Introducing OPEL: a new way to understand winter pressures

This year, a new system has been introduced which permits a little more analysis of the operational pressures facing NHS hospitals in winter | Nuffield Trust Blog

Trusts have been required to record any days on which they have reached any of four different Operational Pressures Escalation Levels, known as OPELs. OPEL 1 involves ‘meeting anticipated demand within available resources’, and OPEL 2 denotes a trust ‘starting to show signs of pressure’. Levels 3 and 4 correspond more closely to the old terms such as ‘black alert’ or ‘major incident’.

So far this winter we have had data published since the start of December, allowing us to get a sense of how the NHS is coping with the considerable pressures it is facing. While it may be too soon to tell how winter 2016/17 is affecting the running of NHS hospitals, a look at the OPEL data does offer us an early clue.

The figures published by NHS England for the period 1-27 December show that:

• Around a third (50) of the 152 trusts that sent data into NHS England declared an OPEL 3 or 4. Of those, seven were OPEL 4s.
• In total, 201 OPEL 3 or 4s were declared between 1-27 December, of which 15 were OPEL 4s.
• The start of the weeks of the 12th and 19th of December saw two peaks in number of trusts at OPEL 3 and 4.
• The worst day in this period was Tuesday 13 December, with 23 trusts at the highest levels, including four at OPEL 4.

Image source: Nuffield trust

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