Doctors and resources poorly distributed, regional inequalities and patchy laws. For these reasons, the wait for a visit with the National Health Service (NHS) can exceed a year. According to the ISTAT 2025 annual report, in 2024 approximately one in ten people (9.9 percent) reported having given up specialist visits or tests in the last twelve months, mainly due to the long waiting lists (6.8 percent of the population) and the difficulty of covering the costs of healthcare services (5.3 percent).
To address this long-standing critical issue, with law 107 of 29 July 2024 the government launched a provision explicitly aimed at reducing waiting times. The decree provides for various measures, among the main ones is the establishment of an online “National Waiting List Platform”, designed to standardize regional data and inform citizens about the times needed to carry out visits and tests.
However, the platform is not yet fully operational: data is not available at regional level and two implementing decrees necessary to complete the full implementation of the law have expired.
National waiting list platform: how it works and what data it contains
The platform collects over 57 million bookings starting from January 2025, relating to all accredited public and private facilities in the country. It also includes services provided as a freelancer. In particular, all first visits and most diagnostic tests are monitored, including CT scans, MRIs, traditional radiology, ultrasounds, mammograms and colonoscopies.
The platform currently monitors 17 specialist visits and 95 diagnostic tests, classified according to the priority indicated on the prescription: Urgent (within 3 days), Short (within 10 days), Deferred (within 30 days for visits and within 60 days for tests) and Scheduled (within 120 days).
Looking at the data, we realize several problems: it is not yet possible to consult the waiting times in individual structures, nor at least at a regional or provincial level; the data cannot be downloaded, making independent and timely analysis impossible; furthermore, the platform uses statistical-technical language that is difficult for the general public to understand and does not indicate maximum waiting times, a significant shortcoming in light of the declared transparency objectives.
The data returned by the PNLA does not paint a reassuring picture. Only a third of citizens accept the first availability offered for a visit and less than half for an exam, a sign that the initial offer is often perceived as excessively distant in time or even far from one’s residence given that the CUP can assign appointments throughout the region.
The pre-list system also shows obvious limitations: when the patient refuses the first appointment he can be placed on a pre-list and awaits an early reassignment, which can occur if someone else cancels, if additional slots become free or if diaries are reorganised. However, only four out of ten bookings manage to meet the deadlines.
Waiting times in the NHS: numbers on visits and tests
In 2025, almost 57.8 million services were booked in accredited public and private facilities, both institutionally and intramurally: 24.2 million first specialist visits and 33.6 million diagnostic tests. Among the 17 specialist visits, the first five – ophthalmology, dermatology/allergology, cardiology, orthopedics and ENT – represent over 54 percent of the total.
Citizens accepted the first availability proposed by the CUP in 39.9 percent of cases for diagnostic tests and in 34.9 percent for specialist visits.
Particularly relevant is the data on pre-list services: over one million for exams and 918,395 for visits, with a system efficiency of 45 percent and 36.8 percent respectively. The delivery priorities show an unbalanced distribution: for exams, the urgent priority represents 1.6 percent, the short one 13.5 percent, the deferrable one 34.5 percent and the programmable one over 50 percent.
Analyzing the volumes of visits in detail, it emerges that only 25 percent of patients accept first availability for a gynecological visit and 28 percent for an oncology visit. Even for exams, the situation does not improve: only one in three women accepts the first appointment for a bilateral mammogram, while just 40 percent of patients accept the first appointment for a complete abdominal ultrasound, which is the most frequently booked exam.
Why are the waiting lists so long
The reasons are multiple. On the one hand, there is a structural imbalance between supply and demand: the public system has a lower provision capacity compared to the real demand for services, especially for non-urgent ones, in a context of growing health needs also linked to the aging of the population.
Added to this is the shortage of healthcare personnel in specific sectors such as emergency medicine, virology, general surgery and others. Precisely in these disciplines there is a transfer from the public sector to the more remunerative private sector or abroad.
Economic resources represent a further critical issue. Despite the announced investments, public health spending is not growing at the necessary pace. In a context of budget constraints, many Regions choose to contain costs rather than enhance the offer, with a direct impact on waiting times.
The strong regional decentralization of the National Health Service contributes to widening territorial inequalities: where there are greater resources and better organizational capacity, especially in the North, the average times are shorter; where resources are scarce, particularly in the South, waits are significantly longer.
Part of the long waits is also due to the inappropriateness of the services: visits and tests that are not always necessary within the required times take up spaces that could be allocated to other patients, contributing to congesting the system.
Finally, organizational problems weigh heavily governance. The management of agendas, priorities and booking processes is not uniform nor always efficient. In many areas, technical and IT difficulties continue in monitoring waiting lists, with data that is incomplete or poorly accessible to both citizens and public decision-makers. Precisely the problem that law 107 of 2024 was supposed to solve.
Waiting list decree: implementation status and critical issues
According to an analysis by the GIMBE Foundation, eighteen months after the decree on waiting lists was converted into law, serious critical issues remain which hinder its full implementation. In particular, two fundamental implementing decrees are still missing: the one relating to the definition of the staffing needs of the NHS and the one on the national guidelines for the management of CUP reservations.
As of 1 February 2026, according to the Department for Government Programme, four of the six envisaged implementing decrees have been published in the Official Journal: three in April and one in August 2025. Two decrees, however, remain unadopted, without a defined deadline, relating to the methodology for estimating the staffing needs of the NHS and the national guidelines for a new system for canceling reservations and optimizing CUP diaries.
One year after the reassurances provided by Minister Ciriani during the question time of 5 February 2025, the decree on exceeding the spending ceiling for personnel is still stalled due to the lack of approval of the new Agenas methodology, while the one on the national guidelines for the CUP has not yet been scheduled for examination in the Conference of the Regions.
