Breach Dates and Targets
The breach date is the single most important field on a waiting list entry. It tells your team the latest date by which a patient should be seen or admitted. Everything else — sorting, filtering, scheduling decisions, escalation — flows from it.
This page explains how breach dates and weeks waiting are calculated, what affects them, and how to read them on the waiting list view.
What is a breach date?
The breach date is the deadline. For an OPD (outpatient) list, it is labelled Appointment By — the date by which the patient should have their clinic appointment. For Inpatient and Day Case lists, it is labelled Admit By — the date by which the patient should be admitted for their procedure. On the list view both appear in the Breach Date column.
If today’s date passes the breach date and the patient has not been seen or admitted, the entry is considered breached. Breached dates are shown in red on the list view so your team can identify and act on them.
How the breach date is calculated
When dates are calculated automatically (the Manage dates manually: switch is off), the breach date comes from two things:
- The join date — the date the patient was added to the list, or the backdated date entered at that time.
- The target days — the maximum waiting time for the entry’s priority on that list.
The calculation is:
Breach date = Join date + Target days
For example, if a patient joins a list on 1 March with Routine priority and the list’s Routine target is 84 days, the breach date is 24 May.
Each list has a target for each of the three priority levels. The targets are set when the list is created and can be changed at any time (see Getting Started).
Priority levels
Each waiting list entry is assigned one of three priority levels. The priority determines which target is used to calculate the breach date.
| Priority | Meaning | Typical use |
|---|---|---|
| Urgent | The patient needs to be seen or admitted within the shortest timeframe. | Suspected serious pathology, time-critical procedures, rapid access referrals. |
| Soon | The patient’s condition warrants earlier review but is not immediately time-critical. | Symptomatic patients where delay may lead to deterioration or increased complexity. |
| Routine | Standard waiting time applies. | Elective referrals where there is no clinical urgency beyond the normal target. |
The number of days behind each priority level varies by list. There are no fixed rules — the targets should reflect the clinical and operational requirements of the service using the list.
Targets are in calendar days
Targets are entered and calculated as calendar days, including weekends and public holidays. There is no option to set targets in weeks or working days.
If your service policy is expressed in weeks, multiply by seven — 12 weeks is 84 days. If it is expressed in working days, convert it to an equivalent number of calendar days and bear in mind that the result will not skip public holidays.
What happens when targets change
Automatically calculated breach dates are worked out from the list’s current targets each time the list is displayed. If an administrator changes a target, every automatic entry at that priority moves to match — existing patients included, not just new ones.
For example, if the Routine target is reduced from 84 days to 70 days, every Routine patient on the list with automatic dates has their breach date brought forward by 14 days, and some may immediately show as breached.
Entries whose dates are managed manually are not affected by target changes.
Before changing a target on a list that is already in use, consider:
- Check the effect first. Filter the list by the affected priority and note how many patients are within 14 days of the new target.
- Protect patients who should keep their original date. If some existing patients must keep the date set under the old target, switch those entries to manual mode and enter the date before changing the target.
- Record the decision. The target change is a policy decision; note it wherever your service records such changes.
Manual mode
When Manage dates manually: is switched on for an entry, the automatic calculation is not used. The user enters the Appointment By Date and Admit By Date directly.
Manual mode is useful when:
- A clinician has specified a particular date by which the patient must be seen, and that date does not match the standard target calculation.
- The patient has been transferred from another list or service and their breach date should reflect their original waiting time, not the date they joined this list.
- The standard priority categories do not capture the clinical urgency and a specific date is more appropriate.
- An existing patient should keep their breach date when the list’s targets change.
Manual dates are shown and sorted in the same way as calculated ones, with two differences:
- They are not moved by suspensions. The date shown is exactly the date entered. If a manually managed patient is suspended, update the date by hand if the deadline should move.
- They are not changed by priority or target changes. Changing the priority on a manual entry does not alter its dates.
On an automatic entry, changing the priority recalculates the breach date using the new priority’s target.
On the list view, a small function icon next to the breach date shows that the date was calculated. Manual dates have no icon.
How suspensions affect the breach date
For automatically calculated entries, suspension pauses the waiting time clock. The breach date shown is moved forward by the number of days the entry has been suspended, preserving the patient’s window of active waiting time.
