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Waiting lists in Italy: the physician's role and how AI can help

5 June 20268 min readClinovus AI Team

In the first four months of 2026, out of approximately 12 million bookings monitored by the new AGENAS national platform, almost 2 million specialist visits and diagnostic exams were delivered outside guaranteed timeframes.[1] The day before, on 4 June, the European Commission published its 2026 Country Report on Italy with a clear warning: "almost one in ten Italians gave up necessary care in 2024, mainly due to waiting times".[2] Waiting lists are not an abstract problem — they are the most visible symptom of a structural crisis. And the GP is at the centre of it.

2026 data: real improvements, unresolved problem

NHS waiting lists — AGENAS national platform, first quarter 2026 First specialist visits within time 78.7% 76.1% (2025) Diagnostic exams within time 84.7% 83.0% (2025) Gastroenterology urgencies met 59.9% 55.2% (2025) Physical medicine urgencies met 62.5% 58.1% (2025) ⚠ 1.5M first visits + 900K exams = 2.4 million services outsid Source: AGENAS — National waiting list platform, Jan.–Apr. 2026 data. 12 million bookings monitored.
Percentage of NHS services delivered within guaranteed timeframes — 2025 vs 2026 comparison

The improvement is real — but must be read correctly. Compliance percentages are rising, but on a volume of 12 million bookings even a 15-20% delay margin represents millions of people waiting. And urgencies still show worrying performance: urgent gastroenterology visits meet timeframes in only 59.9% of cases.[1]

Causes and what physicians can do

Waiting lists: structural causes and intervention levers for physicians Structural causesPhysician leversStaff shortage5,700 GPs missing (GIMBE)Prescribing inappropriatenessToo many non-urgent prescriptionsassigned to wrong priority classesClosed or opaque bookingCUP not updated,slots not released in timeRegional disparitiesSouth and islands withstructurally lower performanceGP–specialist teleconsultationAvoids specialist visitfor many clinical questionsRAO criteria in management softwareAI suggests correct prioritycode at prescriptionAI-assisted appropriatenessAnalysis of diagnostic queries(AGENAS 2026 proposal)
Waiting lists: causes and intervention levers — general practitioner perspective

The AGENAS AI proposal — May 2026

In presenting the new Cruscotto 2.0, AGENAS explicitly cited AI analysis of diagnostic queries as a lever for improving prescribing appropriateness.[4] The goal is to integrate RAO criteria into GP management software with algorithmic suggestions at the point of prescription — reducing inappropriate bookings that saturate CUPs with P codes when D or B would be more appropriate.

The shortage problem: 5,700 missing GPs

According to the GIMBE Foundation, Italy is missing over 5,700 general practitioners relative to actual need.[3] For physicians in practice, this means a growing care burden: more patients, more prescriptions, more documentation.

In this context, every minute saved on documentation is a minute that can be dedicated to the patient. A GP managing 1,500 patients who saves just 30 minutes daily on documentation through dedicated AI tools devotes those extra 30 monthly hours to clinical activity — equivalent to 60-90 additional visits per month.

The response to waiting lists is not only structural — it is also individual. Every physician who prescribes appropriately, uses teleconsultation to avoid an unnecessary specialist visit, and frees up time from documentation to spend more time with patients, concretely contributes to the system.

See also our articles on telemedicine in Italy in 2026, on automatic SOAP notes and on GDPR requirements for medical AI.

Frequently asked questions

How can a GP contribute to reducing waiting lists?

General practitioners have a fundamental role on three fronts. First: prescribing appropriateness — prescribing with the correct priority code (U, B, D, P) and precise diagnostic queries reduces the number of inappropriate bookings saturating CUPs. Second: teleconsultation with specialists — many clinical questions that generate a specialist visit request can be resolved through direct teleconsultation, without taking up a slot. Third: follow-up management — properly organising chronic patient monitoring with telemedicine tools reduces demand for in-person visits.

What does the European Commission's 2026 Country Report say about Italy?

The Country Report 2026, published on 4 June, depicts an Italian healthcare system still capable of good health outcomes, but with growing structural weaknesses: almost one in ten Italians gave up necessary care in 2024, mainly due to waiting times. The report flags shortages of nurses, GPs and specialists, deep North-South divides, and rising out-of-pocket spending (families increasingly pay privately to bypass waiting lists). Italy is cited as a case where deteriorating access to care risks compromising long-term health outcomes.

What are RAO codes and why do they matter for waiting lists?

RAO (Raggruppamenti di Attesa Omogenei) is a standardised system that assigns each diagnostic query a priority code (U=urgent within 72h, B=short within 10 days, D=deferrable within 30 days, P=scheduled within 120 days). AGENAS has identified that in some central and southern regions an excessively high proportion of prescriptions is classified as P (non-urgent), artificially extending lists. Integrating RAO criteria into physicians' management software — with algorithmic suggestions at the point of prescription — is one of the proposed solutions for prescribing appropriateness.

What is AGENAS's Cruscotto 2.0?

Cruscotto 2.0 is the new online platform presented by AGENAS in late May 2026 that allows real-time consultation of regional waiting list data with a colour system: green for services delivered within timeframes, yellow for those approaching deadlines, red for those beyond limits. It is based on over 65 million bookings collected between 2025 and 2026. The goal is to achieve interoperability with all 21 regional platforms by end 2026, with automatic updates from regional CUPs.

Sources and references

  1. AGENAS — National waiting list platform (May 2026). 1.5M first visits + 900K exams outside time, Q1 2026. First visits: 78.7% on time (+2.6pp). Exams: 84.7% (+1.7pp). quotidianosanita.it
  2. European Commission — Country Report Italy 2026 (4 Jun. 2026). Almost 1 in 10 Italians gave up necessary care in 2024. GP and specialist shortage, North-South divides, rising out-of-pocket spending. confederazionecgs.it
  3. Fondazione GIMBE (2026). Italy is missing over 5,700 general practitioners relative to need. tg24.sky.it
  4. Quotidiano Sanità (May 2026). AGENAS: AI analysis of diagnostic queries and RAO criteria integration in management software among solutions for prescribing appropriateness. quotidianosanita.it
Note: this article is for informational purposes. Data cited comes from official AGENAS, GIMBE and European Commission sources.

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