Home / Physical factors / Medical and first aid provision Medical and first aid provisionDuring events, there should be an appropriate level of medical care in place for all those present at a sports ground. During events, there should be an appropriate level of medical care in place for all those present at a sports ground. This is determined by a Medical Needs Assessment (also known as a Medical Risk Assessment). This should be used to develop the Medical Plan, part of the Operations Manual. During events, there should be an appropriate level of medical care in place for all those present at a sports ground. The details on the medical and first aid provisions relate to the needs of all spectators, staff and personnel at an event, and not to those of athletes, players or event officials, for whom other medical arrangements should be in place, as determined by the relevant sport’s governing body. Chapter 18 of the Green Guide outlines detailed information on the medical and first aid provision which should be available at sports grounds. In summary, this includes: Conducting a Medical Needs Assessment in order to determine the appropriate level of provision needed. Developing this assessment into a Medical Plan. The provision and identification of key medical personnel, including a Medical Co-ordinator, Event Doctors and/or Event Practitioners, and first aiders Medical / first aid room, along with its equipment, storage, upkeep and inspection Ambulance provision Communications Inspections and records At many sports grounds, safety management procedures are subject to the regular oversight of a Safety Advisory Group (SAG). At larger or more complex sports grounds it may also be advisable to form a Medical Advisory Group (MAG) to oversee medical and first aid provision and to report to the SAG. Medical Needs Assessment In order to determine the appropriate level of medical and first aid provision needed for a sports ground, a Medical Needs Assessment should be completed. This should be carried out by a competent person or medical provider, such as a Medical Co-ordinator (if the ground has one) and/or an Event Doctor. The Medical Needs Assessment should be carried out in consultation with: medical and first aid providers the statutory ambulance service NHS trust or other NHS authority ambulance providers registered with the Care Quality Commission (in England), or its equivalent the local authority, where a safety certificate is in force. Factors to consider The medical and first aid provision of a sports ground will vary according to its capacity, layout and complexity, along with the nature of the event or events taking place, the profile of spectators and the current level of national security threat. The Medical Needs Assessment should take account of factors including: Physical factors the physical layout of the sports ground and its surroundings (including roads, car parks and other features such as waterways and railway lines) the design of the ground the presence of upper tiers or extensive areas of spectator accommodation, the access and egress routes serving these areas the presence of areas of standing accommodation or temporary demountable stands the location of the ground control/ambulance control point, first aid posts, and other key locations identified in the management’s contingency plans and emergency procedures the type, operation and range of radio and other communication systems. Safety management factors the safety management structure and lines of communication the management’s contingency plans and emergency procedures the training and competency of medical personnel hazards or risks posed to spectators by the nature of the event being staged historical data of treatments for injuries and medical conditions, including those of similar events elsewhere. Event specific factors the type and nature of the event the likely attendance and levels of crowd density the anticipated spectator profile (age, gender, disabled spectators) the anticipated crowd behaviour (including the possible effects of long queuing times, and alcohol or drug use) the timing and duration of the event the use of special effects the requirements of the sport’s governing body the likelihood of a player, athlete or event official needing treatment from medical personnel commissioned by the ground management any event overlay likely weather conditions. Medical Plan The Medical Plan should outline the number of medical personnel needed for an event (including Event Doctors, paramedics or first aiders) It should also include: the numbers, duties and location of all members of the medical team the size, location and number of permanent or temporary first aid rooms and facilities where appropriate, the deployment of mobile first aid units and/or of roving first aiders the type, number and location of ambulances and their crew competencies procedures for the pre-event inspection of medical facilities and equipment procedures for responding to, and managing incidents which require a medical response the command structure, lines of responsibility and decision-making protocol within the medical team, particularly where medical teams consist of multiple providers the co-ordination and means of communication between members of the medical team, interaction with the ground’s safety management team and with medical providers outside the ground the clear identification of all medical personnel, such as uniforms, high visibility jackets or tabards the recording of all medical equipment and materials required for the first aid room, for any satellite first aid facilities, and for use in response kits carried by mobile or roving medical and first aid teams, along with the procedures for the procurement, replacement and safe disposal of such materials and equipment procedures for transferring individuals from specific areas of the ground, for example from the upper tiers of large stands, and the procedures for the transport of patients to NHS services or other providers. arrangements for the evacuation of disabled spectators, when medical assistance is required the provision of welfare facilities for medical service personnel the identification of an appropriate rendezvous point for ambulances, and where appropriate, a landing/rendezvous point for an air ambulance. The Medical Plan should be reviewed annually. Where there has been a serious incident or a near miss event, the relevant sections of the Medical Plan should be reviewed and updated prior to the annual review. The Medical Plan should also be reviewed should there be any changes in medical providers or circumstances, such as an expansion of the ground’s capacity.