A complaint is the expression of disagreement concerning a situation that may give rise to censure, conflict, dissatisfaction or divergence, resulting from an interaction with a service provider (for example, a healthcare provider).

Submitting a complaint is a voluntary act and constitutes one of the most important rights of service users, as enshrined in the Constitution of the Portuguese Republic.

All individuals, regardless of whether they act in a personal or collective capacity, and irrespective of nationality or residence, are recognised and guaranteed the right to make a complaint regarding any aspect of healthcare provision, and the right to receive an appropriate, clear, and understandable response.

Accordingly, a complaint may be submitted not only by patients receiving healthcare and their legal representatives, but also by anyone attending, using, or accessing a healthcare facility, as well as by those accompanying or visiting patients.

A complaint may be made against any establishment that provides services to the public.

With regard to complaints falling within the remit of the Health Regulatory Authority, and by way of illustration only, complaints may be submitted concerning:

• Hospitals (public or private);
• Clinics;
• Dental clinics;
• Health centres;
• Medical practices;
• Nursing centres;
• Physical medicine and rehabilitation clinics or physiotherapy practices;
• Clinical laboratories for medical analyses, pathology, and medical genetics, including sample collection points;
• Long-term care units;
• Any home healthcare unit or services provided through mobile or motorised facilities;
• Telemedicine units.

See here for the complete list of establishments against which a complaint may be made.

The ERS regulates and supervises the activities of healthcare service providers.

Complaints falling within the remit of the ERS are those where the respondent is a healthcare provider (regardless of whether it operates in the public, private, cooperative, or social sector), with a facility located in mainland Portugal, and where the content of the complaint relates to the activities carried out there. Examples include:

• Access to healthcare services;
• Discrimination;
• Quality of healthcare provision;
• Quality of administrative support;
• Patients’ rights;
• Waiting times for appointments (administrative, scheduled clinical, and unscheduled clinical);
• Waiting times for access to healthcare services;
• Financial matters;
• Quality of facilities.

In the analysis of complaints, the following are excluded from the ERS competence: - Healthcare professionals, about their activity subject to regulation and discipline by their respective public professional associations (Orders) - example: clinical malpractice, misconduct by healthcare professionals, disrespect for ethical standards; - Establishments subject to specific regulation by INFARMED - National Authority for Medicines and Health Products, I.P., such as pharmacies, in aspects relating to this regulation - example: dispensing of medicines and health products; - Behaviors that may constitute criminal liability. However, if the ERS becomes aware of facts relating to matters outside its scope of action, it forwards them to the competent authority.

1. Consult the information published by the ERS regarding the rights and duties of healthcare service users, available at https://www.ers.pt/pt/utentes/direitos-e-deveres-dos-utentes/
2. Contact the healthcare provider, who may provide support and information to help achieve a resolution.

Healthcare service users may submit a complaint through the following channels:

1. Directly with the healthcare provider:
2. a) Via the physical Complaints Book, which must be made available in all establishments providing services to the public.

• In private healthcare facilities, the Complaints Book (referred to as the “Red Book”) may be requested by the patient, who retains the duplicate copy (blue sheet).
• In public healthcare facilities, the Complaints Book (referred to as the “Yellow Book”) may also be requested by the patient.

1. b) Via the Electronic Complaints Book (LRE) platform.

The Electronic Complaints Book is a digital platform that enables patients to submit complaints, suggestions, or compliments electronically.

Currently, only healthcare providers in the private, cooperative, and social sectors are required to have an Electronic Complaints Book.

2. Directly with the ERS:
3. a) Via the online complaint form provided by the ERS in the Complaints

The ERS website provides a form that patients may use to submit a complaint directly to the ERS.

1. b) By post to ERS postal address (see FAQ question No. 21), or by email to reclamacoes@ers.pt.