NHS England will work towards incorporating general practice in the ‘OPEL’ system pressures framework over the next year.
Winter plan documents published last week instruct 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 told our sister publication Pulse that it will work to incorporate primary care in the Opel Framework over the next year, but that in the short term, it expects 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.
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 reported 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, the winter plan set out at the NHS England board meeting in Birmingham last week will ‘boost capacity and resilience’, according to the commissioner – although they include no additional funding for general practice, which was also the case last year.
It said that to assist system working this winter, they will be publishing an updated OPEL Framework to ensure ‘we are taking a consistent and co-ordinated approach to managing pressures across all systems’.
It is thought to be unlikely that this will 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 strengthening ambulance response to mental health calls.
And it included a new scheme to encourage trusts to ‘overachieve’ on performance measures with financial incentives provided for these areas.
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, said that the lack of funding for general practice in the plan was ‘concerning’.
He said: ‘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.’
RCGP chair Professor Kamila Hawthorne said: ‘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.
‘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 week, 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.
A version of this story first appeared on our sister publication Pulse
