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Nuffield Trust: A third of trusts declare ‘major pressures’ in December

Pressure on NHS services was so intense in December that one third of NHS trusts warned it was affecting patient care, according to analysis by the Nuffield Trust.

Under new measurements introduced in 2016, trusts are required to record their pressures using Operational Pressures Escalation Levels (OPELs).

At OPEL 3, local health and social care systems report ‘major pressures compromising patient flow’. OPEL 4 is reached when the pressure is so intense that organisations are “unable to deliver comprehensive care”.

Analysis of NHS England figures by the Nuffield Trust has revealed that between 1 and 27 December, 50 out of 152 trusts declared an OPEL 3 or 4.

In total, there were 201 incidents, of which 15 were OPEL 4. The worst day in this period was 13 December, with 19 OPEL 3 and four OPEL 4 cases.

Kettering General Hospital and Peterborough General Hospital are among those urging patients not to use A&E except for in a genuine emergency to try to ease the pressures.

In December 2015, before OPELs were introduced, there were 105 incidents of trusts declaring ‘serious operational problems’, confirming fears that the NHS is facing a substantially greater struggle this year compared to last year.

Nigel Edwards, the chief executive of the Nuffield Trust, warned that the situation could get worse in the next couple of months.

“The real pressures usually start to show as winter gets into full swing later this month,” he said. “But an early look at the OPEL data shows that winter is most certainly here and already tough across the NHS.”

However, Edwards pointed out that the purpose of the OPEL system is to flag up problems early, so if the system works as designed, there will be less OPEL 3s and 4s in January.

In November, the Health Select Committee predicted that the NHS would face “unprecedented” pressures this winter.

Dr Taj Hassan, president of the Royal College of Emergency Medicine, agreed, telling Radio 4’s Today programme this morning that the NHS had entered this winter “in the worst state of affairs possible”.

Dr Hassan added that he had met with Simon Stevens, the chief executive of NHS England, to discuss emergency social care funding to help relieve the pressures.

In response to complaints that funding shortfalls are putting both health and social care under pressure, the government promised a £900m social care funding increase, which was dismissed by NHS leaders as not enough.

An NHS England spokesperson said: “NHS tried-and-tested plans are currently managing the ongoing pressures of this winter.

“Going into the new year, the public can play their part by avoiding going to A&E unless it is an emergency and using local pharmacies and NHS 111 for medical advice.”

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