The Future of Event Medicine
The Future of Event Medicine
A juggernaut is coming that will impact the provision of medical services at all events in England. You need to be aware of these changes if you organise anything, from the smallest volunteer-led event to the most significant commercial events in the UK. These changes are being driven by the recommendations of the Manchester Arena Inquiry (MAI) and can split into three areas:
Care Quality Commission Regulation
Event Healthcare Standard
The Terrorism (Protection of Premises) Bill (“Martyn’s Law”)
Changes to the Care Quality Commission (CQC) mandate are independent of the Event Healthcare Standard (EHS) and separate from Martyn’s Law. However, these three developments are interlinked and, when combined, will significantly impact best practice and regulation related to events in the UK. The changes to the CQC's remit apply only to England; nonetheless, it is anticipated that the devolved nations will adopt these changes eventually.
The Futures Stage at the Event Production Show 2025 discusses these changes' impact on the event industry. The expert panel included Dr Jerry Hill (British Horseracing Authority), Dr Chris Howes (Event Medical Association), Brendan Herbert (Lacey’s Solicitors), Shane Ohly (Shelter Stone) and Bev Osborne (National Outdoor Events Association).
Care Quality Commission (CQC) Regulation
The Health and Social Care Act 2008 (Regulated Activities) gives the CQC its statutory and regulatory powers for the Treatment of Disease, Disorder, or Injury (TDDI), which includes a specific exemption for sporting and cultural events. This exemption is being removed and this change is likely to come into effect by September 2025. At a stroke, this will result in:
Any person or organisation providing medical services at an event must be registered with the CQC.
Any medical services provided at an event will be regulated and must meet a minimum standard.
Any Healthcare professional working at any event, whether in a professional or voluntary capacity, must be compliant with points 1 and 2 above.
The provision of first aid services will continue to be unregulated. However, it is vitally important to recognise that the CQC regulation applies equally to paid and voluntary staff. The activity (TDDI) and discipline trigger regulation, not the contractual arrangement. In practice, a healthcare professional attending an event, even voluntarily, would be deemed to provide medical services, and the CQC regulations would apply to both the event and the individual.
CQC registration is expensive and onerous. Significant evidence of policies and procedures is required to underpin any medical services provided. It is doubtful that any individual providing ad hoc medical services would be willing to absorb these costs and additional administrative load, including the stress of CQC inspection.
Unlike hospitals, if CQC inspect an event and the provider is not registered or the care is below the required standard, the event will likely be shut down.
Event Healthcare Standard
Currently, the CQC only has the standards framework used to assess hospitals, GP practices and ambulance services to work with. These will not be appropriate for an event healthcare setting. Combined with the Manchester Arena Inquiry findings, this has triggered the Event Healthcare Standard (EHS) development.
The current expectation is the Event Healthcare Standard will be split into two phases. Phase one will establish overarching principles such as conducting a medical risk assessment, resourcing an event to provide appropriate care, and ensuring that the event does not rely on NHS services. The second phase will give sector-based guidance on what those minimum standards are in practice regardless of the number of participants and/or whether the event is commercial or voluntary.
Initially, the Event Healthcare Standard will be considered best practice guidance. However, for regulated event medicine (TDDI), the CQC will assess a medical provider against the new EHS. It is expected that a second piece of legislation will then mandate minimum standards and provision of medical care at sporting and cultural events based on the EHS. In practice, this means that failing to meet the required standard would become a criminal offence for an event organiser.
The Terrorism (Protection of Premises) Bill (“Martyn’s Law”)
Martyn’s Law aims to enhance protective security and organisational readiness throughout the UK by mandating that those in charge of certain venues and events take proactive measures to mitigate the risk of harm to individuals from terrorist acts. This legislation is designed to strengthen the UK’s ability to prepare for and safeguard against terrorism. Those responsible will need to put in place public protection protocols and/or measures, ensuring they are better equipped and ready to respond effectively in case of a terrorist incident. Venues that anticipate hosting between 200 and 799 individuals simultaneously will be categorised under the standard tier. In contrast, venues or events expecting 800 or more individuals simultaneously will be classified within the enhanced tier.
What Next?
Changes to CQC Regulation are happening, and there is nothing event organisers can do to alter this, as with Martyn’s Law.
The development of the overarching Event Healthcare Standard principles is at an advanced stage, but the sector-specific guidance is yet to be developed.