Useful documents, links and information

Operational Pressures Escalation Levels (OPEL) Framework and Action Cards

• OPEL Framework – HTV
• OPEL 2 Action Card
• OPEL 3 Action Card
• OPEL 4 Organisational Action Card
• OPEL 4 System Action Card

Onward Care

• Onward Care Procedure

Training

• On Call Training For Winter Preparedness

Mental health

• Case studies – Mental health and A&E pressures

National winter letters

National dashboards

• National AE Dashboard user guide
• The long stays dashboard
• Shrewd

Escalation triggers based on Trust ED Performance

Acute Trusts will continue to report daily to NHS England. The following have been identified as key measures that will trigger intervention from the Programme Management Office (PMO):

• An A&E 4 hour performance of less than 95%, but there will be a particular focus on trusts whose performance is below 85% for the previous day.
• Deterioration of A&E performance of more than 10% compared with the same day 6 week average,
• Ambulance delays where more than five have been delayed for more than 60 minutes.
• One or more 12 hour breach in A&E.
• An increase in beds closed due to D&V by 20 beds from one day to the next.
• In addition, any major patient safety incidents worthy of discussion at a national level will be highlighted.