FHP-SMR study mission to Lisbon: rehabilitation and care coordination

Lisbonne, Portugal · September 27 - October 2, 2026

From 27 September to 2 October 2026, 22 French delegates from FHP-SMR carried out a six-day study mission in Lisbon, organised by Dialog Health, on rehabilitation, integrated continuing care and care coordination in Portugal: SNS funding, ATENTO remote monitoring, Santa Casa da Misericórdia de Lisboa, and private hospitals CUF Tejo and Hospital da Luz.

From 27 September to 2 October 2026, 22 French delegates from FHP-SMR, the federation of private post-acute and rehabilitation (SMR) facilities in France, carried out a six-day study mission in Lisbon organised by Dialog Health. Their starting question: how does Portugal organise rehabilitation, long-term care and continuity of care between hospital, continuing-care facilities and home, and what role do private and charitable providers play?

The mission opened with a seminar at the Administração Central do Sistema de Saúde (ACSS), the central administration responsible in particular for the funding and contracting of the Serviço Nacional de Saúde (SNS). Speakers presented the architecture of the Portuguese system, its organisation into local health units (ULS) that integrate hospital and primary care, funding mechanisms – including risk-adjusted capitation –, contracting and performance monitoring, and the cooperation agreements and convention-based scheme that involve non-public providers in the public service. This framing gave delegates the keys to read every subsequent visit.

The public strand took the delegation to the Unidade Local de Saúde São José, where the ATENTO operational centre provides remote follow-up for patients with chronic conditions. Its technology partner Hope Care Health presented the remote monitoring solution it supplies, before a visit to the centre and an exchange with the nursing team that coordinates follow-up.

The Santa Casa da Misericórdia de Lisboa, a long-established institution running social and health services, played a central role in the programme. The delegation visited three of its facilities: the Unidade de Cuidados Continuados Integrados (UCCI) Rainha Dona Leonor, part of the national integrated continuing-care network; the Centro de Medicina de Reabilitação de Alcoitão, an interdisciplinary rehabilitation centre; and the Hospital Ortopédico de Sant’Ana, specialised in orthopaedics and rehabilitation. Together, these visits traced the logic of a care pathway, from discharge after acute hospital care to the recovery of autonomy.

The private sector was approached from both an institutional and an operational angle. At the Associação Portuguesa de Hospitalização Privada (APHP), the discussion with Óscar Gaspar focused on the role of private hospitals in the Portuguese health system and their relationship with the SNS. At Hospital CUF Tejo, part of the CUF group, teams presented their neurorehabilitation unit, the organisation of the physical and rehabilitation medicine department and a coordination project between intensive care and inpatient wards. Hospital da Luz Lisboa completed the picture with a visit focused on hospital rehabilitation and care coordination. Finally, Hospital do Mar Lisboa presented its specialised care for patients requiring complex long-term care and rehabilitation.

Over the week, the delegation was able to compare public, charitable and private models within a single national system. Lessons for French SMR facilities are a matter for each participant’s own analysis: they concern in particular the integration of funding at territorial level, the place of continuing care between hospital and home, the use of nurse-coordinated remote monitoring and the links between intensive care, inpatient care and rehabilitation – without assuming that these models can be transferred directly to the French context.

The program

Introductory seminar — Administração Central do Sistema de Saúde (ACSS). Welcomed by Ana Potes and her team, the delegation first heard João Sardo Bola present the Portuguese health system and the Serviço Nacional de Saúde. Cláudia Borges and Joana Gouveia then detailed funding, contracting and performance monitoring for local health units, including risk-adjusted capitation, and Sónia Alves Bastos explained cooperation agreements and the convention-based scheme. The aim: understand how the State funds and steers an integrated system that also involves private and charitable providers.
Hospital do Mar Lisboa — complex long-term care and rehabilitation. The delegation discovered a facility specialised in caring for patients who need complex long-term care and rehabilitation after the acute phase. For SMR facility leaders, the visit offered a direct point of comparison: the position of this type of facility in the care pathway, the organisation of care for high-dependency patients and its links with referring hospitals.
Unidade Local de Saúde São José and Hope Care Health — ATENTO operational centre. Ana Isabel Santos presented ULS São José, the context in which ATENTO was created and the results achieved to date. Paulo Carvalho described the remote monitoring solution Hope Care Health provides to ATENTO and how it can support the service’s future objectives. A visit to the centre with nurse Neuza Reis and her team, followed by questions, showed in practice how nurses coordinate the remote follow-up of chronic patients.
UCCI Rainha Dona Leonor — Santa Casa da Misericórdia de Lisboa. Following a presentation by Filipa Klut and Nelson Batista of the Santa Casa’s Directorate for Integrated Continuous Care, together with clinical director Dr José Barata and head nurse Sérgio Sebastião, delegates toured the unit. Discussions covered the place of integrated continuing care between hospital and home, rehabilitation and autonomy, and how the transition from hospital is organised.
Centro de Medicina de Reabilitação de Alcoitão — Santa Casa da Misericórdia de Lisboa. Welcomed by Sílvia Pereira and Cláudia Dias Rodrigues, the delegation heard a presentation of the Santa Casa, Hospital Ortopédico de Sant’Ana and the Alcoitão centre, before touring the site in two groups. The purpose was to observe a rehabilitation centre working in interdisciplinary teams and to understand its place within the Santa Casa’s health services.
Hospital Ortopédico de Sant’Ana — Santa Casa da Misericórdia de Lisboa. The clinical director, nursing director and director of the patient management unit presented the hospital before a tour of the facilities. Specialised in orthopaedics and orthopaedic rehabilitation, the hospital allowed delegates to examine the sequence between surgery, rehabilitation and patient flow management in a specialised setting.
Associação Portuguesa de Hospitalização Privada (APHP) — the role of private hospitals. The meeting with Óscar Gaspar shed light on the place of private hospitals in the Portuguese health system, their relationship with the SNS and the issues they share. For a French federation of private facilities, the exchange offered a peer-to-peer view of how the sector is represented and how it engages with public authorities.
Hospital CUF Tejo — rehabilitation and continuity of care. After an introduction to the CUF group and the hospital by the management team, Dr Alexandre Amaral Silva presented the neurorehabilitation unit, and therapist Ana Oliveira and Dr Sara Rego the organisation of the physical and rehabilitation medicine department. Nurses Nelson Santos and Júlio Mesquita presented the project developed jointly by the intensive care unit and inpatient wards to better coordinate transitions between these two levels of care.
Hospital da Luz Lisboa — hospital rehabilitation and care coordination. The final visit focused on how rehabilitation is organised within a large private hospital in Lisbon and on coordinating care around the patient. It allowed delegates to complete their comparison of the public, charitable and private facilities observed during the week, and to set these approaches against their own post-acute and rehabilitation practice.