Useful documents, links and information

Operational Pressures Escalation Levels (OPEL) Framework and Action Cards

Onward Care


Mental health

National winter letters

National dashboards

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.
Where performance has triggered one indicator PMO to discuss with ICS lead
Where performance has triggered two indicators Regional Director to contact ICS lead
Where performance has triggered three or more indicators Regional Director to contact Trust CEO