Out with the Cowboys! Queue safer medical cover at events… something we have campaigned for as one of the UK’s leading event medical providers.

The UK government is currently consulting on the proposal to remove the Care Quality Commission (CQC) exemption for providing treatment of disease or disorder at temporary events or sporting arenas. This move could significantly impact the way medical services are provided at events such as festivals, fairs, and at sporting arenas.

What is “Treatment of Disease or Disorder”?

‘Treatment of Disease or Disorder’ known as TDDI in the industry is the act of providing treatment for a disease, disorder or injury by or under the supervision of a registered healthcare professional such as Nurses, Paramedics, Doctors and Social Workers.

At the moment those carrying out the activity have to be registered with the Care Quality Commission and meet the requirements set out in the Health & Social Care Act unless they are covered by an exemption. Current exemptions include:

1. Treatment provided through temporary arrangements for sporting or cultural events (such as festivals, sporting or motor sport events).

2. Treatment provided in a sports ground or gymnasium (including associated premises) where it is provided for the sole benefit of people taking part in, or attending, sporting activities and events.

3. First aid where it is delivered by:

   • healthcare professionals in unexpected or potentially dangerous situations requiring immediate action

   • non-healthcare professionals who are trained to deliver first aid

   • organisations established for the purpose of providing first aid

Regulation in the events sector has been a hot topic for many years and poses a risk to the public as unregulated providers aren’t required to carry out things like background checks for recruitment and have procedures in place for patients who deteriorate.

Presently, medical treatment at temporary events is often provided by organisations that do not fall under the CQC's regulatory framework. This exemption has allowed event organisers to arrange medical care without the extensive compliance requirements that permanent facilities must meet. However, the government believes that this exemption could compromise the quality and safety of care provided to attendees.

The CQC is the regulator for all other health and social care settings and ensures care is safe, effective, caring, well-led and responsive. Whilst the element of transporting patients from an event to a hospital is a regulated activity, some providers are skirting registration by misleading event organisers despite the requirements not to call 999 for all but the smallest low-risk events.

Removing the CQC exemption would mean that all medical providers at temporary events would need to register with the CQC and adhere to its stringent standards. This includes ensuring proper staffing, maintaining medical equipment, and following specific protocols for patient care. The goal is to enhance the safety and quality of medical services provided at these events, ensuring a consistent standard of care.

The impact of this change could be significant. Some event organisers may face increased costs and logistical challenges in meeting CQC requirements. There is an argument that smaller events might struggle with the additional administrative burden, potentially leading to fewer events or higher ticket prices.

The contrary argument from regulated providers who spend considerable amounts of money on patient safety and governance, often only to be undercut by unregulated providers who can make large profits with minimal overheads or lack of knowledge or consideration for patient safety, regulations or governance is that the much-needed legislation will create a fairer playing field for providers.

Some unregulated providers have been known to hire vehicles from CQC regulated providers thinking this lets them borrow their registration, which in itself shows a lack of insight in to the purpose of the regulations and poses significant risk to the public.

The majority of members of the public aren't aware of the difference as all providers look similar and are usually dressed in green. However, the public deserves safer standards of care, which would reduce the risk of medical incidents and improve overall safety at temporary events.

How will affect events?

The purple guide already sets out guidelines for industry best-practice which include ensuring the event does not impact our already struggling NHS and selecting an experienced medical provider who is regulated by the CQC. It should be noted that any provider that transports patients to hospital is already required to be registered.

This change is legislation, if approved, will make it a requirement for any organisation utilising nurses, paramedics or doctors at events to register with the CQC and meet the standards.

Will this improve safety?

Yes, this will undoubtedly improve safety. However, it will take time. Registering is relatively easy and involves a small fee; inspectors do not review whether the provider meets the regulations until an organisation is formally inspected, which may not happen for a year or two. Providing safe medical services is costly, and this change will impact some events that have previously hired unregulated providers, often without being fully aware that the provider is unable to take patients to the hospital without breaking the law.