In brief
91.1% of responding units had three or more failures of computer applications in the past year, and 15.7% waited more than a day for access to be restored.
82.6% of units reported shortages of basic material, and in 68.6% of cases replacement took 48 hours or more.
54% of units reported at least one episode of violence, with psychological violence in 95.8% of them; the SNS recorded 3,429 episodes in 2025.
85.7% of units have institutional incentives owed or not yet available, and satisfaction with the reform fell from 31.9% to 26.0%.
The Associação Nacional de Unidades de Saúde Familiar (USF-AN) published its report on Friday, 16 October, based on answers from 541 coordinators of family health units (USF). The survey ran from 19 June to 4 August 2026, when 712 units existed, and 76% of invited coordinators took part. The findings are being presented at the 17th national USF meeting in Gondomar, in the Porto district.
Repeated IT outages and supply shortages
Of the responding units, 91.1% recorded three or more failures of computer applications in the past year. In 15.7% of units the failures happened more than 50 times, and 15.7% waited more than a day for access to be restored, up from 10.0% in 2024/25. Every unit that answered had at least one outage, and 98.7% said the outages hurt the quality of care, the highest figure in the series. Shortages of basic material were also widespread: 82.6% of units ran short, and in 68.6% of cases replacement took 48 hours or more. Because records are now fully digital, units have no paper fallback. Speaking to the Lusa news agency, USF-AN president André Biscaia described the impact on staff.
“A computer failure, sometimes for a day and sometimes for more than a day, means working in the dark, working without any kind of support. It is very serious.”
Violence against health staff
54% of the responding units reported at least one episode of violence in the past year. Psychological violence was the most common form, reported by 95.8% of those units, followed by physical violence (17.1%), violence against personal property (13%) and sexual violence (1.8%).
- Psychological
- 95.8 %
- Physical
- 17.1 %
- Property
- 13 %
- Sexual
- 1.8 %
Data from the article text
Because these figures cover only units that reported an incident, the association recalculated the rates to include units with none. On that basis, every type of violence fell compared with 2024/25. The report also cites the Executive Direction of the SNS, which recorded 3,429 episodes of violence in 2025, 33% more than in 2024 (2,581), causing 2,012 days of absence from work, 827 more than the year before. Biscaia stressed the toll on staff.
“Psychological violence, when it is sustained over time, has a very large impact on professionals. It is something that cannot be tolerated.”
Biscaia said the issue must stay at the top of the agenda and pointed to Law No. 26/2025, which strengthens the criminal framework for assaults on health professionals. Last year the association argued that patients with a history of aggression should change family doctor, and Biscaia said that such patients are generally removed from that professional's list.
Incentives and satisfaction
85.7% of units have institutional incentives that are either owed or not yet made available, and 63.6% were told that incentives earned in 2025 would only become available in 2026. Biscaia explained that units earn funds for meeting quality targets, try to use them, and are blocked by their Local Health Unit (ULS). He said a share of ULS have no mechanism to release the money or do not intend to, and spend it on other investments.
- Satisfied 2024/25
- 31.9 %
- Satisfied 2025/26
- 26 %
- Dissatisfied 2024/25
- 43.7 %
- Dissatisfied 2025/26
- 46.8 %
Data from the article text
Satisfaction among coordinators with the reform fell from 31.9% to 26.0%, while dissatisfaction rose from 43.7% to 46.8%, ending an improvement seen since 2022/23. Biscaia said he was not surprised, because satisfaction falls when no improvements arrive. Fewer coordinators saw the contract as an incentive, at 56.6% in 2025/26 against 64.5% a year earlier, and 80.9% disagreed that it meets its deadlines.
Staffing and workload
85.0% of units confirmed absences of more than 30 days, which Biscaia linked to pregnancies, long illnesses and staff moved to other services. Teams also lack psychologists, nutritionists, physiotherapists and social workers, so the core team of doctor, nurse and clinical secretary is expected to cover every role. Biscaia said they cannot always do this well, and that patient lists are now much larger than before.