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NEWS: Practices are testing a new “black alert” system.

NEWS: Practices are testing a new “black alert” system.

NEWS: Practices are testing a new “black alert” system.

As reported Family doctor, Overstretched GP practices in Kent and Medway can now refer patients to other services and receive extra support under a trial of a black alert scheme.

GP leaders have long called for a support system similar to the operating pressure escalation levels (OPEL) system used in general practice hospitals.

Under the OPEL system, hospitals report the level of pressure they are under on a four-point scale, triggering specific responses to support them when they face unsustainable pressures.

NHS England confirmed last year that it was working on plans to bring general practice under the OPEL framework, and a manifesto published by the RCGP in October last year stated that integrated care boards (ICBs) should be required to set up OPEL-style alert systems for general practice .

Black GP warning system

Kent and Medway ICB have developed the OPEL general practice framework in partnership with Kent LMC and are currently looking for practices to test it. The system takes into account both internal pressures, such as staff shortages, and external factors, such as problems with the wider health system, which increase pressure on general practice.

The Kent system would enable practitioners to report to OPEL 4 – the highest alert level, equivalent to a “black alert” – for reasons including the availability of less than 70% of clinical staff or problems on the premises such as flooding or a complete loss of power that prevent care from being provided. External factors such as a sharp increase in the number of staff referred to NHS 111 surgeries or a sharp increase in the number of care home patients requiring face-to-face assessment can also trigger an OPEL 4 alert.

In the case of an OPEL 4 practice, the ICB would be required to “mobilize support from teams within the ICB” by taking steps such as providing additional staff, agreeing plans to cover care homes and homebound patients, among others. You could also support temporarily closing practices, ceasing appointments and redirecting patients elsewhere.

OPEL 3 may be activated for reasons including operational practice with clinical staff attendance of less than 80% and unplanned activity at elevated levels. Practitioners in OPEL 3 could be offered additional staff, and the ICB could launch actions such as asking urgent care centers to provide same-day access or community teams to take on additional roles to support care homes.

Supportive practices

A practice could declare its presence in OPEL 2 if, for example, it is busier than usual and employs less than 90% of its clinical staff. OPEL 1 was classified as meaning “business as usual” – with practices “able to meet patient flow and anticipated demand within available resources.”

A spokesperson for NHS Kent and Medway said: “We plan to launch a pilot alert system in primary care soon. This pilot will test a range of potential actions to support practices and enable the continuation of safe, high-quality patient care during additional periods of pressure.”

The pilot will run alongside the existing GPS Alert System (GPAS) which is used across much of England, with practices in Kent being asked to continue to complement GPAS.

The Kent LMC update said: “The ICB has developed, with our support, the OPEL response framework, which sets out the support that can be offered to practitioners when a practitioner declares an amber/red/black condition.

“This guidance outlines the criteria that can determine a practice’s red-amber-green (RAG) status, the triggers, both internal and external, and the response the system can provide.”

LMC added that the pilot will not be used as a performance management tool and that participating practices will have the opportunity to withdraw.

“We appreciate the pressures placed on practices and do not intend to increase practice workload, but hopefully provide assistance,” the LMC said.

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