health.waiting-time Unreviewed

def rtt_waiting_time(clock_start: str, clock_stop: Optional[str], on_date: str) -> RttWait

@dataclass(frozen=True)
class RttWait:
    """The length of an RTT pathway as NHS England reports it."""

    #: clockStop (or onDate while waiting) minus clockStart
    days: int
    #: whole weeks waited, days divided by 7 rounded down
    completed_weeks: int
    #: n of the reporting time band ">n-1 to n weeks": 0-7 days is 1, 126 days is 18; above 104 is the ">104 weeks" band
    week_band: int
    #: more than 126 days
    breached18_weeks: bool
    #: clockStart + 126 days, the last day still within 18 weeks
    eighteen_week_date: str
    #: whether clockStop was given
    clock_stopped: bool

from fune.health.waiting_time import rtt_waiting_time  # health.waiting-time@^1

from typing import Optional

from .dates_add_days import add_days, days_between, parse_iso_date  ← from dates.add-days ^1.0.0 · built alongside by fune
from .health_waiting_time_types import RttWait

#: 18 weeks: a wait of exactly 126 days is still within the standard.
_EIGHTEEN_WEEKS_DAYS = 126


def rtt_waiting_time(clock_start: str, clock_stop: Optional[str], on_date: str) -> RttWait:
    """The length of a referral-to-treatment pathway, counted from the clock
    start to the clock stop, or to ``on_date`` while the patient is still
    waiting. There are no pauses: NHS England removed them in 2015."""
    parse_iso_date(clock_start)
    parse_iso_date(on_date)
    if on_date < clock_start:
        raise ValueError("onDate %s is before clockStart %s" % (on_date, clock_start))
    if clock_stop is not None:
        parse_iso_date(clock_stop)
        if clock_stop < clock_start:
            raise ValueError("clockStop %s is before clockStart %s" % (clock_stop, clock_start))
        if clock_stop > on_date:
            raise ValueError("clockStop %s is after onDate %s" % (clock_stop, on_date))
    days = days_between(clock_start, clock_stop if clock_stop is not None else on_date)
    return RttWait(
        days=days,
        completed_weeks=days // 7,
        # The 0-1 week band holds eight days (0 to 7), every later band seven.
        week_band=1 if days <= 7 else (days + 6) // 7,
        breached18_weeks=days > _EIGHTEEN_WEEKS_DAYS,
        eighteen_week_date=add_days(clock_start, _EIGHTEEN_WEEKS_DAYS),
        clock_stopped=clock_stop is not None,
    )

Install

fune build

With that line in your source, in a Python project (language python in fune.project), fune build resolves it and its 1 dependency, pins them in fune.lock, downloads only the Python package of each, and builds the code above into your project’s .fune/build, one readable file per capability with a header linking back here. Or pin a range in fune.project and build in one step:

fune add health.waiting-time

The manifest, vectors and README with only the Python implementation. Install it without the registry with fune add ./health.waiting-time-1.0.1-python.fune, or fetch it from a terminal with fune pull health.waiting-time@1.0.1:python.

The whole function, every language, is one file too: health.waiting-time-1.0.1.fune, 17,626 bytes, sha256 07f74e0f2679def6b1c69bdf5b69be088b085710b9cb337bf662c9823b46f0b0. It installs into a project of any language.

# fune: before health.waiting-time

# fune: after health.waiting-time

# fune: replace dates.add-days in health.waiting-time

# fune: step health.waiting-time after <n|label>

More from the author

**Week bands.** RTT returns put each pathway in a weekly time band, ">n-1 to n weeks", and `weekBand` is that n. The first band, 0-1 weeks, holds eight days (0 to 7), every later band seven: 8-14 days is band 2, 120-126 days band 18, 127 days band 19. NHS England's last band is "104+ weeks", 729 days and more; `weekBand` keeps counting above 104 (729 days is 105) so a caller can still tell long waits apart, and a return should put anything above 104 in the >104 band. `completedWeeks` is simply whole weeks (days divided by 7, rounded down), for display. A clock that starts and stops on the same day is a real pathway of zero days.

**No clock pauses.** Earlier versions of the rules allowed "patient-initiated clock pauses". NHS England removed them in 2015 with the admitted pathway standard: "there is no longer any provision to report pauses or suspensions in RTT waiting time clocks ... under any circumstances". This capability therefore takes a clock start and an optional clock stop and nothing else, deliberately. Events that the rules do recognise are the caller's to apply:

- a clock stop (rules 4 and 5: first definitive treatment, a decision not to treat, active monitoring, a patient declining treatment, and so on) is the `clockStop` date; - a DNA of the first appointment nullifies the clock (rule 5e, footnote 10), and when the patient rebooks a new clock starts (rule 3e), so pass the rebooking date as a new `clockStart`; - other new clock starts (rule 3: a second bilateral procedure, a new treatment, the end of active monitoring) are likewise new pathways.

**Errors.** A measuring date before the clock start, a clock stop before the clock start, and a clock stop after the measuring date (a stop that has not happened yet) are errors. Dates are ISO `YYYY-MM-DD`, and the measuring date is always an argument, never the clock.

## Source

NHS England, "Recording and reporting referral to treatment (RTT) waiting times for consultant-led elective care", version 5.2, February 2025: section 2.2 reproduces the "Referral to treatment consultant-led waiting times rules suite" (clock starts, rules 1-3; clock stops, rules 4-5), the introduction records the removal of clock pauses, and section 10.1.7 "Measuring the length of RTT pathways" defines the time bands. https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2025/10/Recording-and-reporting-RTT-waiting-times-guidance-v5.2-Feb25.pdf

## Before you rely on this

**Not professional advice.** This capability calculates health figures from published rules. It is a software component for developers, not medical advice. Rules change and every rate here has an effective date. Check that the dates cover your case. Verify results against the official sources listed above, and have a clinician review how you use it, before anyone relies on the output. Provided "as is" under its licence, without warranty.

**Not a medical device.** It is not intended to diagnose, treat or support clinical decisions about any individual. Anyone building it into clinical software is responsible for that software's regulatory status, and must validate it under their own clinical governance.

**Unreviewed.** This capability's implementations agree in every language and pass its published test vectors, which were worked out from the official sources cited. But no qualified clinician has yet checked those vectors, or confirmed that the capability covers the cases it claims. Treat it as a draft. Do not use it for real people, money or decisions without your own expert review. Once a qualified reviewer signs off, this notice is replaced with their name, qualification and the date. Each new version needs fresh sign-off.

1.0.1 marks it unreviewed. The code and the tests are unchanged.

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