The Sustainable Health Index, developed by the NOVA Information Management School (NOVA-IMS), indicates that the value (84.8 points) suffered the biggest drop last year (minus seven points), with the exception of 2020, when sustainability stood at 83.9 points. However, without the effect of the pandemic, it could have reached its highest value ever (103.6 points).

Speaking to Lusa, the study coordinator, Pedro Simões Coelho, recalled that this value "has been systematically decreasing", which means that, "over these years, it has become more expensive to treat a patient in the NHS [National Health Service]".

"When we say that our vision of a sustainable NHS is an NHS that is productive, that is, that manages to carry out its activity at a reasonable cost, that offers quality services and that is accessible, allowing it to meet the needs of citizens, we have three vectors that contribute to sustainability: productivity (...), quality and accessibility", he explained.

The data justify the drop in the sustainability of the NHS with the increase in expenditure (7%), which was not accompanied by an equal increase in activity (1.3%), resulting in an overall drop in productivity.

Productivity has been falling over the years, registering in 2023 the lowest value of the last decade.

The "technical and perceived accessibility", which assesses access to healthcare, also fell in relation to 2022, which is considered "one of the greatest weaknesses of the NHS".

"The NHS (...) is unable to meet demand in the time it should and is unable to grow its activity at the same pace as expenditure is growing", recalls the study coordinator, who points out that the current context is one of a population that is "much older and with a longer life expectancy, with much less mortality in a number of diseases".

"This means that there are many more chronic patients, who are expensive, and so it is normal that an NHS that was designed in a completely different social context, without organisational changes, has difficulty in responding to the demographic dynamics of today's society", he concluded.

The data indicate that technical accessibility fell by 1.9 points, presenting one of the lowest values of the index. This item considers values such as first consultations in a timely manner, patients on waiting lists, emergency episodes attended to in the expected time and use of available home hospitalisation capacity.

"The picture is inevitable: if productivity has fallen, if quality has stabilised and if accessibility has also shown a downward trend, it was inevitable that the sustainability index would fall significantly", concluded Pedro Simões Coelho.

Looking at the other dimensions that make up the sustainability index, from the users' perspective, the perceived quality of services (72.4 points) is higher than access (64.3 points).

However, technical quality, which had shown a positive evolution in previous years, fell to 66.5 points.

A positive point is the 23% reduction in overdue debt, maintaining the trend of previous years. The data collected also show a decrease in the deficit (-59%).

"The stock of overdue debt has been decreasing over the last few years and this is very important. In fact, if it were not for this fact, the drop in the index would have been even more significant", said Simões Coelho.

From the user's perspective, the effectiveness of the NHS has an impact on their health status (79.3 points) and quality of life (78.8 points). However, users consider the effectiveness of medicines to be higher than that of the healthcare they receive.

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