One in four users in Lisbon and Vale do Tejo does not have a family doctor.

In Lisbon and Vale do Tejo (LVT), one in four users registered in the primary health care system did not have a family doctor in 2023, while in the North only 2.3% of users were in this situation.

“There continues to be a downward trend in the proportion of users assigned to a family doctor and greater heterogeneity at the regional level, which affects rates of access to care provided in primary health care (PHC) settings,” warns the Health Regulatory Authority . (ERS) in a monitoring report published today.

According to the National Health Service (SNS) transparency portal consulted by Lusa, at the end of April this year 1,565,880 users did not have a family doctor in mainland Portugal, an increase of 26,658 on the previous month.

ERS’s monitoring of CSP access shows that last year 24.6% of users registered with LVT did not have a nominated GP, a percentage that has increased from 18.2% in 2021 and 19.2% in 2022.

The Algarve is the second region of mainland Portugal where the most people do not have access to specialists in general and family medicine, and this scenario has also developed negatively in the last three years: 15.1% in 2021, 17.6% in 2022 and 20% in 2023. .

Alentejo saw the largest percentage increase in the number of people without a family doctor – eight percentage points – from 9.4% in 2021 to 17.3% in 2023, according to ERS.

In the Center, the number of people registered but without an appointed family doctor increased from 6% to 12.6% from 2021 to 2023.

The Northern region stands out positively for this indicator: only 2.3% of users registered in clinics did not have a family doctor last year, a slight increase compared to 1.9% in 2021 and 2.2% from 2022.

At the end of 2023, 83.5% of users registered in the CSP had a designated family doctor on the Portuguese mainland, with a continuing downward trend of 2.1 points compared to 2022 and 5.3 points compared to 2021 .

The North had the highest percentage of registered users with a designated GP (97.6% in 2023), while in LVT this figure drops to around 70%.

According to the regulator, in 2023 the rate of requests for medical consultations reached 69%, with a downward trend observed in all regions.

“Comparing the percentage of use of family doctors with rates of use of consultations, it is noteworthy that the LVT and Algarve regions had the lowest rates of all analyzed years for these indicators, suggesting that the availability of a family doctor represents an important factor contributing to access to PHC in National Health System,” warns ERS.

In 2023, the number of face-to-face medical consultations increased by 3.7%, following the same trend as in 2022, but still lower in number than recorded in 2019 (20,715,482).

The number of non-face-to-face medical consultations in 2023 decreased by 6.3% compared to 2022, which is also consistent with the 2022 trend.

Comparison of these data “appears to suggest a change in the way health care is delivered, with an increase in face-to-face medical consultations at the expense of non-face-to-face consultations, and, on the other hand, favoring face-to-face nursing consultations over face-to-face consultations,” the regulator said.

For cancer screenings, with the exception of mammography, which decreased in 2023, the remaining population-based screenings analyzed (colpocytology and colorectal cancer) increased, all recording higher values ​​than in 2019.

Given that the North has the best performance and is the region with the highest percentage of Model B family health care facilities, its “outperforming performance may be due to the organizational model of these units,” according to ERS.

In terms of the resumption of care activities, ERS found that it had “failed to recover 2019 levels”, the year before the Covid-19 pandemic, for face-to-face consultations (medical and nursing), doctor-at-home consultations, percentage of newborns in care homes up to 15 days of age and during consultations regarding influenza.