Northern Devon Healthcare NHS Trust (NDHT) started operating at OPEL 4 - formerly known as 'black alert' - on Monday (November 4) after seeing high numbers of 'very poorly' patients coming into the hospital in Barnstaple. The OPEL framework is used nationally by NHS hospitals to help monitor and measure operational pressures, such as how many poorly patients are in hospital and how busy staff are. The status means pressure 'continues to escalate', leaving organisations possibly 'unable to deliver comprehensive care'. Non-urgent surgery due to take place on November 4 and 5 has been postponed, and the trust said it will review non-urgent operations scheduled for the rest of the week. Jill Canning, deputy chief operating officer at NDHT, said: "We have seen very high numbers of very poorly patients coming into hospital over the past week and our services continue to be extremely busy. "We are dealing with this increased pressure through our usual escalation plans. We are focusing as many of our staff as possible on treating our patients with the most urgent needs. "Our staff are doing an incredible job and I would like to thank them for their hard work, dedication and flexibility. "We have made postponements to non-urgent surgery due to take place today and tomorrow, and we will review non-urgent operations for the rest of the week. "We know this is extremely frustrating and we apologise to those patients affected by this. Patients will be contacted if we need to cancel their planned operation and those who have not been contacted should attend as planned." People are being asked to think carefully about the most appropriate NHS service for their needs, whether it is getting advice from a pharmacy, making use of GP appointments, visiting a minor injury service, or by using NHS 111. People can find their local healthcare services by visiting the NDHT website.