An Emergency Health Care Plan (EHCP) is a written document that explains what should happen if someone experiences a health emergency. It helps ensure that families, carers and healthcare professionals know exactly what actions to take.
What is the purpose of an Emergency Health Care Plan?
The purpose of an emergency health care plan is simple: to make communication easier and ensure the right treatment is given as quickly as possible.
An EHCP is particularly important for:
- Children with complex healthcare needs
- Individuals with life-limiting conditions
- People with multiple long-term conditions
- Anyone at risk of predictable medical emergencies
All individuals have the right to receive appropriate treatment based on their needs — not assumptions about quality of life.
What does an EHCP include?
While formats can vary locally, most emergency care plans include:
1. Medical summary
- Diagnosis and active health concerns
- The individual’s understanding of their condition
- Current treatments and medication (including rescue medication)
- The date and weight (for children) used to calculate doses
2. Foreseeable emergencies
The plan outlines predictable situations, such as:
- Seizures
- Breathing difficulties
- Severe infections
- Sudden deterioration
For each emergency, it should explain:
- How to recognise it
- What first aid steps to take
- When to call for urgent help
- Who to contact (with phone numbers)
- What healthcare professionals should do next
3. Agreed levels of care
The EHCP should clearly state what level of treatment is appropriate in an emergency, including:
- Whether hospital transfer is recommended
- Escalating steps of care
- Whether CPR is appropriate
- If relevant, a DNACPR form kept alongside the plan
It’s important to understand that while an EHCP must be taken into account, senior clinicians may use their judgement if circumstances differ from what was predicted.
Who is involved in creating an EHCP?
An emergency health care plan should be developed through open and sensitive discussion between:
- The individual (where they have capacity)
- Parents or carers (for children)
- The lead clinician (often a consultant paediatrician)
- The GP
- The wider multidisciplinary team
This may include:
- Ambulance and paramedic services
- Hospitals and community teams
- Schools and education services
- Social care services
- Hospices
The plan should be:
- Written in simple language
- Brief and clear
- Signed by the lead clinician
- Kept in one current version
What if someone lacks capacity?
If an individual cannot make decisions themselves, decisions must follow the principles of the Mental Capacity Act 2005.
For young people aged 16–17, the Act applies with some exceptions (for example, only those aged 18+ can make a legally binding advance decision to refuse treatment).
All decisions must prioritise the individual’s best interests.
How often should an EHCP be reviewed?
An EHCP should:
- Be reviewed at least annually
- Be updated if the individual’s condition changes
- Be dated whenever changes are made
- Clearly state who is responsible for updates
Only one current version should be in use to avoid confusion during an emergency.
What happens during an emergency?
If an emergency occurs:
- Carers should follow the steps in the plan.
- If instructed to call for help, they should tell services they are following an Emergency Health Care Plan.
- The EHCP should accompany the individual if they are transferred to hospital, hospice or another care setting.
Emergency services should be aware that an EHCP exists and know to ask for it.
What if there is disagreement?
If there is disagreement about what is in the individual’s best interests:
- A second opinion should be sought
- Mediation should be attempted
- Ethics advisory groups may be consulted
- Legal advice may be sought if necessary
The child or individual’s best interests must always remain the priority.
Example of how an emergency care plan might work
For example, a child with severe epilepsy may have an EHCP that states:
- If a seizure lasts longer than 5 minutes, administer prescribed rescue medication.
- If breathing becomes laboured or recovery does not occur within 10 minutes, call 999.
- Inform paramedics that an EHCP is in place.
- Transfer to hospital only if specific criteria are met.
This clarity prevents confusion and ensures rapid, appropriate action.
Why is an Emergency Health Care Plan important?
An emergency health care plan:
- Reduces panic and uncertainty
- Ensures consistent decision-making
- Respects the individual’s wishes
- Supports families during crisis situations
- Improves communication across services
Most importantly, it ensures care is delivered promptly, ethically and in line with agreed plans.