General Practice Alert System (GPAS) launched in September 2022 and in October 2025 was replaced by Operating Pressures Escalation Level (OPEL) to report pressures in general practice.
OPEL is used by many parts of the NHS system, including acute trusts, community health services, mental health services, and NHS 111, to communicate their demand and capacity to commissioners and the rest of the NHS system to identify where support is required in the short term, and where transformation is required in the long term.
General practice does not currently have access to an official OPEL system but Kent LMC’s OPEL pressure reporting system allows practices to reflect back to the rest of the system and to commissioners, the pressures they are currently experiencing. We have simplified our reporting process and have altered our reports to make them clearer and easier to interpret. Our OPEL scores in General Practice align with those in secondary care.
The Kent LMC OPEL report will enable us to provide system partners with weekly reports that highlights describing the pressure that general practice in Kent and Medway is under. This report does not allow outside agencies to identify practices which may be struggling but does highlight to the whole health and care system that help is required.
The four states that practice report on are:
Green: This implies low level of pressure; the practice is appropriately staffed and there is sufficient capacity to meet patient demand and expectations. GPs in the practice are working to BMA recommended safe working limits.
Amber: This indicates the practice is under moderate pressure. The practice is unable to fully meet patient demand or expectations. GPs in the practice are likely to be working beyond BMA recommended safe working limits meaning some patient demand cannot be met by the practice. This is unsustainable in the long term without action.
Red: This indicates the practice is under severe pressure and although it may be able to run safely for a very limited period, immediate action is required to mitigate the situation. The GPs in the practice are continuously working beyond BMA recommended safe working limits and significant levels of patient demand cannot be met by the practice
Black: The practice is unable to provide safe care and there is a risk of service failure. Without intervention, it is likely the practice will be forced to close. The practice would be expected to declare this state to the commissioner and seek guidance from the LMC.
At HCP and at Kent & Medway level, the OPEL status is then reported as:
Kent LMC are asking GP practices across Kent to provide simple data about workforce capacity, workload demand, and practice list size on a weekly basis so that we can generate a OPEK report weekly. These reports highlight where support is required in the short term and identify patterns where support is required in the medium to long term. We ask that you engage with this process as it will help articulate to our NHS the pressures which we are facing.