COVID-19 NHS preparedness and response – notification of return to Incident Level 4


4 November 2020

Dear colleague,
COVID-19 NHS preparedness and response – notification of return to Incident Level 4

In response to increasing coronavirus infections the Government and Parliament have today enacted a further set of national COVID measures. The NHS is also seeing increased COVID demand on our hospitals, which is projected to intensify over the coming weeks. NHS Chief Executive

Sir Simon Stevens has therefore today announced that the health service in England will return to its highest level of emergency preparedness, Incident Level 4, from 00.01 tomorrow, 5 November.

This means the NHS will move from a regionally managed but nationally supported incident under Level 3, returning for the time being to one that is co-ordinated nationally.

Sir Simon and Amanda Pritchard will shortly be writing to NHS leaders in the light of this current wave 2 of COVID.

In the meantime, today’s EPRR move will support interregional mutual aid across the NHS in England as required. Potential or current capacity/service issues should continue to be escalated to regional and national teams through established incident escalation routes.

Local, regional and national incident co-ordination centres should be staffed appropriately to ensure robust 7-day cover and timeliness of communication. The National Incident Co-ordination Centre continues to operate 12 hours a day (0800-2000) with IMT taking place 6 days a week. There is an expectation that regional co-ordination centres (and local organisations) should similarly adjust their hours and meeting frequency accordingly.

All communications related to COVID-19 should continue to be sent via established COVID-19 incident management channels, with NHS organisations not expected to respond to incident instructions received outside these channels.

The importance of full completion of sit rep returns over 7 days will be of critical to ensure high data quality to support the NHS and the wider Government response. A review of sit reps is underway with the aim of streamlining data collection and reducing burdens.

Once again, thank you for your leadership at this challenging time. If you have any queries, please discuss them with your regional NHS England and NHS Improvement team in the first instance.


Yours sincerely
Professor Keith Willett
NHS National Director for Emergency Planning and Incident Response
NHS England and NHS Improvement