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Maximum waiting times, 2013 Maximum waiting time Denmark Finland 1993: Waiting times from GP or specialist referral to treatment: 3 months reduced to 2 months in 2002. 2007: 4 weeks independent of disease type or severity. Cancer (except cancer which require bone marrow transplantation, and skin cancer which is not melanoma): To surgery: 2 weeks from information about diagnosis and treatment possibilities. To medical treatment as primary treatment: 2 weeks from information about diagnosis and treatment possibilities and no later than 4 weeks from referral. To radiation treatment as primary treatment: 4 weeks from referral to radiation therapy has been received by the relevant hospital ward. To follow-up treatment: 4 weeks from referral to follow-up treatment has been received by the relevant hospital ward. Life-threatening cases: Cervical cancer: 2 weeks from referral to pre-examination. Ischemic diseases: By main stem disease: 2 weeks from when a referral with the diagnosis has been received by the specialised hospital. By documented unstable angina pectoris: 3 weeks to coronary arteriography and revascularisation from when the hospital has received the referral from a cardiological intensive ward. By angina pectoris immediately after a myocardial infarct: 5 weeks to coronary arteriography and revascularisation from when the hospital has received a referral from a cradiological intensive ward. No delay during weekday office hours for a health centre or health care unit or 3 working days from first contact if an assessment of the need for treatment cannot be carried out immediately. 3 weeeks for assessment of need for treatment for specialised medical care provided in connection with primary health care extended to 3 months if highly specialised consultation or special imaging or laboratory tests are necessary. Any treatment deemed necessary must then be provided within 3 months of the assessment extended by a maximum of a further 3 months in cases involving oral health care or specialised medical care provided in connection with primary health care. Ireland 1993: 12 months for adults and 6 months for children. 2001: 3 months for public patients. 2011: 12 months for elective surgery; 6 hours in Emergency Departments. 2012: 9 months for elective treatment in hospitals; 9 hours on a trolley. Italy 2002: Ambulatory care (60 days for five major diagnostic procedures and 30 days for eye and cardiology visits); oncology services (2 weeks for first visit; 30 days for surgical interventions, chemotheraphy and radiotherapy treatment); and 80 days for cataract surgery and hip replacement and 120 days for percutaneous transluminal coronary angioplasty. 2010-2012: Cardiovascular diseases Emergency treatment within 72 hours; 10 days for treatment that, if not promptly provided, may impact significantly on short term prognosis, pain, dysfunction or disability; and 30 days for treatment that is required owing to patient’s pain, dysfunction or disability. Oncology diseases: 3 days for urgent diagnostic priorities; 10 days for diagnostic priorities within a therapeutic programme; follow-up of patients already treated for neoplastic disease. Netherlands 2000: 4 weeks for first visit to a hospital’s outpatient clinic, diagnosis and medical assessment; 6 weeks for outpatient (day care) treatment; and 7 weeks for inpatient treatment. Page 1 of 4 Maximum waiting times, 2013 Maximum waiting time Portugal 14th May 2008 to present: Level of clinical priority P1 – Normal Group of pathologies General Cancer Obesity Maximum waiting time 270 60 270 P2 – Priority General Cancer Obesity 60 45 60 P3 – High priority General Cancer Obesity 15 15 15 P4 – Urgent General Cancer Obesity 3 3 3 Spain 180 days for specific surgical procedures (cataracts, cardiovascular, and hip and knee replacements). Sweden 1992-1995: 3 months from the physician’s decision to treat/operate. 2005: 24 hours for phone consultation with health centre; 7 days for a GP appointment if necessary; and 90 days for an appointment at a public or private hospital and from the decision to treat to treatment. 2009: 60 days for an appointment with a specialist. United Kingdom England: 1991: Inpatient treatment within 2 years (soon reduced to 18 months). 1998: “Ensure everyone with suspected cancer is able to see a specialist within 2 weeks of their GP deciding they need to be seen urgently and requesting an appointment for: all patients with suspected breast cancer from April 1999, and for all other cases of suspected cancer by 2000.” 2000: 3 months for outpatient appointment and 6 months for inpatient treatment. 