Planning Event Medical Cover – Where do you start?

Event organisers need to talk to their medical provider early in their planning cycle, as the best and most effective medical cover is evolved by discussion and debate and not as the result of any box ticking, says Dr Brian Robertson, Chairman, Event Medicine Company.

So you have an idea for an event and start with a blank sheet of paper........There is a long list of requirements and things to think about before one even gets to the artists or performers if it is that type of event. This list includes, in no particular order, licensing, venue, structures, trackway, toilets, barriers, waste disposal, litter picking, ticketing, health and safety, catering, communications, security and stewarding, traffic management and parking, branding, electrical services and, not least, insurances.

There is then another list of agencies and organisations to liaise with including local authorities, safety advisory groups, emergency services, residents groups and some specialist agencies such as the Maritime and Coastguard Agency, the Forestry Commission, the Royal Parks and the Civil Aviation Authority, all depending on the type of event being planned.

Missing from the above are your event medical cover requirements that do not only apply to the live show days but the build and break periods, which both require appropriate cover. At a recent very medically low risk three-day event, covered by the author’s Company, 65% of the patient contacts occurred on the single build day, so the risks must not be ignored.

It has been stated many times that it feels that medical cover is at the bottom of some people’s agenda and last week an e-mail rejecting our quotation for an event blatantly stated they had to deal with more important issues first and the budget had now run out, so they couldn’t afford our quote. One has to wonder what cover that event eventually had, if indeed it had any.

Many event organisers need to remember that at the end of the day, they will be held liable for the services provided to their public by any or all or their contractors. So who does set a budget for a specialised area such as medical provision? Very few event organisers or event management companies will ever admit who sets their budgets and many will say their ultimate Clients. Sadly, it is felt that too few event organisers have any understanding of the real costs of professional medical services. Event organisers are urged to talk to their medical provider early in their planning cycle as the best and most effective medical cover is evolved by discussion and debate and is not the result of any box ticking operation. 

The Author was asked recently to consider some questions posed by event organisers who felt they were confused by the whole field of medical cover, particularly after the rewrite of the Purple Guide. They are of relevance to all at this “blank sheet of paper” stage and were, in the words as presented to the author:-

  • How do you know you’ve got it right?
  • Why do medical companies charge such massive variations?
  • Why do they recommend different levels of cover?
  • Don’t take the cheapest, but will it be safe.

The answer to all of these can be summed up in just one word “quality”. By striving for and ensuring a quality service all of these four questions, along with the subsequent ones that fall out of them, are answered.

How do you know you’ve got it right?

As urged in the Purple Guide, appoint a competent medical provider. Make that appointment on the basis of track record, recommendations, oral presentations, quality of service and results of patient satisfaction surveys. Do not appoint on the basis of asking for several quotes for a vague specification and then just take the cheapest.

Why do medical companies charge such massive variations? 

The basis of this is the lack of a level playing field in the industry sector. There are the first aid only providers versus medical providers. There are also regulated and non-regulated providers.

The event organiser needs to undertake their due diligence to establish what types of providers are bidding for their work and then ensure they compare like with like. Medical providers have significant overheads, not least insurances including medical malpractice. There are also regulatory costs, and now most providers have to provide workplace pensions. This is not to mention all the vehicle related costs: when vehicles have to be hired in from a sub-contractor costs can escalate significantly, as they will require to be hired from a regulated Company whose overheads are in turn higher.

Why do they recommend different levels of cover?

This again is a reflection of the first aid only provider, versus a medical provider situation. It is also a reflection of the experience of the provider. If you are talking to one of these expert providers, use that expertise; listen to what they recommend; discuss, debate and even argue by all means, but they are the experts. The competent medical provider will walk away from an event where the level of cover that is being paid for leaves a medically unsafe event.

All event medical provision should be structured to ensure that the event in question makes minimal impact on the local NHS facilities and services. This can only be done by the use of health care professional grades of staff, which include doctors, nurses and paramedics who can make an appropriate clinical decision and thus reduce vehicle movements and unnecessary referrals to hospitals. Even though health care professionals are more expensive, their use in appropriate numbers will reduce the total number of first aid staff an event needs and all their attendant costs.

Don’t take the cheapest, but will it be safe?

More and more procurers pay lip service to the fact they may not take the cheapest. However, it needs to be said that in our industry sector, as in so many other, “you get what you pay for”.

The number of times event organisers have been heard to say they were not happy with a particular provider, and when pushed as to why they were engaged in the first place, the response was invariable that they were the cheapest. There is another aspect to this in that the cheapest may not be the most appropriate for the venue or the event, and so we come full circle back to the medical risk assessment for the event.

What now?

Hopefully, having moved from a blank sheet of paper to one labelled “Medical Cover” and that the subject may have moved up the order of priorities somewhat, the following list can now be written:-

  • Engage early with a competent medical provider considering all the factors above
  • Let that medical provider advise on the medical risks of the event based on their expertise.
  • Discuss and evolve the medical capability needed to ensure a safe event.
  • Evolve a meaningful budget once the medical risks and the capability that is required to mitigate them is known.
  • Ensure your medical provider is involved in Safety Advisory Groups or any other planning or regulatory meetings.