The following questions have been developed to support the introduction of the Operating Pressures Escalation Level (OPEL) and is based on feedback obtained through one-to-one interviews and other general discussions with Practices that have been involved in the pilot programmes coordinated by the Kent & Medway LMC.
Rationale
OPEL reporting allows general practice to report the state of pressure and resilience in their practice and local areas.
All other parts of the healthcare system can signal when they are at capacity, except for general practice. Hospital trusts use the national Operating Pressures Escalation Level (OPEL) to communicate demand and capacity issues, but general practice does not have a similar system. The LMC is encouraging all Practices to submit data weekly, to provide system leaders with better visibility of the pressures being experienced by general practice, and to demonstrate the case for extra support and investment
The most important thing to note is that the collection of this data is not intended to be punitive in any way. It is about building an evidence base that the LMC can use to demonstrate the breadth and depth of general practice services and the demands being made on it. Each week the LMC will produce a report to inform system leaders about the OPEL State in general practice across all 4 Kent and Medway HCPs and will monitor how it is changing over time. The report will also be shared with practices.
Yes. The LMC does not collect the names of Practices that submit data. We do collect your HCP and PCN within which you operate. This information is only visible to LMC officers. We will not share individual responses with system partners and the report we produce will contain aggregate data at Health and Care Partnerships (HCPs) and Integrated Care Board (ICB) levels only. As individual practices cannot be identified from responses, if a practice requires support, we ask them to contact the LMC office.
The system which the LMC uses to collect and analyse the data submitted by Practices is independent from any NHS systems and is not being collected for performance management. Individual practices cannot be identified from submissions.
Your participation is optional but the more Practices that submit data the more robust our evidence base becomes. We strongly encourage you to take part as OPEL will provide general practice the opportunity to demonstrate to the rest of the system the tremendous contribution it makes. It will also help to build the case for additional investment and support and to understand how pressures differ across the different HCP areas.
Completing the forms
On Tuesday each week we will send an email to the nominated practice contact that contains a link to an online form through which data can be submitted. The process should take no more than 1- 2 mins. The link does not change so you are able to bookmark it, but the timing of the submission is important so that the system can accurately allocate the data to the correct week.
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.
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.
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.
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.
This is an opportunity for you to provide context behind your RAG rating. For example, whether your practice has experienced IT issues, capacity/ demand issues, challenges with secondary care or other parts of the system, commissioning problems. This provides a richness to the information that helps paint a picture for stakeholders of the current situation in general practice.