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NHS England to include GPs in OPEL framework over the next year

NHS England to include GPs in OPEL framework over the next year
By Anna Colivicchi and Sofia Lind
31 July 2023

NHS England will work towards incorporating general practice in the ‘OPEL’ system pressures framework over the next year, our sister title Pulse can reveal.

Winter plan documents published yesterday instructs ICBs to ensure tools are in place to’ understand demand, activity and capacity in primary care’, including operational pressures escalation levels (OPEL) reporting.

NHS England has told Pulse that it will work to incorporate primary care in the Opel Framework over the next year, but that in the short term it expect systems to have tools in place to understand primary care pressures.

‘This should be shared across the system to give a comprehensive view of primary care pressures and where support may be required that could alleviate pressure on primary care and on the [urgent and emergency care] pathway,’ a letter to ICSs from NHS England chair Amanda Doyle said.

GP Alert System

The news comes as LMCs have been leading the development of the General Practice Alert State (GPAS) with the aim of escalating ‘black status’ reports to NHS leaders.

This would be equivalent to OPEL level 4 in hospitals – a situation when pressure means organisations are unable to deliver comprehensive care and patient safety may be compromised.

Currently, 40 LMCs led by Devon LMC are collecting GPAS data from their practices and 20 more are rolling out the system, with the first national report published at the beginning of July.

Pulse understands that 60% are reporting red or black alerts indicating unsustainable pressure and 80% are reporting levels of patient contacts roughly double or more the level general practice is funded to deliver.

Meanwhile, winter plan measures, set out at the NHS England board meeting in Birmingham yesterday, will ‘boost capacity and resilience’, according to the commissioner – although they include no additional funding for general practice.

It said that to assist system working this winter, next week they will also be publishing an updated OPEL Framework to ensure ‘we are taking a consistent and co-ordinated approach to managing pressures across all systems’, but Pulse understands this will not include primary care yet.

The winter plans also included a nationwide rollout of ‘care traffic control centres’ to provide ‘one stop’ for staff to locate and co-ordinate discharge options for patients, expanding the use of Acute Respiratory Hubs, extra hospital beds and strengthen ambulance response to mental health calls.

It also included a new scheme to encourage trusts to ‘overachieve’ on performance measures with financial incentives provided for these areas.

The funding announced as part of the plan included:

  • £1b of dedicated funding to support capacity in urgent and emergency services, building on the £500m used last winter.
  • £250m worth of capital investment to deliver additional capacity.
  • £200m for ambulance services to increase the number of ambulance hours on the road.
  • Together with DHSC, an additional £1.6bn of discharge funding over 2023/24 and 2024/25, building on the £500m Adult Social Care Discharge Fund.

However, GPs have raised concerns about the lack of extra funding to support general practice within these plans.

Dr Steve Taylor, GP spokesperson for the Doctors’ Association, told Pulse that the lack of funding for general practice in the plan was ‘concerning’.

He said: ‘It is known that many attend for “emergency” treatment at A&Es because of lack access to non-urgent GP appointments.

‘With GPs already providing two million extra appointments a month, on top of the 1.3 million a day, it doesn’t take many unable to get an appointment to overwhelm A&E departments.

‘The Government need to recognise that GPs need more support not less, particularly as over 10% of the population are now waiting for hospital  treatments, some of which is urgent.

‘Winter pressures will have a greater effect on primary care and funding here will be more cost effective, helping to prevent urgent care being overwhelmed.’

RCGP chair Professor Kamila Hawthorne told Pulse: ‘Last winter was one of the most difficult the NHS has ever experienced, and our own college surveys warned that without urgent action, this coming winter would be even worse.

‘GPs and our teams deliver a vast amount of patient contacts for the NHS and play an absolutely crucial role over the winter period.

‘If the government wants to ensure that patients can access GP services this winter, it will need to create a plan that ensures primary care can cope with the seasonal surge in demand.’

Last year, also NHS England provided ‘no additional’ winter funding to support GPs.

And yesterday, GPs warned of ‘intense workload and workforce pressures’ as practices have offered millions of appointments more per month than in 2019, despite the number of GPs continuing to fall.

This story first appeared on our sister title, Pulse.

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