Step by step plan for a family in crisis – England edition
When a loved one’s health suddenly deteriorates, families are often forced to make urgent decisions about care, safety, funding and discharge – all at once.
Below is a step-by-step crisis plan for families in England to help you stabilise the situation and secure appropriate funding quickly.
1 Make the Situation Safe (First 24–48 Hours)
If your relative is:
- Unsafe at home
- Falling repeatedly
- Severely confused
- Not eating/drinking
- Rapidly deteriorating
Contact:
- GP (urgent same-day appointment)
- 111 for urgent advice
- 999 in a medical emergency
- Hospital discharge team (if already admitted)
👉 If in hospital, state clearly that discharge is unsafe without care in place.
2 Ask for an NHS Continuing Healthcare (CHC) Checklist
If needs are complex or worsening, request a CHC Checklist from:
- Ward nurse
- GP
- District nurse
- Hospital discharge coordinator
- Local Integrated Care Board (ICB)
This is funded by the NHS and is not means-tested.
Say something like: “Given the complexity and deterioration of needs, I am requesting a CHC Checklist assessment.”
Do not wait to be offered it.
3 Consider NHS Fast Track (If Deteriorating Rapidly)
If the person is:
- Rapidly declining
- Possibly entering end of life
- Increasingly frail with unpredictable health
Ask the question: “Should this be considered for NHS Fast Track funding?”
Fast Track:
- Does not require a full assessment
- Can be arranged within days
- Covers full care costs
It is also funded by the NHS.
4 Document Everything
From today, start a care evidence log: and record:
- Falls
- Aggression or distress
- Night-time waking
- Incontinence
- Medication changes
- Choking risks
- Carer breakdown
This documentation is powerful in CHC assessments and appeals.
Focus on:
- Unpredictability
- Risk
- Intensity
- Skilled intervention needed
5 Apply for Attendance Allowance (If Over State Pension Age)
Even while waiting for NHS decisions, apply for Attendance Allowance via the Department for Work and Pensions.
It is:
- Non-means-tested
- Paid weekly
- Tax-free
Apply immediately – claims can be backdated to the date you request the form.
Complete the form describing the worst days, not the best days.
6 Request a Local Authority Needs Assessment (Backup Plan)
Contact your local council’s Adult Social Care team and request:
- A Needs Assessment
- A Carer’s Assessment (for yourself)
This is means-tested and falls under the Department of Health and Social Care framework.
Even if CHC is being explored, having this running in parallel avoids delays.
7 Attend All Assessments
Never allow assessments to happen without family present (in person or by phone).
During assessments:
- Correct minimising language (“she’s fine most of the time”)
- Emphasise risk if care is reduced
- Clarify what happens at night
- Ask for copies of assessment paperwork
Use phrases like:
- “This is unpredictable.”
- “This requires skilled monitoring.”
- “Without supervision there is significant risk.”
8 Prevent Unsafe Hospital Discharge
If your relative is in hospital, you can say words to the effect that “This discharge would be unsafe without a funded care package in place.”
Hospitals must ensure:
- A safe discharge plan
- Appropriate care arranged
Do not agree to take someone home if you cannot safely manage.
9 If Funding Is Refused – Appeal
If CHC is denied:
- Request written reasons
- Request a Local Resolution Meeting
- Escalate to Independent Review if necessary
Many families win on appeal when evidence is clearly presented.
10 Consider Personal Health Budgets (If CHC Approved)
If CHC is awarded, ask about:
- A Personal Health Budget
- Direct payments
- Employing a live-in carer
This offers more control and flexibility.
Crisis Priority Order (Quick Reference)
- Safety first
- Request CHC Checklist
- Consider Fast Track
- Apply for Attendance Allowance
- Request council assessment
- Document everything
- Challenge unsafe discharge
- Appeal if needed
Important Emotional Reminder
In crisis, families often:
- Understate needs
- Feel guilty asking for funding
- Try to cope alone
Remember:
- You are not asking for a favour.
You are asking for a legal entitlement based on assessed need.
This article was created with the help of ChatGTP in March 2025. Details may change but the guiding principles are likely to remain valid.
Find our downl0adable quick checklist for England
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