In the scope of the Supplementary State Budget presented in June 2020, the government announced an additional amount of 504.5 million Euros for the health sector. The government also foresees to keep all 2,800 health care workers hired during the pandemic (until the end of May), for a 4-month period, under special rules, and to hire 2,700 additional health care workers to strengthen the response of the NHS. The measure will cost an estimated amount of 200,000 Euros more, as the initial 2020 State Budget already foreseen hiring 8,400 health care workers during 2020 and 2021. The Supplementary State Budget also increases the investment in intensive care units, which includes hiring more human resources specialized in intensive care.
By the end of September, 5,300 health care workers have been hired by the NHS under the new rules, including 218 doctors and 1,738 nurses. Meanwhile, 545 of those health care workers have already terminated their contracts and left the NHS. The government has decided to keep the remaining healthcare workers permanently in the NHS, and the tender for hiring them is to be published soon.
By the end of October, 6,492 health care workers have been hired by the NHS under the new rules, including 262 doctors and 2,155 nurses. Meanwhile, 741 of those health care workers have already terminated their contracts and left the NHS. The government has decided to keep the remaining healthcare workers permanently in the NHS, and the tender for hiring them is to be published soon.
The government has announced a number of measures to strengthening the health system response to the pandemic, including:
• Reactivate backup structures to received vulnerable patients who no longer need hospitalization;
• Hiring retired nurses for contact tracing;
• Special rules for hiring ICU nurses;
• Further expansion of ICU beds: 50 more until the end of 2020 and 100 new beds until March 2021;
• Issuing isolation declaration through he SNS 24 hotline.
By the end of February 2020, the Portuguese NHS had the following human resources:
• 30,172 doctors, including the following specialties: 133 Infectious Diseases, 389 Pneumologists, 1,803 Internal Medicine, and 359 Public Health;
• 45,560 nurses;
• 61,181 other professionals.
When the outbreak started in Portugal, NHS institutions were asked to report their needs for human resources. Hiring of healthcare workers was facilitated through an exceptional procedure (https://dre.pt/application/conteudo/130243053). Additionally, caps for extraordinary work payments were removed and hiring retired health care workers without any age limit became possible. Either to increase human resources or to replace workers, NHS institutions are also authorized to directly acquire services and hire health care workers for up to 4 months and to renew those contracts (https://dre.pt/application/conteudo/130277343).
Following the closure of educational institutions, the government has decided to keep some schools open to ensure childcare for health workers and people with other essential activities (https://dre.pt/application/conteudo/130273592). The same legislation also defines other rules to provide family support and ensure health care professionals’ availability to work, so that the NHS response can be maintained.
Medical students and retirees have been invited into the workforce, with students’ unions and professionals’ associations establishing ‘banks’ of volunteers to collaborate in the national response. This allowed, for example, to double the number of health care workers simultaneously answering phone calls at the SNS 24 Contact Centre and to have four times more doctors answering the Medical Support Line. Clinical training for medical students at hospitals as well as exams to conclude their specialty have been suspended.
As hospital and primary care activity has been reduced by postponing non-critical treatment, a number of health care workers can be redeployed to deal with COVID-19. Redeployment and schedules of health care workers is decided within each institution, according to the needs and available human resources, since some health care workers have also become infected by COVID-19.
Each institution is responsible for providing the necessary psychological support to their health care workers and to ensure they have all the necessary equipment to protect themselves and others. The Directorate-General of Health has issued guidance on the use of personal protective equipment both for health care and non-health care workers (https://www.dgs.pt/directrizes-da-dgs/normas-e-circulares-normativas/norma-n-0072020-de-29032020-pdf.aspx; https://www.dgs.pt/directrizes-da-dgs/orientacoes-e-circulares-informativas/orientacao-n-0192020-de-03042020-pdf.aspx).