Task-shifting in Portuguese primary care: how Via Verde Saúde staff view a fix for family doctor shortages

Portugal’s shortage of family doctors has left a substantial share of patients without a designated physician, and a qualitative study now offers a close look at one attempt to cope with the gap. As of the beginning of 2026, 14.9% of patients in Continental Portugal lacked an assigned family doctor. In response, a bottom-up initiative called Via Verde Saúde (VVS) was set up in 2022 under the National Health Service in the Almada-Seixal region to provide temporary primary care to more than 57,000 unattached patients, relying on task-shifting and work reorganisation rather than on recruiting additional family physicians.

Researchers interviewed 12 healthcare professionals at the clinic—seven physicians and five nurses—representing over one-third of its workforce. The semi-structured interviews, conducted in English and/or Portuguese and transcribed for analysis, were examined through deductive thematic content analysis across five domains: professional satisfaction, mission alignment, task-shifting, perceived quality of care, and future sustainability. The study, published in BMC Health Services Research, reports staff perceptions and experiences rather than objective measures of patient outcomes.

The interviews pointed to high levels of professional satisfaction among the staff surveyed. Participants attributed this primarily to strong team dynamics, modern facilities, and alignment with the clinic’s mission. Task-shifting itself—particularly the expanded clinical roles of nurses in maternity and paediatric care—was viewed positively, with participants perceiving it as enhancing efficiency and optimising the use of limited resources.

Quality of care was generally rated as good by respondents, and all of those interviewed acknowledged that the clinic had significantly improved healthcare access for a population that would otherwise have been without a regular point of contact with the health system. Yet the findings also surfaced a clear trade-off. The walk-in model’s high patient volume limits personalised care, a concern that was voiced especially by the physicians interviewed. In other words, the same design that allows the clinic to absorb tens of thousands of unattached patients also constrains the continuity and individual attention that traditional family medicine provides.

Staff retention emerged as the model’s most pressing vulnerability. Financial compensation below that offered in other National Health Service models was identified by participants as the main threat to keeping staff and to the initiative’s long-term sustainability. The authors conclude that, in the perception of the healthcare professionals interviewed, task-shifting can help address temporary primary care gaps caused by family doctor shortages while maintaining acceptable care quality, and that VVS’s organisational features are potentially replicable in other contexts facing similar physician shortages—provided adequate financial incentives are in place to ensure staff retention.

Subject of Research: Healthcare professionals' perceptions of a task-shifting primary care model addressing family doctor shortages in Portugal

Article Title: Addressing family doctor shortages through task-shifting in primary care: a qualitative study of the Via Verde Saúde initiative in Portugal

Article References: Matos, N., Villeneuve, O., Santos, C., & Barros, P. P. (2026). Addressing family doctor shortages through task-shifting in primary care: a qualitative study of the Via Verde Saúde initiative in Portugal. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15686-6

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15686-6

Keywords: primary care, task-shifting, family doctor shortage, Portugal, Via Verde Saúde, qualitative study, nurse roles, walk-in model, staff retention, National Health Service, healthcare access, workforce sustainability