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Surgical waiting lists in Spain: Status and possible solutions to address the situation

Surgical waiting lists are one of the main problems of the Spanish healthcare system. According to the latest data available from the Ministry of Health, as of December 2022, there were 704,106 patients awaiting non-urgent surgery, with an average delay of 115 days. These figures represent an increase of 9.6% in the number of patients and a decrease of 3.4% in the average delay compared to the same period the previous year.

However, these figures do not reflect the reality of each autonomous community, as there are major differences between them. Thus, for example, surgical waiting lists reach 151 days in Aragon and Catalonia, and 64 days in the Basque Country. Andalusians wait an average of 107 days for an appointment with a specialist, while the Balearic Islands wait an average of 50 days.

These disparities are due to various factors, such as the provision of human and material resources, the organization and management of care processes, patient demand and expectations, and the impact of the COVID-19 pandemic, which has forced many operations to be rescheduled or suspended.

Proposals to reduce waiting lists

Given this scenario, it is necessary to seek solutions to improve the efficiency and quality of health care, reducing waiting lists and ensuring equitable access to benefits. Some of the possible solutions are:

📍 Strengthening coordination between care levels (primary, specialized, and hospital care) to optimize the use of available resources and avoid unnecessary referrals.

📍Promote major outpatient surgery (MOS) and minor outpatient surgery (MOS) as alternatives to conventional surgery requiring hospital admission, whenever possible depending on the type of intervention and the patient’s condition.

📍Set homogeneous and transparent criteria to prioritize interventions according to their severity and urgency, as well as to inform patients about their situation and their rights.

📍Apply technology based on RTLS (Real-Time Locating System) for the automation and orchestration of surgical processes.

In addition to these general solutions, some Regions have adopted specific measures to reduce surgical waiting lists in their territories. For example:

➡ Andalucia has implemented a strategic plan to reduce surgical waiting lists by 30% in four years, by hiring more healthcare staff, extending surgery hours, or referring to subsidized centers.

➡ Castilla y León has approved a decree that establishes a maximum access time to SNS health services of 180 days for non-urgent scheduled surgery with major outpatient surgery or with hospital admission.

➡ Catalonia has promoted a shocking plan to reduce surgical waiting lists by 25% in two years, by increasing the health budget, activating more operating theatres, and collaborating with private centers.

➡ Madrid has launched a comprehensive plan to reduce surgical waiting lists by 40% in two years, by hiring more healthcare professionals, extending operating hours, or using its own or contracted resources.

These measures have had varying results depending on the autonomous communities. According to data from the Ministry of Health, some have managed to reduce both the number of patients and the average delay for surgery between December 2021 and December 2022. This is the case of the Balearic Islands (-17% and -18%), the Canary Islands (-10% and -14%), Castile-La Mancha (-7% and -13%), Extremadura (-8% and -11%), Galicia (-5% and -9%), Madrid (-8% and -7%) and Murcia (-7% and -6%). Others have managed to reduce only one of the two indicators. This is the case of Andalusia (+1% and -9%), Aragon (+5% and -5%), Asturias (+2% and -6%), Cantabria (+3% and -5%), Castile and Leon (+1% and -5%), Catalonia (+3% and -4%), Valencia (+2% and -6%), La Rioja (+2% and -6%) and Navarre (+1% and -6%). Finally, only the Basque Country recorded an increase in both the number of patients and the average delay for surgery (+8% and +9%).

The role of process automation and RTLS in reducing surgical waiting lists

In conclusion, surgical waiting lists are a complex problem that requires comprehensive and innovative solutions. Although the measures taken by some communities are positive and help to curb the problem, the situation is not new and a deeper transformation of the healthcare system is needed.

Technology offers innovative tools and systems that can optimize hospital processes and streamline the management of surgical waiting lists.

Solutions based on RTLS (Real Time Location Systems) in healthcare offer significant benefits. They provide accurate and up-to-date real-time information, making it possible to identify bottlenecks, improve workflows and enhance coordination between the different departments involved in the surgical process.

But going further, RTLS offers a unique opportunity to automate processes, as it is able to read in real time the movements of patients in the hospital, allowing orchestration solutions to coordinate staff automatically through dashboards or task triggering.

Some of these solutions include:


These are solutions created specifically to manage processes in disparate hospital units, such as the surgical block and the emergency department. They have already demonstrated results in several European hospitals, achieving an increase in hospital capacity of more than 16% per year without increasing other resources.


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