Land waiting lists for medical visits and tests are increasingly longer. Finding your way around obtaining specialist visits and tests under the NHS has become extremely difficult and even stressful. Added to the long phone waits punctuated by music are the frustration of not having found any availability for the service prescribed to us by the doctor. Even when there is a code on the request that indicates priority.
Waiting lists for visits and exams: how to ensure deadlines are respected?
«Many citizens do not know their rights and often do not know how to recognise priority class that is indicated in the recipe. Making citizens aware of their rights is necessary for them to be enforceable. The alternative is resignation or recourse to private healthcare”, comment Irene Prosperato and Mario Pittella, actively involved as volunteers in the campaign that is part of the party’s programme Communist Refoundation for the defense and relaunch of public health. They helped us understand how to obtain compliance with the deadlines described by the doctor.
In compliance with the Constitution
The content of article 32 of the Constitution states “The Republic protects health as a fundamental right of the individual and interest of the community, and guarantees free care to the indigent”, it is therefore legitimate to make some reflections that generate as many questions. There healthcare is an inalienable right for which we contribute as citizens or a commodity reserved for those who can afford to pay individually? If the current trend that the difficulties we have talked about created the conditions to discourage citizens from enforcing their rights and as a consequence there was a progressive dismantling of the Italian public health system, would it be an edifying drift? What would the definitive dismantling of the public healthcare system in favor of the private one entail?
The campaign to reduce waiting lists
The first step for the citizen to take is therefore to inform yourself well.
“There is a campaign to reduce waiting lists which is part of the path that has seen numerous births and spreads at a regional level health offices which aim to help citizens who have difficulty seeing the priority prescribed by their GP respected. More generally, the branches try to build the citizen mobilization Lombards for the right to health and in defense of public health”, explain Irene Prosperato and Mario Pittella.
Respect for urgency priorities and waiting lists
The main problem encountered is the failure to respect deadlines indicated by National Plan for the Government of Waiting Lists (PNGLA 2019/2021) by the relevant public and private structures in agreement. There are regulatory gaps that do not allow the structure to be contacted to request the service to be clearly and immediately identified, sometimes communication with the telephone operators in charge of bookings is even difficult and it happens that the information is conflicting between the various structures and those received from the GP.
The private sector seems to be the only way out
The organization makes it so complicated to unravel in this system that we often feel trapped in a dead end, and often encouraged to evaluate the opportunity of paid service, as a rule, immediately available.
«There is a notable lack of information for citizens on the part of the institutions in charge regarding the procedures to be activated in case of failure to respect the waiting times in order to prevent citizens from turning to private structures», add Irene Prosperato and Mario Pittella.
To further confirm this, the private/affiliated entities recently propose “smart tariffs” with increasingly systematic frequency. Alternative that reaches the citizen at the heart of the hardship who finds himself faced with an either/or: submit to a long wait or pay for a service within the indicated time at a more affordable cost? A middle ground between the amount of the ticket and that of a service in complete solvency regime.
What is the Healthcare Vademecum for waiting lists
In February 2019 the National Plan for Government of Waiting Lists (PNGLA) 2019-2021, which includes the topic of “waiting lists” with the Healthcare handbook, a clear, simple and instructive tool. This handbook contains practical and detailed information for citizens who intend to lodge an appeal to enforce the prescribed waiting times. Both are indicated email addresses to which to write both the content of the text and the any actions to be taken in case of no response. Here are the key parts.
Performance monitoring
Plan National of Government of Waiting Lists (PNGLA) 2019-2021 has revised thelist of performances to be monitored and identified:
- 69 outpatient services (14 specialist visits and 55 instrumental services)
- 17 services under ordinary or day hospitalization
Look at thelist of monitored performances (pdf) based on PNGLA 2019-2021.
At the time of prescription, the doctor is required to indicate the diagnostic question and the priority class
The PNGLA 2019-2021 highlights theobligation to clearly indicate the diagnostic question on all prescriptions and, for first access services, the priority class.
The diagnostic question describes the health problem that motivates the doctor’s request to carry out the service. The priority class defines the times for accessing healthcare services.
Communication and information on times and waiting lists
The PNGLA 2019-2021 underlines the importance of communication and information on waiting lists (and in particular about booking and “guarantee paths” in case of exceeding the maximum times) through dedicated and accessible sections on regional and company websites , information campaigns, Public Relations Offices (URP), service charters and the participation of users and protection and voluntary associations.
Definition of waiting times
The Regions and Autonomous Provinces, within the scope of organizational autonomy in healthcare matters, may define waiting times that are lower than those envisaged in the National Waiting List Government Plan (PNGLA) 2019-2021, but certainly not superior.
Priority classes provided for by the PNGLA National Waiting List Plan 2019-2021
For them specialist outpatient services I am:
- Class U (Urgent), services to be carried out as soon as possible and, in any case, within 72 hours;
- B (Short), services to be performed within 10 days;
- D (Deferrable), services to be performed within 30 days for visits / within 60 days for diagnostic tests;
- P (Scheduled), services to be performed within 120 days (from 1 January 2020). Until December 31st the P class will be 180 days.
For them hospitalization services the priority classes are:
- Class A: hospitalization within 30 days for clinical cases that can potentially worsen rapidly to the point of becoming emergent or, in any case, causing serious damage to the prognosis;
- B: hospitalization within 60 days for clinical cases that present intense pain, or serious dysfunctions, or serious disability, but which do not show a tendency to worsen rapidly to the point of becoming emergent, nor can the prognosis be seriously compromised by waiting;
- C: hospitalization within 180 days for clinical cases that present minimal pain, dysfunction or disability and do not show a tendency to worsen, nor can the prognosis be seriously compromised by waiting;
- Q: hospitalization without a defined maximum wait for clinical cases that do not cause any pain, dysfunction or disability. These cases must however be carried out at least within 12 months.
Protection paths
The new Plan includes the definition and application of “protection paths”, alternative access to specialist services which provide that, if the maximum waiting time is exceeded at an institutional level, it may be a specific procedure has been activated that allows the patient resident and for requests for first services in priority class la possibility of carrying out the service at an accredited private provider in compliance with the times established by current legislation.
For more info: https://www.salute.gov.it/portale/listeAttesa/dettaglioContenutiListeAttesa.jsp?lingua=italiano&id=4977&area=listeAttesa&menu=vuoto.
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