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KCE reports vol. 40 APPENDICES Physiotherapy 43
6.3. CONDITIONS FOR COVERED SERVICES
Under the NHS system patient co-payments finance from 10% up to 20% of physiotherapy services. This
percentage depends on the number of medical acts 14 the physiotherapist performs.
In order to qualify for reimbursement a referral prescription by a specialist physician of general practitioner is
required. Further limitations regard the number of reimbursed acts. A maximum of 4 to 5 acts per day is set
depending on type of treatment. The overall number of acts is limited per semester depending on the type of
treatment (e.g. treatment for osteo-arthritis is limited to 80 acts per semester). No precise limits defining the
duration of each treatment session prevail. In practice, though, physiotherapists treat 2 to 3 patients an hour.
6.4. QUALITY ASSURANCE AND EVALUTION SYSTEM
6.4.1. NHS reform
At present, the NHS is undergoing a general overhaul. The New National Healthcare System drafted by the
government came into effect during 2002-2006. The reform was inspired by a need for cost containment and
an awareness of lacking efficiency, accessibility and accountability in the national healthcare. The main traits of
the reform concern (1):
The introduction of Public/Private Partnerships (PPPs), with far-reaching
consequences in the field of hospital management.
The shortening of existing waiting lists for surgery and consultations.
Curbing expenditures for pharmaceuticals by promoting generics through
public campaigning and reference pricing.
A more expedient management of human resources, specifically addressing
geographic distribution through means of an integrated information system.
An assessment of the above policy measures would be premature at this stage.
6.4.2. Self-regulatory efforts
The APF laid down a code of professional conduct. It would appear this self-regulatory initiative is not legally
binding, however. Local programs inducing quality of care indirectly concern physiotherapy through mostly
hospital-based management programs.
6.5. HEALTH INFORMATION SYSTEMS
No general Health Information Systems for physiotherapy services were identified for Portugal.
14 A typical treatment includes 3 up to 5 acts . Heat, Ice, Mobilisation, Massage are examples of medical
acts .