A demo reference for how commvita runs the daily operation: a single integrated OPEL picture of system pressure, NQB safe-staffing and the bank-first cascade that fills gaps, and a shift-aware priority board that turns all of it into what to do this shift — with escalation that stays human-authorised.
Operational management in commvita is not one screen — it is a spine: measure the pressure, match the workforce to it, and drive the shift. Each surface is a real module, on shared standards.
The On-Call Manager scores each pillar 0–100 and computes an integrated OPEL 1–4; commvita Flow renders it as a live Control Centre with the ambulance front door as a first-class pressure input.
Safe Staffing tracks CHPPD RN/HCA planned vs actual per ward with RAG and a professional-judgement log; the Bank & Agency cascade fills gaps bank-first, escalating to agency only with rationale and rate control.
The Shift Priority Board detects the current shift band and lays out Act Now / Due This Shift / Monitor with a handover countdown; OPEL-triggered escalations route to a human-authorised EPRR decision.
The day starts with a single, honest read of how much pressure the system is under. commvita computes it on the NHS England Integrated OPEL Framework 2024–2026 — normalised, comparable and deadline-bound — not a subjective colour someone picks.
The On-Call Manager normalises each domain — Acute, Community (CHS), Mental Health and NHS 111 — to a 0–100 score so wildly different services become comparable. A daily 10:00 assessment deadline keeps the picture current.
The pillar scores roll into an integrated OPEL level on published bands — 0–15 → OPEL1, >15–40 → OPEL2, >40–70 → OPEL3, >70–100 → OPEL4. Acute, CHS and MH are contributing pillars; NHS 111 is assessed standalone.
commvita Flow's Control Centre shows the OPEL 4-level banner, a live alert ticker, 8 KPI cards and a 30s auto-refresh, plus an Ambulance Front Door panel — handover & turnaround against the 15-minute NHSE standard, hours lost to handover, drilling to the Handover Clock and Ambulance Hub.
An OPEL rise triggers an escalation record with the required OPEL actions surfaced. Crucially, OPEL does not auto-declare EPRR: declaring a major incident is a human-authorised decision with a mandatory rationale — the design guardrail against a number pulling the trigger.
Pressure is only actionable if you can staff to it safely. commvita tracks Care Hours Per Patient Day (CHPPD) per ward against the NQB Safe Staffing standard, and fills any gap bank-first — agency only as a controlled, evidenced escalation.
Safe Staffing shows 8 wards with RN and HCA planned vs actual, the computed CHPPD and a RAG band. A red ward carries an Escalate button; a professional-judgement log records the nurse-in-charge's narrative when the numbers alone don't tell the story (NICE NG94).
Unfilled shifts cascade Internal Bank → NHS Professionals → secondary agency, each step tracked. Overriding to agency needs a recorded rationale + rate; rate cards flag any breach of the agency cap, and WTD compliance (48-hour limit, opt-out register) is checked as workers book.
Fill rates and the professional-judgement narrative flow into the NQB board return — the monthly safe-staffing evidence a board must see — closing the loop from a red ward at 08:00 to a governed assurance statement.
| Ward | RN plan / actual | HCA plan / actual | CHPPD | RAG | |
|---|---|---|---|---|---|
| AMU | 6 / 6 | 4 / 4 | 5.9 | safe | |
| Ward A — Care of Elderly | 5 / 4 | 4 / 3 | 4.9 | monitor | Log PJ |
| Ward B — Respiratory | 5 / 3 | 4 / 2 | 4.1 | unsafe | Escalate |
| Surgical | 5 / 5 | 3 / 3 | 5.6 | safe |
Pressure measured and workforce matched, the operation still has to run. The Shift Priority Board is shift-aware — it knows whether it's Early, Late or Night — and turns the whole picture into a short list of what to do before handover.
The board detects the current shift band (Early 07:00–15:00 · Late 15:00–23:00 · Night 23:00–07:00), shows a shift progress bar and a handover countdown, and lays priority actions across Act Now / Due This Shift / Monitor against the live OPEL level.
SDEC and the Urgent Care Centre keep same-day and minor flow moving; the Handover Clock tracks the 15-minute ambulance handover target; the Bed Board, Discharge Hub, Theatre Productivity and Diagnostics Capacity keep beds, discharges, lists and tests flowing — each feeding pressure back to OPEL.
Winter Pressures Forecast projects OPEL 6 weeks forward with flu/RSV demand, scenario planning, escalation & mutual-aid cascades and UKHSA surveillance — so today's shift is run with tomorrow's pressure in view.
| Operational concept | Module | Route | Model / API | Standard | Status |
|---|---|---|---|---|---|
| Integrated OPEL & escalation | On-Call Manager | /oncall-manager | /oncall/ · OnCallAssessment · OnCallEscalation · OnCallDutyLog · OnCallHandover | Integrated OPEL Framework 2024–2026 | ● Live |
| Live Control Centre & front door | commvita Flow | /flow | /flow/ · OPEL banner · 8 KPIs · Ambulance Front Door | NHS OPEL Framework · 15-min handover standard | ● Live |
| Safe staffing & CHPPD | Safe Staffing / CHPPD | /safe-staffing | ward CHPPD · professional judgement log · NQB board return | NQB Safe Staffing 2014 · NICE NG94 | ◍ Demonstrated |
| Bank-first cascade & agency control | Bank & Agency Cascade | /bank-agency | bank→NHSP→agency cascade · rate cards · WTD compliance | NHS Employers Agency Control Framework · WTR 1998 | ◍ Demonstrated |
| Shift-aware priorities | Shift Priority Board | /shift-priority | Act Now / Due This Shift / Monitor · handover countdown · OPEL | shift bands · OPEL-aware | ◍ Demonstrated |
| 6-week pressure forecast | Winter Pressures Forecast | /winter-pressures | OPEL projection · flu/RSV demand · mutual aid · UKHSA | NHS England Winter Planning 2024/25 · UKHSA | ◍ Demonstrated |
| Same-day & minor flow | SDEC Hub · Urgent Care Centre | /sdec · /urgent-care | ambulatory pathways · triage queue · 4-hour target | NHS England SDEC · NHS UEC Strategy | ◍ Demonstrated |
| Ambulance handover & front door | Handover Clock · Ambulance Hub | /handover-clock · /ambulance-hub | 15-min handover queue · breach & delay-reason capture | NHS England 15-min handover target | ◍ Demonstrated |
| Beds & discharge flow | Bed Board · Discharge Hub | /bed-board · /discharge-hub | bed state · predicted discharge · SAFER · D2A | SAFER Bundle · NHSE Discharge Framework 2023 | ◍ Demonstrated |
| Elective & diagnostic capacity | Theatre Productivity · Diagnostics Capacity | /theatre-productivity · /diagnostics-capacity | utilisation · turnaround · DM01 · GIRFT | GIRFT · NHS England 6-week Diagnostics (DM01) | ◍ Demonstrated |
| National OPEL return | OPEL Submission | /opel-submission | daily OPEL 1–4 return · auto-populated from Flow | NHS England Integrated OPEL Framework | ◍ Demonstrated |