The Questions Every Event and Production Organiser is Asking
The amendment to the Health and Social Care Act 2008 was passed by Parliament earlier this year, with the changes due to come into effect in December 2027. However, this is only one part of a much wider and increasingly complicated landscape.
The Event Healthcare Standard is being developed, the recommendations from the Manchester Arena Inquiry continue to influence the sector, and organisers are trying to understand how these developments fit alongside established guidance, Pre-Hospital Emergency Medicine (PHEM) definitions, professional regulation and the role of the Care Quality Commission in event healthcare.
I was invited to join a webinar this week with Katie Hodson and First Option, where we gained valuable insight into the number and complexity of the questions people are trying to answer. These included where the line sits between first aid and Treatment of Disease, Disorder or Injury (TDDI); whether a CQC-registered provider will be required; how to procure the right level of healthcare provision; what evidence organisers and production teams should request from providers; and how the Event Healthcare Standard applies across events, television and film production.
One of the most significant changes for the sector is the extension of CQC registration requirements. However, that change cannot be considered in isolation. As one webinar attendee pointed out, much of the relevant guidance and many of the wider requirements are already in place.
That is true. The principles of healthcare planning, clinical provision, clear governance and effective risk assessment are not new. The difficulty is that they have not always been understood or implemented consistently across the sector.
The current changes are therefore doing more than introducing a new regulatory requirement. They are prompting organisers, production teams and providers to look again at how decisions about healthcare provision are made, what evidence those decisions are based on and whether the arrangements in place are appropriate for the risks involved.
The question many people are now asking is whether they need a CQC-registered provider. It is an important question, but it is not the first one that needs to be answered
Where to begin
Every organiser understands their event. They know the audience, the programme, the environment and the risks already identified through the planning process. The next step is to consider those risks in terms of their potential impact on people’s wellbeing and the healthcare response that may be required.
Which risks could result in physical or psychological harm? What types of presentation are reasonably foreseeable? What level of response might be needed if those risks materialise? These questions help define the healthcare provision the event or production is likely to require.
Previous treatment and incident data can help show what has happened at the event before, while data from comparable events may provide a useful starting point where no event-specific information exists. Audience demographics, attendance, duration, environmental conditions, alcohol availability and the nature of the event can all affect likely demand. Measures such as the Patient Presentation Rate (PPR) can also support planning by estimating how many people may seek healthcare during an event. None of these factors provides the answer on its own, but together they offer a more informed basis for deciding what provision may be required.
For some organisations, particularly where the event or production is more complex, independent advice can help translate the event risk assessment, available data and likely demand into a clear healthcare requirement. That gives organisers and production teams a stronger basis for procurement, helps them ask better questions and reduces the risk of simply buying a familiar package of staff, vehicles or job titles without knowing whether it is appropriate.
From there, discussions with prospective providers can focus on the healthcare activities they will be expected to undertake.
The Event Healthcare Standard
Although the final Event Healthcare Standard has not yet been published, it is intended to provide a more consistent framework for planning and delivering healthcare at events and productions. It will sit alongside existing legislation, professional regulation and established guidance, helping organisers and providers take a more structured approach to deciding what healthcare is required.
Once those activities are understood, the next question is whether the care required falls within first aid or crosses into Treatment of Disease, Disorder or Injury.
Understanding the Line: First Aid or TDDI?
Once the likely healthcare requirement has been identified, the next step is to understand what those delivering the service will be expected to do. The next question is whether the care required falls within first aid or crosses into Treatment of Disease, Disorder or Injury.
It is often described as a line, and in practice that line is not always easy to identify. It is not determined simply by a person’s job title, the equipment available or the name given to the service. What matters is the healthcare activity being delivered on site.
Some presentations may be managed within first aid. Others may involve clinical assessment, decision-making or treatment that falls within TDDI. An event or production may require both, and the distinction cannot always be reduced to a straightforward list of treatments.
As the event organiser or production lead, you need to understand as clearly as possible what healthcare your event is likely to require before approaching providers.
Providers will respond based on the services and models of care they are able to offer. This may result in different proposals, leaving the organiser with an important question: how do you assess those recommendations and decide what is right for your event?
Having a clear understanding of the likely healthcare need gives you a stronger basis for asking questions, comparing proposals and making an informed decision. Where the position is unclear, independent advice can help establish that starting point before providers are approached.
Do you need a CQC registered provider?
Once you have established that your event requires Treatment of Disease, Disorder or Injury (TDDI), the next step is to consider the regulatory requirements that apply to the service being provided.
Broadly speaking, where an event requires TDDI, the service will generally need to be delivered by a CQC-registered provider under the new regulatory framework.
As with many areas of healthcare regulation, there are proposed exceptions for specific circumstances. The Care Quality Commission consultation has outlined a number of these, although the final position has yet to be confirmed at the time of writing. Rather than exploring every exception here, it is more important to understand the general principle. This article is intended to help event organisers understand the process and recognise when specialist advice may be needed.
How do you check CQC registration?
If your event requires a CQC-registered provider, don't rely solely on searching by name. Many organisations have similar trading names, making it easy to check the wrong provider.
Ask the provider for their CQC registration number. This can be verified on the Care Quality Commission's online register. While you're there, check that they are registered for the activities they will be providing at your event.
https://www.cqc.org.uk/care-services
For example, if they may need to take patients off-site for treatment, check they are registered for patient transport. If they are providing treatment beyond first aid, check they are registered for Treatment of Disease, Disorder or Injury (TDDI). If they are offering on-site diagnostic services, such as X-rays or ultrasound, check they are registered for the appropriate diagnostic activities.
A reputable provider should be happy to supply this information as part of their tender or proposal.
Final thought
For event organisers, you do not need to become experts in healthcare regulation, just know which questions to ask. Start by understanding the healthcare needs of your event. Decide whether those needs can be met through first aid or require Treatment of Disease, Disorder or Injury (TDDI). If regulated healthcare is required, ensure the provider has the appropriate CQC registration to deliver the services they are proposing.
Taking this structured approach will help you select the right provider, meet your responsibilities as an organiser and, most importantly, ensure that people attending your event receive safe and appropriate care when they need it.
The regulatory landscape may be changing, but the principle remains the same: understand the healthcare your event or production requires first, then select the provider best placed to deliver it.