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The Trust Escalation status is an indicator of the operational pressure that the Trust is under and will rise and fall in a controlled manner based on prevailing and anticipated pressures. It is RAG rated for ease of interpretation and response. To ensure standardisation of terminology used, the current Rag rating (Green, Amber, Red & Black) levels have now been aligned to the national framework for operational/escalation levels. The new escalation levels are known as Operational Pressures Escalation Levels (OPEL 1 - 4).



This plan has been developed for operational pressures response and is applicable all year round, not just in response to winter pressures.


Aims and Objectives

The aims of this plan are to provide a consistent approach in times of pressure, specifically by:

  • Enabling the Trust to maintain quality and patient safety
  • Providing a nationally consistent set of escalation levels, triggers and protocols for local A&E Delivery Boards to align their existing escalation processes with
  • Setting clear expectations around roles and responsibilities for all those involved in escalation in response to surge pressures at local level
  • Setting consistent recognised internal, local and nationally recognised terminology


Policy Details

Download: PDF version
Compiled by: Claire O’Brien, Head of Emergency Planning and Resilience
Ratified by: N/A
Date Ratified: June 2018
Date Issued: June 2018
Review Date: June 2021
Target Audience: All staff
Contact name: Claire O’Brien, Head of Emergency Planning and Resilience


See also:

  • Divisional Business Continuity / Escalation Plans: ED, Medicine, Surgery, MSK (Therapies, diagnostics, Pharmacy)
  • Internal Incident Plan
  • Surrey-wide Surge Escalation Plan