Health announces policy to expand access to specialists in the SUS

The Ministry of Health launched this Monday (8) the More Access to Specialists Program. The proposal is to reduce waiting times for surgeries, exams and treatments within the scope of the Unified Health System (SUS) by strengthening the Digital SUS, facilitating access to information and expanding the potential for remote care. Data from the folder show that 99.9% of municipalities have already joined SUS Digital.

Currently, public and private health services receive resources and are evaluated for carrying out procedures such as consultations and exams. The focus, therefore, is not on comprehensive patient care or resolving the problem by completing the diagnosis and offering treatment in a timely manner. From now on, according to the ministry, public and private services will be encouraged to expand their offerings to the SUS based on this new logic.

“The current system is focused on procedures. A consultation, an exam. If you need to take another exam, it’s a little longer. In other words, the guidance is not that the citizen can have this entire process carried out at the right time with the follow-up in their medical records and with their rights”, he said. “Today, this system has no integration with Family Health care and this integration will be the basis for this process”, assessed the Minister of Health, Nísia Trindade.

“Service will be focused on the patient’s needs and not on isolated procedures. The patient will have access to integrated care, including all necessary exams and consultations. There will be a reduction in waiting time, in the number of places the patient needs to go, in addition to the expansion of the use of telehealth to support this entire process”, explained the minister.

The proposed new care model aims to reduce the number of places the patient needs to go and integrates exams, consultations and follow-ups. “It’s about reducing waiting times. People have to be treated with dignity and the system has to solve health problems and not postpone them – in some cases, this means a great loss of health or even, unfortunately, the loss of life”, pointed out Nísia .

Family Health

Based on the new model, Family Health teams, who serve in basic health units, will have their patient records reviewed, so that they can offer quality care, creating a bond with the patient and carrying out territorial monitoring, focused on the particularities of each region.

The goal is to create, per year, until 2026, 2,360 Family Health teams, in addition to 3,030 Oral Health teams and a thousand multi-professionals. The federal government’s forecast is to reach 80% coverage of people with access and quality care in primary care.

“The family doctor will be responsible for this monitoring”, highlighted the Minister of Health, Nísia Trindade, remembering that 80% of problems can be solved in the basic health units themselves. “This monitoring will continue to be carried out with the basic health unit as the center of this entire process”, she added, mentioning that the reference is universal systems in countries such as the United Kingdom, Spain and Canada.

Telehealth

In March, the ministry opened a public call for SUS Digital. Within a month, all 26 states and the Federal District, including 5,566 of a total of 5,570 municipalities, joined the program. According to the ministry, R$460 million will be allocated to federated entities – the resources will support the development and implementation of action plans for digital transformation.

Currently, 24 telehealth centers are operating in the country, three of which offer national specialized telediagnosis. Through these centers, specialists such as cardiologists and ophthalmologists carry out online consultations and analyze diagnoses from doctors who work in primary care.

Data from the ministry indicate that, in 2023, 1,200 municipalities were served, for example, with teleelectrocardiograms with an average of 6,000 reports per day. “The initiative makes it possible to reduce geographic barriers, given the difficulty of bringing specialized professionals to remote regions, and ensure the population’s access to this service”, assessed the ministry.

Resources

In a note, the department itself admitted that, over the last few years, the federal government has reduced its role in financing specialized care, placing an overburden on states and municipalities. In 2023, the resources allocated to this type of service, according to the ministry, were corrected. With the More Access to Specialists program, resources are conditioned on completing the care cycle within the maximum time allowed.

“Federal resources will only be passed on to local managers to be used to pay for public services and contracting the private network if they carry out the necessary consultations and exams for a patient within a specified maximum time. This model gains relevance, for example, in the diagnostic investigation of suspected cases of cancer”, informed the ministry.

How will it work

The private sector, which already plays an important role in offering specialized consultations and exams, will be able to join state or municipal notices of call that will be launched with the support of the Ministry of Health, or even have its current contracts added to offer services. called Integrated Care Offer (OCI), a set of care management procedures and devices for a specific condition or illness.

The OCI for diagnosing breast cancer, for example, includes: consultation with a breast specialist; diagnostic bilateral mammography; breast ultrasound; fine needle aspiration puncture; histopathological; active search for the patient to ensure exams are carried out; return consultation with the mastologist; and contact with the primary care team to ensure continuity of care.

“The amount that the Ministry of Health will transfer for each OCI to managers who prove their performance in contracted public and private services is greater than the sum of each procedure separately and was updated based on what is currently practiced in the market”, he informed. the folder.

The proposal is that managers use these resources to, through added or new contracts, better remunerate providers who, in addition to offering the procedures provided for in the OCIs, must adopt a new stance in the journey with the patient, based on humanization, in care coordination, resolution and integration with primary care.

Accession

To join More Access to Specialists, state and municipal managers must develop action plans indicating priority queues, services responsible for each OCI, the amount of OCI that each one must offer per year and the corresponding financial impact. This will make it possible to plan actions and monitor the implementation of action plans in each health region.

“Each health problem, and the corresponding specialties, that require multiple access to specialized care services and the carrying out of several specialized consultations/examinations to complete a stage of care will have an OCI”, highlighted the ministry. Initially, the main types of cancer (cervical, breast, prostate, colorectal and gastroesophageal) will be a priority, in addition to cardiology, otorhinolaryngology and ophthalmology.

Application

The government’s expectation is that, with the new care model, each citizen and health professional will be able to monitor the care cycle in the SUS through technologies such as the Meu SUS Digital application. The app works as a kind of medical record in the palm of your hand, with the patient’s entire history.

The app’s features include the issuance of a complete vaccination card and a document for collecting sanitary pads through the Farmácia Popular program, in addition to real-time monitoring of the transplant queue. The tool has more than 49 million downloads.

Vaccines

During the launch of the program, at Palácio do Planalto, in Brasília, President Luiz Inácio Lula da Silva received a dose of the flu vaccine. At 78 years old, he is part of the target audience for the National Flu Vaccination Campaign, which began on March 25th.

In addition to seniors aged 60 and over, children aged 6 months to under 6 years can receive the dose in the public system; health workers; pregnant women; postpartum women; primary and higher education teachers; Indian people; homeless people; among other priority groups.

“I’m going to take the vaccine here now to encourage the Brazilian people to take the vaccine again. With a vaccine, we don’t become an alligator, we don’t become what we don’t want. With a vaccine, we avoid catching diseases that can kill people,” said Lula.

On the occasion, Nísia highlighted the importance of immunization against the flu, as the disease still accounts for many deaths in the country, and cited other doses available to the population.

“Right now, we have vaccinations in schools; the polio vaccine and we cannot have polio return in Brazil; the measles vaccine; HPV vaccine, thinking about our young people aged 9 to 14. This vaccine [contra o HPV]Last year, we had a 42% increase in doses, but we have to reach 80% coverage for girls and boys. Now in one dose only because our scientists have shown it to be effective,” he said.

*With information from Agência Brasil

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