The Arnau de Vilanova and Santa Maria hospitals in Lleida are set to launch a clinical integration process, which includes the establishment of a single waiting list and the joint management of human resources. As first reported by Segre, this measure aims to coordinate the clinical workflows of the city’s two main hospital centres, eliminating administrative duplication and optimising the allocation of diagnostic tests and scheduled surgeries. This operational reform does not alter the public status of the facilities, which remain under the jurisdiction of the regional government and the Institut Català de la Salut (ICS); however, it restructures their internal management to enhance the efficiency of patient care in Lleida.

New common governance structure

The core of this integration is the implementation of a shared governance framework across both hospitals. Until now, the Arnau de Vilanova and Santa Maria hospitals managed their staff independently, resulting in two parallel structures for recruitment, training and shift planning. The new directive will unify human resources management under a single strategic command.

This decision directly impacts healthcare professionals working at both sites. The joint management of human resources means that decisions regarding shift allocation, leave entitlements and professional development will be made at a joint negotiation table. The managers’ stated objective is to prevent conflicts over the allocation of high-demand specialists, such as radiologists and surgeons, who have previously been distributed between the two hospitals based on the prevailing clinical pressures at any given time.

It is crucial to clarify that this integration does not entail the legal merger of the entities. The Arnau de Vilanova Hospital and the Santa Maria Hospital will remain distinct legal entities under the jurisdiction of the regional administration. Operationally, however, they will function as a single body. The objective is not to establish a new commercial company or to privatise services, but rather to align internal management processes to enhance the efficiency of the public health service in the county capital.

Unified waiting list: a prioritisation mechanism

The most visible change for patients will be the unification of the waiting list. Currently, a patient requiring a diagnostic test or surgical procedure may face varying wait times depending on the centre they attend, even if both hospitals offer the same service. The new unified list will consolidate these records into a common database.

The operational mechanism will prioritise appointments based on clinical urgency and actual resource availability. By operating with a single list, the appointment management system will assign the first available technical slot, regardless of which of the two centres provides it. This measure eliminates the scenario in which one hospital has idle capacity while the other accumulates a backlog of patients awaiting the same treatment.

For residents of Lleida, appointments will be allocated based on medical priority and technical availability, rather than the geographical location of the hospital or the original referral. If Hospital Santa Maria has a slot available for an MRI scan while the Arnau does not, the new system will assign the Santa Maria slot to the patient. The objective is to reduce disparities in response times and ensure more efficient care across the city.

Impact on workforce management

The shared management of human resources represents a significant shift in operational structure. The management of clinical staff constitutes one of the primary costs and areas of complexity for hospitals. The new structure will enable the human resources departments of both centres to operate under a single strategic direction, facilitating long-term planning of staffing needs.

Should an increase in demand for emergency services be anticipated, the joint leadership can redistribute nursing or medical staff between the two hospitals according to the actual needs of each shift. This mechanism allows for a more agile response to demand peaks without the need to process complex internal transfers or await separate recruitment processes.

Furthermore, this measure impacts industrial relations and collective bargaining. With a common leadership structure in place, trade union representatives and management will negotiate from a unified position. The aim is to simplify the resolution of labour disputes and ensure a homogeneous application of working conditions across both centres, thereby reinforcing the stability of public sector jobs.

Administrative dependence and funding model

It is necessary to clarify that this operational integration does not supersede the regional administration or the Catalan Health Institute (Institut Català de la Salut, ICS). Both hospitals remain under the jurisdiction of this body, and the funding mechanism continues to be governed by the regional healthcare framework. The reform is strictly organisational in nature.

The ICS retains clinical and strategic oversight of the facilities. The new joint governance structure functions as an intermediate management layer designed to optimise resource allocation between the two hospitals in Lleida. The regional administration remains the entity responsible for financing services and setting general healthcare policy. The integration aims to enhance the implementation of these directives through tighter local coordination.

This approach enables the healthcare administration to maintain control over health policy while delegating the operational optimisation of resources to local managers. For users, services remain public and funded by the healthcare system, but with coordinated management aimed at minimising waiting times and improving continuity of care.

Implementation phases and next steps

According to available information, the implementation of this new governance structure and single waiting list is currently in the preparatory phase. Exact effective dates have not been published, although the process requires the adaptation of appointment management IT systems and the restructuring of human resources departments.

The management teams of both hospitals, working in coordination with the ICS directorate, must define the operational protocols governing the new single waiting list. This entails establishing prioritisation criteria, integrating patient databases and training administrative staff in the new working system.

Implementation will proceed on a phased basis, allowing for error correction and operational adaptation before the single list is rolled out on a large scale. The efficacy of the measure will be monitored by the citizens of Lleida, who will see the first results reflected in waiting times for scheduled tests and treatments. Transparency in communicating these operational changes will be key to building confidence in the new municipal healthcare management model.