Aims To assess the “Okay to Stay” plan to investigate if this reduces visits to emergency departments, unplanned admissions and elective admission to hospital in elderly patients with long-term health conditions. Background The incidence of long-term conditions is rising as the elderly population increases, resulting in more people from this group attending emergency departments and being admitted to hospital. Okay to Stay is a simple plan for people with long-term conditions to help them remain in their own home if they suffer an acute exacerbation in their health. It was co-designed with professional and patient representatives with the aim of empowering patients and their carers to more effectively manage their long-term conditions. Methods Data from 50 patients (20 males, 30 females, mean baseline age 77.5 years) was compared 12 months before implementation of the plan and in the subsequent 12 months, with the significance of effects assessed at the 5% significance level using t-tests. Findings Visits to emergency departments were reduced by 1.86; unplanned emergency admissions were reduced by 1.28; and planned elective admissions were raised by 0.22 admissions per annum. The reduction in visits to the emergency department was significant (p=0.009) and the reduction in emergency admissions was significant (p=0.015). The change in elective admissions was not significant (p=0.855). The Okay to Stay plan is effective in reducing visits to the emergency department and unplanned hospital admissions in people with long-term conditions. This is a positive step to supporting vulnerable and complex patients who are cared for at home, and facilitates the recognition by the individual of the possibility to stay at home with the support of health professionals. There are potential cost benefits to the investment of initiating an Okay to Stay plan through the avoidance of visits to the emergency department and non-elective admissions to hospital.