The Central Administration of the Health System (ACSS) in Portugal is introducing new rules for managing the National Patient Registry (RNU). The changes, which will take effect in June 2026, aim to update data and free up slots with family doctors, without restricting overall access to the public health service.
Update of the RNU registry
Patients who have not used SNS services for 5 years or have incomplete data may lose their assignment to a family doctor.
Freeing up vacancies
The reform aims to help 122 thousand people who currently do not have an assigned primary care physician.
Concerns from the medical community
The APMGF Association warns against an administrative method to artificially shorten waiting lists.
The Central Administration of the Health System (ACSS) explained that the new rules for organizing and managing the National Patient Registry (RNU) do not mean a loss of access to the public health service. The changes were introduced under Regulation No. 3118/2026, published on March 11, 2026. The main goal of the new regulations is to improve access to healthcare, strengthen the quality of IT systems, and adapt registration conditions for primary healthcare facilities. The new rules will come into force in June 2026. ACSS emphasizes that data updating is essential for the efficient functioning of the system. The Portuguese National Health Service (SNS) is grappling with a growing shortage of family doctors, currently affecting about 1.5 million citizens. The RNU registration system is a key tool for managing patient lists, and its last significant modifications aimed to digitize processes after the COVID-19 pandemic. The current changes are part of a broader reform aimed at shortening waiting lists for primary care specialists.
A key element of the reform is verifying patient activity in the system and the completeness of their data in the RNU registry. Individuals who have not used public health services for the last five years, since the outbreak of the pandemic, may lose their assignment to a specific family doctor. Similar consequences await patients whose documentation in the system is incomplete or outdated. This action aims to free up slots on doctors' lists for people who are actively seeking medical care and currently do not have an assigned primary care physician. Scale of the problem in the patient registry: Outdated data: 262000, No activity for 5 years: 122000, No family doctor total: 1500000
The government's decision has been met with criticism from medical circles, which question the administrative nature of the changes. The Portuguese Association of General and Family Medicine (APMGF) expressed concern, considering the new regulations an attempt to artificially and bureaucratically reduce waiting lists. According to the organization, removing patients from family doctors' lists due to inactivity does not solve the structural staffing problems in the SNS. Despite losing their assigned doctor, these patients retain their status as system users and can access medical assistance, though without the guarantee of continuous care from one physician. Implementation timeline of the new regulations: March 11, 2026 — Regulations published; March 12, 2026 — ACSS clarifications; June 2026 — Entry into force
Mentioned People
- Marta Alexandra Fartura Braga Temido de Almeida Simões — Politician and administrator, specialist in hospital administration, former Minister of Health, currently a Member of Parliament.