Health, led by Ana Paula Martins, confirmed it has received the final report from the Independent Technical Commission, which identified “structural flaws” within the National Institute of Medical Emergency.
“The government guarantees that by the end of January 2026, it will approve the decree-law establishing the new structure and organization of INEM, ensuring a robust, transparent model fully aligned with international best practices,” it noted.
The ministry emphasized that the report’s findings reinforce the government’s decision to “reform INEM, restructure its management, and strengthen its functions within the Integrated Medical Emergency System (SIEM).”
