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Empowering nurses by redesigning the care delivery model

Luís Filipe Barreira, Vice-President, Ordem dos Enfermeiros, Portugal.

In 2019, the OECD identified Portugal as one of the countries where chronic diseases have increased, causing an increase in healthcare, especially nursing care. It is imperative to re-design the healthcare delivery model as a matter of urgency.

This new approach appears in the Recovery and Resilience Plan, which assumes the reform of primary healthcare and identifies promotion and prevention in health management as key alongside the implementation of effective disease management. It is imperative to reduce services overload, increase community care and ensure its promptness and quality. Primary healthcare requires a new framework that strengthens its response capacity and reinforces the effectiveness, resilience, accessibility and quality of care.

The Ordem dos Enfermeiros considers it urgent to recognise the role and importance of nursing teams, reinforcing the number of nurses in Family Health Units, Personalised Health Care Units and Community Care Units, particularly in Integrated Long-term Care Teams by increasing their skills and areas of intervention, namely in Family Health Nursing, and assigning a Family Nurse to each patient/family.

These measures would ensure greater access to personalised care and lower consumption of differentiated healthcare, reducing the health and social vulnerabilities associated with disease and freeing other professionals for different functions.

Primary healthcare nurses already have the necessary differentiation and skills to monitor patients and families in disease prevention and promotion, chronic disease management in a perspective of articulation, integration and continuity of care as advocated by the WHO.

Nurses are overwhelmed with demands. It is essential to respond to the healthcare needs arising from COVID-19, including vaccination and recovering healthcare activity. This goal will only be achieved by expanding and developing nurses’ areas of intervention and strengthening primary healthcare.

Portugal has around 3000 nurses ready to start working. We believe that a new approach and expansion of nurses' competences could decisively contribute to the recovery and consolidation of healthcare activity, ensuring access to high quality healthcare that is closer to the patients, particularly the most vulnerable ones.