2002: 3 months for inpatient and day case treatment; 4 hours in A&E from arrival to admission, transfer or discharge; within 24 hours for a primary care professional and within 48 hours for a primary care doctor. 2004: 18 weeks from GP referral to hospital treatment. 2010: Within 2 weeks from GP referral to a cancer specialist. 31 days from diagnosis to surgery for cancer and start of an anti-cancer drug regimen. 62 days from referral for suspected cancer to first treatment for all cancers. 2 weeks to see a specialist for all patients referred for investigation of breast symptoms. 3 months for patients who need a revascularisation. 2 weeks for Rapid Access Chest Pain Clinics. Access to a genito-urinary medicine clinic within 48 hours of contacting a service. All patients who have operations cancelled, on or after the day of admission (including the day of surgery), for nonclinical reasons to be offered another binding date within 28 days, or the patient’s treatment to be funded at the time and hospital of the patient’s choice. All ambulance trusts to respond to 75% of Category A calls within 8 minutes; 95% of Category A calls within 19 minutes; and 95% of Category B calls within 19 minutes. Page 2 of 4 Maximum waiting times, 2013 Maximum waiting time United Kingdom (cont.) Scotland: 1997-1998: 12 months. 2000: 9 months for inpatients; 12 weeks for angiography or 24 weeks for revascularisation; 2 months from urgent referral to treatment for all cancers (1 month for breast cancer). 2003-2011: Maximum waiting time between specialist decision to treat and inpatient/daycase treatment: 9 months by end December 2003; 6 months by end December 2005; 18 weeks by end December 2007; 15 weeks by end March 2009; 12 weeks by end March 2010; and 9 weeks by end March 2011. Maximum waiting time between referral and first specialist assessment as an outpatient: 6 months by end December 2005; 18 weeks by end December 2007; 15 weeks by end March 2009; and 12 weeks by end March 2010. Maximum waiting time from referral to treatment: 18 weeks by end December 2011. 2012: (GP) referral to treatment of 18 weeks. 9 weeks for hospital inpatient or day case treatment. 12 weeks for new outpatient appointments. 6 weeks for (8) key diagnostic tests. Coronary heart disease: 16 weeks from referral to cardiac intervention; and for outpatient specialist appointment to treatment. Cancer: 62 days for patients screened positive or with an urgent referral with a suspicion of cancer to treatment and 31 days from decision to treat to first treatment for all patients diagnosed with cancer. Cataract surgery: 18 weeks from referral by a GP or optometrist to cataract surgery. Accident and emergency: 4 hours between arriving at a Unit and admission, discharge or transfer. Addiction services: 3 weeks from referral received to appropriate drug or alcohol treatment. Primary care: 48 hour access or advance booking. Child and adolescent mental health services: 26 weeks referral to treatment, reducing to 18 weeks by December 2014. Psychological therapies: from 31 December 2014, 18 weeks referral to treatment for patients of all ages for psychological therapies. Norway 30 days from receipt of referral to decision to treat. Patients suitable for treatment given an individual maximum waiting time to start of treatment. If this waiting time is exceeded, 14 days for provision of treatment. 2002: Provide treatment within 2 years to all patients registered on the waiting list at the end of the first semester of 2002. 25th November 2004 to 14th January 2008: Level of clinical priority P1 – Normal Group of pathologies General Cancer Maximum waiting time 12 months 12 months P2 – Priority General Cancer 2 months 2 months P3 – High priority General Cancer 2 weeks 2 weeks P4 – Urgent General Cancer 3 days 3 days Page 3 of 4 Maximum waiting times, 2013 Maximum waiting time Australia 30 days. Patient’s health has the potential to deteriorate quickly. 90 days. Patient’s health not likely to deteriorate quickly. 365 days. Patient’s health unlikely to deteriorate quickly. Canada Hip and knee replacements within 26 weeks. Cataracts within 16 weeks for high-risk patients. Cardiac bypass surgery, from 2 to 26 weeks depending on urgency New Zealand 10 days to inform patient if they will be assessed by a specialist. 6 months from referral for first specialist assessment. 6 months for treatment (of patients accepted for treatment) or clinical review for patients not accepted for treatment but placed under “active” review. Source: Waiting Time Policies in the Health Sector: What Works?, OECD Health Policy Studies, 2013, pp. 52-54. Page 4 of 4