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 are calculated, what affects them, and how to read the information displayed 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.
If today’s date passes the breach date and the patient has not been seen or admitted, the entry is considered breached. Breached entries are highlighted on the list view so your team can identify and act on them immediately.
How the breach date is calculated
When a patient is added to a waiting list in automatic mode, the breach date is calculated 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 patient’s priority level on that list.
The calculation is straightforward:
Breach date = Join date + Target days
For example, if a patient joins a list on 1 March with a Routine priority and the list’s Routine target is 84 days (12 weeks), the breach date is 24 May.
The target days are determined by the waiting list’s configuration — each list has a target for each of the three priority levels. These targets are set when the list is created and can be customised at any time (see Getting Started with Waiting Lists).
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 actual number of days, weeks or working days behind each priority level varies by list and is set in the list’s target configuration. There are no fixed rules — the targets should reflect the clinical and operational requirements of the service using the list.
Target units
Targets can be expressed in three units:
| Unit | How it counts |
|---|---|
| Days | Calendar days from the join date, including weekends and public holidays. |
| Weeks | Converted to calendar days (1 week = 7 days) for the purpose of calculation. |
| Working days | Weekdays only, excluding Saturdays, Sundays and public holidays. |
The unit is set at the list level and applies to all three priority targets on that list. Most services use weeks or calendar days. Working days are used where service policy is expressed in those terms — for example, “patients should be seen within 10 working days of referral.”
When the target unit is working days, the breach date calculation skips weekends and public holidays. This means two patients joining on different days of the week with the same target may have breach dates that differ by more than you might expect — a patient joining on a Friday has their first two working days on the following Monday and Tuesday, while a patient joining on a Monday starts counting immediately.
What happens when targets change
When an administrator updates the target days on a waiting list, the change applies to new entries only. Patients already on the list retain the breach date that was set when they were added.
This is deliberate. If a Routine target is reduced from 12 weeks to 10 weeks, existing patients should not suddenly find themselves closer to breach through no fault of their own — their breach date was set under the previous policy and should be honoured. The new target governs how breach dates are calculated for patients added from that point forward.
Manual mode
When a patient is added to a waiting list with Manage Dates Manually enabled, the automatic calculation is bypassed. Instead, the breach date is entered directly by the user.
Manual mode is useful when:
- A clinician has specified a particular date by which the patient must be seen, and that date does not align with 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 adequately capture the clinical urgency and a specific date is more appropriate.
In manual mode, the breach date behaves exactly as it does in automatic mode for the purposes of display, sorting, breach detection and suspension adjustment. The only difference is how it was originally set.
If the priority is changed on an entry that is in automatic mode, the breach date is recalculated using the new priority’s target. On a manual entry, changing the priority does not alter the breach date — it must be updated by hand if needed.
How suspensions affect the breach date
When a waiting list entry is suspended, the waiting time clock pauses. The breach date shifts forward by the number of days the entry was suspended, preserving the original 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 | — | New breach date is 7 June (24 May + 14 days). |
The stored breach date — the one originally calculated or manually entered — does not change. It remains 24 May in the example above. What changes is the displayed breach date, which is the stored date adjusted forward by the total number of suspended days. This distinction matters: the stored date represents the original clinical intent, while the displayed date represents the current operational deadline.
If a patient is suspended more than once, the adjustments are cumulative. A patient with two separate suspensions totalling 30 days will have their displayed breach date shifted forward by 30 days from the stored date.
The adjustment indicator
When a suspension has caused the displayed breach date to differ from the stored date, an indicator appears alongside the date on the list view. This tells your team at a glance that the date they are seeing has been adjusted.
Hovering over or clicking the indicator shows the original stored date and the total number of suspended days, so the adjustment is always transparent.
If an entry has never been suspended, no indicator is shown and the displayed date matches the stored date exactly.
Currently suspended entries
While an entry is actively suspended, the displayed breach date reflects the completed suspension days accumulated so far. It does not continue to drift forward day by day during the suspension. When the suspension ends and the entry is resumed, the final suspension duration is calculated and the breach date adjusts accordingly.
This means the breach date shown for a currently suspended entry represents the deadline as it stood when the suspension began, adjusted for any prior suspensions. It will update once the current suspension is closed.
Weeks waiting
The Weeks Waiting column on the list view shows how many weeks the patient has been actively waiting. Like the breach date, this figure excludes suspended time.
The calculation is:
Weeks waiting = (Today − Join date − Total suspended days) ÷ 7
This means two patients who joined on the same date will show different weeks waiting if one of them was suspended for a period. The patient who was suspended will show a lower number, reflecting the fact that their clock was paused.
Weeks waiting updates automatically each day. It is a display value and is not stored — it is always derived from the join date and the suspended days total.
Breach detection
An entry is considered breached when today’s date has passed the displayed breach date (the stored date adjusted for suspensions). Breached entries are visually highlighted on the list view so they stand out during scheduling.
Breach status is also calculated automatically and does not need to be set manually. It is a property of the current date relative to the breach date — an entry can move into breach simply by 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 demands 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. Everything on the list view is designed to make it easy to identify 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 intervention.
Manual mode handles exceptions. When the standard calculation does not fit, the breach date can be set directly without losing any of the other waiting list functionality.
Suspensions pause the clock, not the entry. The patient stays on the list, the stored breach date stays as it was, and the displayed date shifts forward to reflect the time that was paused. The indicator makes the adjustment visible and transparent.
Targets are snapshotted, not live-linked. Changing the target on a list affects new entries only. Existing entries are not retrospectively recalculated, protecting patients from policy changes that would shorten their available window.