ABRUZZO – In recent months, the topic of waiting lists, as it should be, has assumed maximum centrality in the national and local media, highlighting the critical issues that characterize the national health system and, without distinction, the Italian regions. This joint note intends to contribute to informing citizens about some specific issues, which have attracted the attention of the mass media, representative bodies, politics and citizenship.
The topic we intend to address here is that of pre-lists or floating lists, an operational methodology for governing waiting lists that is widely spread on a national scale (ex multis, Veneto, Valle D’Aosta, Lombardy, Tuscany, etc.). On this point, we wish to clarify that:
1) The pre-list methodology does not alter – in any way – the monitoring of waiting times and specifically the data of the index week (ex ante detection), which are defined at the time of booking;
2) The pre-lists not only do not alter the results of the ex ante monitoring in an improvement sense, but – in concrete terms – have a positive impact on satisfying the needs expressed by citizen-users;
3) In regulatory terms, the processes of taking charge and the pre-lists are, in fact, configured in point 3.5 (Back office) of the Regional Plan for the governance of the waiting lists of the Abruzzo Region (DGR 265/2019), for effect of which “The correct functioning of the CUP System is made possible by a Front-office service for the collection of requests, booking and/or collection and a Back-office service, which takes care of the management and planning of agendas and support for booking and dispensing points, activating the role of a “Cup Specialist”. The priority task of this figure is the management of critical issues that arise at the counters and the call center, to be addressed in different ways. The Specialist intervenes in the event that the services requested with the priority classes are not available and in general in situations in which the counter operators do not have the possibility of giving an effective response to the user. The back office – CUP operators of each of the four ASLs take charge of the booking with the indicated priority and using the computerized waiting list procedure; contact the prescribers as a priority, if there are errors and critical issues found in filling out the prescription with respect to the clinical question, and also the patients who have not found availability, when the service becomes available, relieving them from the burden of contacting the doctor again CUP.
4) The regulatory provision referred to in the previous point outlines, in operational terms, the creation of pre-lists, i.e. lists in which to place citizens to whom the local health authorities have not guaranteed the services required within the terms of the law. In fact, it prefigures the need for the activation of functional pre-lists for taking charge of the patient and for recalling the same when the service becomes available (due to an increase in availability or due to cancellation/movement by other users).
5) The pre-lists are configured as an additional organizational solution aimed at responding to particular critical issues in favor of citizens, through complex computerized care taking processes.
It is right to remember that a long and demanding work has been carried out, in recent years, by the Regions, by Agenas, by the Ministry of Health, in order to regulate the complex universe of waiting lists, harmonizing – among other things – the strategies of governing waiting lists. This process has largely passed the preparatory phase and is about to reach the legislative and regulatory ratification phase. On a regional basis, it will now be necessary, also in consideration of the new scenarios envisaged by the Legislative Decree of 7 June 2024, n. 73, which introduces important measures of surrogate access, if healthcare companies are not able to guarantee services within the timescales set by current legislation (use of intramural freelance activity, additional services or the accredited private system), standardize and harmonize the different organizational methods put in place, precisely in order to fully implement the Regional Plan for the management of waiting lists (DGR 265/2019).
Furthermore, the ASLs – by virtue of the new organizational and digital models introduced – will further promote the strengthening of the back-office, as already done during the 2023 financial year. Even in the rationalization plans just presented to the Abruzzo Region, the ASLs have not decreased the human resources dedicated to these precious activities, which is based on the aforementioned waiting list management tools.
In conclusion, we believe that, in terms of waiting lists, much effort has been made to guarantee citizens-users the most effective and timely services possible. We are perfectly aware that critical situations still persist that, with the support of the central State, the Region and the Regional Health Agency, we intend to counter with our best intentions and energy.
THE GENERAL DIRECTORS
ASL n. 1 Prof. Ferdinando Romano
ASL n. 2 Dott. Thomas Schael
ASL n. 3 Dr. Vero Michitelli
ASL n. 4 Dr. Maurizio Di Giosia