For example:
| Event | Date | Detail |
|---|---|---|
| Patient joins list | 1 March | Routine priority, target 84 days. Breach date is 24 May. |
| Entry suspended | 15 March | Patient is medically unfit. Clock pauses. |
| Entry resumed | 29 March | Suspension lasted 14 days. |
| Breach date adjusts | — | Breach date shown is 7 June (24 May + 14 days). |
If a patient is suspended more than once, the adjustments add up. A patient with two separate suspensions totalling 30 days has their breach date moved forward by 30 days.
The list view shows only the adjusted date; there is no separate marker for a suspension adjustment. To see why a date has moved, open the entry — the Suspensions table on the WL Entry section lists every suspension with its start and end dates.
The Appointment By and Admit By values in the WL Entry section show the date before any suspension adjustment, so they can differ from the Breach Date on the list for a patient who has been suspended.
Currently suspended entries
While an automatic entry is suspended, the days of the current suspension count towards the adjustment as they pass. The breach date shown moves forward by one day for each day the patient remains suspended, so the patient does not drift towards breach while their clock is paused.
When the suspension ends, the end date entered on the status change fixes the final length of that suspension, and the breach date stops moving.
Weeks waiting
The Weeks Waiting column shows how many whole weeks the patient has been actively waiting. Like the breach date, it excludes suspended time.
For most entries the calculation is:
Weeks waiting = (Today − Join date − Suspended days) ÷ 7, rounded down
Two patients who joined on the same date will show different weeks waiting if one of them was suspended. The patient who was suspended shows a lower number, because their clock was paused.
Weeks waiting is recalculated every time the list is displayed. It is not stored.
For entries with manual dates, only completed suspensions are deducted; the days of a suspension still in progress are not deducted until it ends.
Review patients: Last Attended and Review Due
Some patients are seen and then need to wait again — for a review, a follow-up or a further decision. Counting their wait from the original join date would overstate how long they have been waiting since they were last seen. The Review panel on the entry’s edit form handles this with two optional dates.
Last Attended Date
When a Last Attended Date is set, Weeks Waiting counts from that date instead of the join date:
Weeks waiting = (Today − Last attended date − Suspended days since last attended) ÷ 7, rounded down
Only suspension days that fall after the last attended date are deducted, including any suspension still in progress. Suspensions from before the patient was seen no longer count.
On the list view, a rotate icon appears next to Weeks Waiting for these entries; hover over it to see the date being counted from. The WL Entry section shows the date under Last Attended:, and labels Weeks Waiting since last attended rather than since joined.
Setting a Last Attended Date does not change the breach date, the targets or the join date. The referral clock and the review clock are separate. The breach date continues to reflect the original referral; Weeks Waiting reflects the current wait.
Review Due Date
The Review Due Date is a second deadline, used as a warning for when the review should take place. It does not change the breach date or the Breach Date column.
The WL Entry section shows it under Review Due: with the number of days remaining — for example (in 12 days) — or, once the date has passed, in red with (overdue).
Rules for the review dates
The review dates are only available when editing an existing entry, not when adding one. Diarybook will not save them if:
- the Last Attended Date is in the future
- the Last Attended Date is before the Join Date
- the Review Due Date is before the Last Attended Date
Clearing the Last Attended Date returns Weeks Waiting to counting from the join date.
Breach detection
Breach status is calculated automatically and does not need to be set manually. It depends on today’s date relative to the breach date, so an entry can move into breach simply through the passage of time if no action is taken.
When reviewing a list, the combination of breach status, weeks waiting and priority gives your team a clear picture of urgency. A breached Urgent entry needs immediate attention. A Routine entry approaching its breach date is a prompt to schedule before it crosses the line.
Summary of key principles
The breach date is the deadline your team works against. The list view is designed to make it easy to see who is closest to that deadline and who has already passed it.
Automatic mode handles the common case. For most entries, the join date plus the target for the patient’s priority gives the correct breach date with no manual work.
Automatic dates follow the list’s current targets. Changing a target moves the breach date of every automatic entry at that priority. Use manual mode for entries that must keep a fixed date.
Manual mode handles exceptions. A manual date is exactly what was entered. It is not moved by suspensions, priority changes or target changes.
Suspensions pause the clock, not the entry. For automatic entries, the breach date shown moves forward by the time suspended, including a suspension still in progress.
Review patients have their own clock. A Last Attended Date restarts Weeks Waiting from when the patient was last seen, and a Review Due Date adds a warning deadline, without changing the breach date.
Related
- Getting Started — creating a list and setting its targets.
- Adding and Managing Clients — the list view columns and editing an entry.
- Status and Suspensions — suspending and resuming entries.