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Jan 10th, 2018

NHS Funding Crisis: hospitals on red or black alert

By Ruby Earle

Hospitals across England have been under intense pressure this winter. Thousands of operations had to be cancelled.

In the past this level of crisis was known as hospitals being on ‘red alert’ or ‘black alert’ and so the media is referring to this current situation in the same terms. The new ranking NHS England uses is known as Operational Pressures Escalation Levels (OPEL). Red alerts are now known as OPEL 3 and black alerts are known as OPEL 4.

You can see how NHS England designates these warnings in the below table:

The key language used in these alerts, that 38 Degrees have referred to to explain what the situation means for patients, are as follows:

OPEL 3 (‘red alerts’):

“The local health and social care system is experiencing major pressures compromising patient flow and continues to increase.”

OPEL 4 (‘black alerts’):

“Pressure in the local health and social care system continues to escalate leaving organisations unable to deliver comprehensive care. There is increased potential for patient care and safety to be compromised.”

NHS trusts are large organisations whose services and facilities often provide care to people across regions and cities. Whilst a hospital or A&E building might be based on a single site, it is likely that a trust will have other facilities and services elsewhere – which is why trusts are spread across multiple constituencies.

Unlike previous years, NHS England is no longer publishing hospital trusts on alert. 38 Degrees have used national and local news reports to find the 27 hospital trusts as of 5th January 2018. The office team then mapped these trusts across 126 constituencies.

This spreadsheet contains the NHS Trusts reported to be on alert, mapped against constituencies served by these trusts. It also includes the original news source reported the alerts.


Hospital trust catchment areas are not precise when it comes to what constituencies use individual hospitals. We’ve attempted to identify the constituencies most likely to be affected by these OPEL alerts, but if you think we’ve got any of them wrong we would welcome feedback.

If your local NHS services go on alert, please let the office team know! You can send an email to emailtheteam@38degrees.org.uk

If you live in an affected area and want to get in touch with your MP to ask them to speak out for more funding for the NHS you can do so here:


This news shouldn’t stop any of us asking for the care we need if it’s an emergency. Doctors and nurses are still saving lives every day. If you or a family member is unwell or has an emergency you can find out what to do here:



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