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The Trust’s escalation status is an indicator of the operational pressures the organisation is experiencing. Key factors influencing divisional and overall Trust escalation status include: predicted demand, available resources, and capacity. The national framework for operational escalation levels (referred to as Operational Pressure Escalation Levels – OPEL) is designed to ensure standardisation of escalation status declaration, interpretation and response. This plan is based upon the national framework and has been adapted to incorporate specific triggers (at a local level), influencing both departmental and Trust wide escalation status. This plan should be read in conjunction with the NHSE/I-South East OPEL Framework, local Onward Care/Repatriation Procedures, the National Operational Escalation Levels Framework 2018, and all local System Plans relating to winter and surge/escalation.


Aims and Objectives

The aims of this plan are to enable NW Surrey Local A&E Delivery Boards (LAEDB) & ASPH to align their escalation protocols to a standardised process ensuring:

  • Maintenance of quality and patient safety as a priority
  • A consistent approach to mitigation strategies in times of pressure
  • Clear expectations around roles and responsibilities for all those involved in escalation in response to surge pressures at local level, in and out of hours
  • Setting consistent terminology.
  • This framework is designed for managers, allied health professionals and clinicians involved in managing capacity and patient throughput (as business as usual) and at a time of excess demand and/or other operational pressures.
  • It is to be circulated to all staff to provide a practical working reference tool, thereby aiding co-ordination, communication and implementation of the appropriate actions in each division/dept at every level of command and control (Bronze, Silver & Gold).


Policy Details

Download: n/a
Compiled by: James A. Thomas, Chief Operating Officer
Claire O’Brien, Head of Emergency Planning and Resilience
Janet McAuley, Patient Flow and Discharge Lead
Filipe Alves, Clinical Site Nurse Practitioner Team Leader
Anne Carey, Deputy Chief Operating Officer
Ratified by: TEC
Date Ratified: December 2021
Date Issued: January 2022
Review Date: December 2022
Target Audience: All staff
Contact name: Claire O’Brien, Head of Emergency Planning and Resilience


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