As a regulated provider we have been pushing for regulation in the events sector and removal of exemptions which enable first aiders to provider “ambulance services” without he necessary skills, governance, knowledge and qualifications.

Last month the CQC launched a consultation around the areas of health care which currently fall outside of the scope of regulation. We saw this as a raised awareness for the risks associated with medical care delivered in stadiums or events. In 2018 the National Lead for Ambulance Service wrote to the Chief Executive of the Care Quality Commission (CQC) advising of the risks around unregulated providers delivering healthcare at events. Some providers have hired staff without DBS checks or references which has resulted in patients being placed at significant risk of harm, other providers do not have major incident plans which are required for regulated providers.

https://www.cqc.org.uk/sites/default/files/20181116%20Local%20Authority%20CEO%20letter%20re%20medical%20cover%20at%20events%20risk%20.pdf.

Whilst event sites fall outside the scope of regulation, transporting patients to hospital remains a regulated activity. Some providers may confuse event managers implying that an ambulance may take a patient to hospital when in fact doing so would be illegal. They circumnavigate the rules by calling 999 and transferring patients to the gate. Other providers some contract the transport to hospital by hiring a CQC provider only for hospital transport, however, this means the on site service is likely to be unsafe. The main benefits of not being regulated is the cost saving to the provider. Maintaining CQC registration is costly and requires a dedicated team.

The Manchester bombings of the Arianda Grande concert at the Manchester Arena resulted in loss of life. The medical provider was not regulated by CQC and lessons have been learnt with recommendations which should be taken onboard by all Event Organisers and Large Venues. The recommendations apply for events with 2000 or more attendees.

We have reviewed our major incident plans which encouraged us as many of the recommendations we were already doing, however, we have made further improvements as part of our commitment to a safety culture where we learn from other people mistakes as well as our own. For example we have reduced our threshold for senior clinician review from events with 5000 people present down to 2000.

What should you do if you are running an event with more that 2000 people?

1. You should certainly read the inquiry report

2. You should ensure your medical provider is CQC regulated, until such time as registration becomes mandatory

3. You should ensure the provider is knowledgeable, up-to-date and have the right qualifications and experience.

4. You should be familiar with the event safety guide www.thepurpleguide.co.uk

5. You should ensure your medical provider is carrying out a proper risk assessment and you should carry out your own risk assessments

6. You should ensure both you and your medical provider have major incident plans and equipment in place

7. You should engage with partner agencies such as police, fire and ambulance

8. You should practice your emergency plans to ensure they work

Some people believe in the even of a major incident the NHS will take over and do everything. The likelihood is there will be significant delay and limitations in resources due to the current pressures on services. The NHS ambulance service will be relying on the plans, training and experience of senior management and clinicians from the on site provider.

View the inquiry report here