ICSs need to implement an overall operational pressures escalation levels (OPEL) score to provide an ‘aggregated view’ of operational pressures across the system, according to a new framework.
Published this week, the OPEL framework 2024-26 set out a number of changes from the 2023/24 guidance, including revising the existing acute OPEL parameters and including actions to be taken in response to changes in operational pressures.
ICSs will need to use the scores for their acute, community health service (CHS), mental health (MH) services and NHS 111 providers to form an ‘overall ICS OPEL score’.
It said: ‘This provides an aggregated overview of the operational pressures across the ICS using a consistent scoring method, as well as an indication of the OPEL for each pillar.’
It added: ‘Compared to the OPEL framework 2023/24, this updated framework is an iterative step towards a whole ICS representation of system pressure.’
Acute trusts, CHS, MH and NHS 111 providers will now be required to submit data on OPEL parameters to their ICS which will then be passed onto NHS England for oversight.
ICSs will be required to monitor OPEL scores and when a provider escalates, they should enact the provider-specific actions for the corresponding operational level and review their own organisational operational level actions.
‘For example, if a CHS provider enters OPEL 4, the ICS should enact the specific ICS MH OPEL actions, review all other ICS OPEL 4 actions and consider enacting them as appropriate,’ the guidance said.
‘Additionally, if an ICS’s overall OPEL score reaches OPEL 3, it should implement all OPEL 3 actions, and the relevant NHS England region should also review and enact its OPEL 3 actions accordingly. Providers should continue to implement actions at their corresponding escalation level based on their OPEL scores.’
It comes as the General Practice Alert System (GPAS) aimed at mapping workload pressures in Devon, is being retired as it has not had the uptake nor impact GPs had hoped for.
Earlier this year ICBs were told to ensure patients with complex needs and long-term conditions were proactively identified and managed so that care is ‘optimised’ over winter.
Changes from the 2023/24 framework
- Comprehensive revision of the existing acute OPEL parameters, including their definitions, scores and weighting, to ensure they continue to give an accurate and reflective representation of current needs,
- Updated proportional representation for acute OPEL using the latest emergency department (ED) attendance data to accurately reflect the current proportionality,
- Introduction of 3 new pillars of OPEL, with new OPEL parameters for MH services, CHS and NHS 111 as well as the actions to be taken in response to changes in operational pressures within these pillars,
- Introduction of a process for OPEL score normalisation to provide consistent OPEL scoring across all pillars and organisations using OPEL,
- Implementation of an overall ICS OPEL score based on the parameter scores for the acute, CHS, MH and NHS 111 pillars. This provides an aggregated overview of the operational pressures across the ICS using a consistent scoring method, as well as an indication of the OPEL for each pillar,
- Updated actions for acute trusts, ICSs and NHS England regions to ensure they remain effective and aligned with the current and evolving operational requirements.
Source: NHS England
