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22 April 2022

On Wednesday 20 April 2022, the Trust declared that it was escalating to Operations Pressure Escalation Levels (OPEL) Level 4 - the highest level of internal escalation in the NHS.  

The decision to escalate was made due to rising attendances at our Emergency Departments (EDs); ongoing challenges in discharging patients who are well enough to leave hospital; difficult staffing levels in some areas; and an increase in patients with COVID-19.  

Teams have been working immensely hard - both inside our hospitals and out in the community with our partners - and some of the actions taken included:  

  • Setting up daily calls with our partners, including Cumbria and Lancashire County Councils, North West Ambulance Service and Morecambe Bay Clinical Commissioning Group to review current pressures and agree actions  
  • Working with social care colleagues to expedite the safe discharge of NMC2R patients wherever possible
  • Sourcing additional colleagues for the Urgent Treatment Centre (UTC) over the next 48 hours in Morecambe to accommodate more patients with minor illnesses or injuries
  • Requesting mutual aid from our system partners to ask if they could accommodate diverted emergency patients for a period of time
  • Diverting ambulances at Junction 36 to take patients to FGH rather than the RLI  
  • Putting additional occupational therapy and support colleagues in place to assist teams assess patients quickly
  • Liaising with our colleagues in mental health services to expedite the discharges of patients wo are waiting for specialist beds
  • Identification of additional residential care beds in Lancashire who can accept suitable patients with relevant risk assessments in place
  • Standing down all non-essential activity (meetings, etc) to allow senior teams to support ward colleagues and help unblock any delays in discharge  
  • Facilitating a special bulletin to primary care colleagues and other providers to make them aware of the escalation and request they redirect all patients with non-life threatening illnesses or injuries to other services rather that the EDs

The RLI and FGH sites are now in an improved position with less patients waiting in our Emergency Departments, a small number of beds available on both sites, and no immediate patient safety concerns. Therefore, the Trust has taken the decision to formally de-escalate to OPEL Level 3.  

Whilst de-escalation to OPEL Level 3 is positive news and a real testament to colleagues and our partners; our services do remain under extreme pressure. Therefore, we will continue to work closely with our partners to monitor the pressures and take appropriate action where needed.

The public can continue to help us manage these periods of demand by ensuring they are seeking help from the most appropriate health services, and only attending A&E for serious accidents and emergencies. If you are unwell, visit NHS 111 online for 24/7 advice about the most appropriate care for your needs. 


Aaron Cummins 

Chief Executive