The NHS Executive Board is facing criticism for ignoring recommendations from the SINACC working group regarding maximum response times for hospital appointments. The new regulations extend the proposed waiting times for priority patients and omit a crucial seven-day triage consultation window, which experts warn could lead to increased pressure on hospital emergency departments. While the Executive Board claims the new rules improve upon previous legislation by shortening overall wait times, critics argue the changes undermine the system's goal of facilitating patient access and fail to meet clinical standards, particularly in cardiology.
NHS Executive Board ignores proposal to reduce hospital appointment waiting times
Wednesday, 1 April 2026RSS
Context & Explainers
The Alfredo da Costa Maternity Hospital (Maternidade Alfredo da Costa, commonly known as MAC) is Lisbon's principal public maternity facility and one of the busiest maternity units in Portugal's National Health Service (Serviço Nacional de Saúde).
Located in central Lisbon, the MAC is a referral center for high-risk pregnancies and complex neonatal care. It handles a large volume of births annually and serves as a teaching hospital affiliated with Lisbon's medical schools.
The MAC has been at the center of recurring debates about maternity ward closures and staffing shortages across Portugal's public health system. Expectant parents in the Lisbon area may be referred to the MAC for specialist care or diverted there when other maternity units temporarily close due to staff shortages.
SINACC (Sistema Nacional de Acesso a Consultas e Cirurgias—National System for Access to Consultations and Surgeries) is Portugal's new digital healthcare management platform replacing the outdated SIGIC system, created in 2004. Approved by the government on October 24, 2025, SINACC became operational in late 2025, with President Marcelo promulgating it on January 8, 2026.
The system is fully computerized, requiring all patient referrals to be electronic, eliminating paper-based processes. Patients can track their position on waiting lists in real time via app, website, or SNS contact center and choose between public, private, or social-sector hospitals when reaching 75% of guaranteed maximum response times for surgery. The platform uses artificial intelligence to identify anomalies—unusual pricing or suspicious list growth—addressing perverse incentives in SIGIC where longer waiting lists generated more additional-surgery revenue.
SIGIC permitted doctors in private/social sectors to refer SNS patients then operate on them in public hospitals. SINACC's strengthened incompatibility regime prevents this conflict of interest. The system also prevents physicians from cherry-picking additional surgeries, eliminating a distortion where hospitals profited from maintaining long queues.
Financed by Portugal's Recovery and Resilience Plan (PRR) with €5 million for phase one, SINACC aims to reduce patients exceeding maximum waiting times and increase operational transparency. Implementation delays occurred due to insufficient staff training across health units, though testing in Coimbra, Alto Ave ULS, and Lisbon's Oncology Institute proceeded smoothly. The system represents a major modernization of Portugal's surgical-access governance.
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