Portugal orders internal emergency doctors to back external emergency rooms under pressure

What the dispatch requires

Doctors on the internal emergency teams at SNS hospitals must now support external emergency departments when demand surges, waiting times climb or staff are short for the rota. A dispatch from the health minister, Ana Paula Martins according to PÚBLICO, was published on Thursday, 22 October in the Diário da República and takes effect on Friday, 23 October. The external emergency department is set as the priority.

The triggers listed include an exceptional influx of patients, an unforeseen shortage of human resources, a backlog of patients waiting to be seen or re-assessed, and a significant rise in waiting times. Support is also due when several seriously ill or unstable patients are present in the external department at the same time.

Why the rules changed

Financial incentives were created in June 2026 to keep emergency services running regularly and to compensate doctors who work beyond the legal annual limit on overtime. They initially left out internal emergency doctors, who were brought in by a second dispatch published in August. The dispatch says the split between the two kinds of emergency care does not prevent them from working together, and in fact requires it. Rotas drawn up by inpatient departments may not, it adds, lead to a fragmented urgent response:

“It cannot, however, lead to the fragmentation of the urgent response, nor stop rostered doctors from supplementing the effort of staff in the external emergency department.”

The arrangement is framed around patient needs, clinical safety, continuity of care and integrated use of available resources.