Waits, second opinions and treatment gaps

You will come away knowing your real options when the system is slow or disagrees with your existing care.

Start with "What the national waiting-time guarantee actually promises". It shows which procedures have a guaranteed maximum wait and what happens when that wait is missed. From there, move to whichever situation matches yours:

• Paying privately for a diagnosis while you stay on the public list.
• Keeping your place in line when you move to another region.
• Getting a second opinion or reaching a reference hospital.
• Responding when Spain will not continue a treatment that was working.

Key rules

• Maximum wait: The national guarantee covers only a short list of scheduled surgeries, with a maximum wait of 180 calendar days.
• Private care and your place: Paying privately for tests or a consultation does not remove you from the public list, and it does not change your order on it.
• Not covered: First specialist consultations and diagnostic tests have no national guaranteed wait.
• Private results: Public specialists decide whether to accept your private results, and they may repeat the tests.
• Place in line: Your waiting-list position and registration date do not transfer between regions.
• New referral: Your new GP issues a fresh referral, and your wait runs from that date.

Waits, second opinions and treatment gaps: the whole process, step by step

From first wait to treatment gap

• Get entered on the surgical waiting list and learn which guarantee applies to you (read: What the national waiting-time guarantee actually promises): when the specialist indicates surgery; the guarantee clock starts once you are entered on your region's list

• Check whether your operation is on the national short list, with a maximum wait of 180 calendar days: as soon as you are on the list; your region may set a shorter time or add procedures

• Use private tests or a consultation if you want faster answers, knowing it does not change your place on the public list (read: Paying privately for a diagnosis while staying on the public list): any time while you wait

• If the maximum wait is passed, ask the health service to offer the operation at another centre at no cost to you: once the maximum wait is exceeded; each region sets how the offer is made

• If you move to another region, get entered on the new region's list and learn its guarantee (read: Does your place in line survive a move to another region?): as soon as you move; the guarantee clock restarts under the new region's rules once you are on its list

• Ask for a change of doctor, talk to the patient service, or request a second opinion (read: Getting a second opinion or reaching a reference hospital in Spain): when you disagree with a clinical decision; second-opinion rights for serious conditions exist in some regions

• File a formal complaint, and go to the regional ombudsman if it stays unresolved: after the patient service; the written answer comes within your region's deadline

• Bridge a treatment gap by bringing your existing medicine, with original packaging and a prescription or doctor's letter naming the active ingredient and dose (read: What to do when Spain won't continue a treatment that was working): before you travel; non-EU arrivals can usually bring up to about 3 months of supply, and medicines with narcotics need extra documents

• Get a Spanish prescription to continue the supply: before the medicine you brought runs out

• Challenge a refusal to fund a treatment: ask your doctor and the hospital pharmacy committee to review it, then appeal to the regional health authority: appeal normally within 1 month of the written decision

• Go to the contentious-administrative courts if the appeal fails: generally within 2 months of the decision

Documents you may need

Identity and residence

• Your ID or NIE — Does your place in line survive a move to another region?
• Your empadronamiento certificate — Does your place in line survive a move to another region?

Other documents

• Your social security number or affiliation document — Does your place in line survive a move to another region?
• Your previous health card — Does your place in line survive a move to another region?
• Your medicine in its original packaging — What to do when Spain won't continue a treatment that was working
• Your prescription or a letter from your doctor naming the active ingredient — What to do when Spain won't continue a treatment that was working
• Your private diagnostic reports and test results — Paying privately for a diagnosis while staying on the public list
• The clinical report and pending-procedure documents — Does your place in line survive a move to another region?
• Copies of your earlier referral and the surgical indication — Does your place in line survive a move to another region?
• The written report from the private or foreign specialist who gave your second — Getting a second opinion or reaching a reference hospital in Spain

Waits, second opinions and treatment gaps: questions that cross several articles

Does paying for a private operation get me my money back if the public wait is too long?

No, the national guarantee does not give a right to reimbursement for care you arrange privately yourself. If the maximum wait is exceeded, the health service must instead offer the operation at another centre, public or contracted private, at no cost to you. Read "What the national waiting-time guarantee actually promises" for the detail.

Is my region's maximum wait the same as the national one?

Not always, because some regions set shorter times or cover more services than the national short list. The national list has a maximum of 180 calendar days, and no region can set a longer one for it. Read "What the national waiting-time guarantee actually promises" and ask your region's health department for its own list.

If I move to another region, does my guarantee clock carry over?

No, the guarantee clock restarts under the new region's rules once you are entered on its list. No national rule carries it across regions. Read "Does your place in line survive a move to another region?" for records and treatment.

Does the clock keep running if I delay or turn down an offer?

Not always, because the clock can be paused or stopped when the delay is due to you, such as refusing a reasonable offer, or when clinical reasons require postponing surgery. Each region defines the causes. Read "What the national waiting-time guarantee actually promises" before you decline an offer.

Where do I start if I disagree with a doctor and want to challenge a funding refusal too?

Start with a change of doctor, the patient service or a second opinion, and use a formal appeal for a funding refusal. Appeals normally run within 1 month of the written decision. Read "Getting a second opinion or reaching a reference hospital in Spain" and "What to do when Spain won't continue a treatment that was working".