Why every UK event organiser must create a proper medical needs assessment – and why most get it completely wrong.
If you’re organising an event in the UK, the Purple Guide requires you to create a medical needs assessment. It’s not optional, it’s not a suggestion – it’s a legal requirement for licensed events. But here’s the problem: most event organisers think this is just about counting first aiders and calculating ratios based on attendee numbers.
They’re wrong.
A proper medical needs assessment isn’t about how many first aiders you need – it’s about identifying every medical risk at your event and ensuring you have the right resources to manage them safely. Get it wrong, and you’re not just risking attendee safety – you’re exposing yourself to serious liability.
What the Purple Guide Actually Requires
The Purple Guide is crystal clear: “Every event should have an appropriate level of medical cover, set out in a specific medical plan and based on a comprehensive medical needs assessment.”
It goes further: “The calculation of medical needs should not be based solely on expected numbers attending.”
This isn’t bureaucratic box-ticking. This is about understanding that a 5,000-person rock festival needs completely different medical provision than a 5,000-person classical concert, even though the attendance numbers are identical.
Why Most Medical Needs Assessments Fail
We’ve reviewed hundreds of medical needs assessments over our 5 years in the industry, and the majority make the same fundamental mistakes:
- Focus only on attendee numbers – “We have 3,000 people, so we need X first aiders”
- Use generic templates without considering event-specific risks
- Miss environmental hazards completely
- Created by people who don’t understand medical emergencies or event dynamics
- Ignore site-specific factors that could cause multiple casualties
The result? Inadequate medical cover that fails when you need it most, and potential legal liability for failing to meet your duty of care.
The Purple Guide’s 3-Step Assessment Process
The Purple Guide outlines a specific methodology for calculating medical needs:
Step 1: Predict Expected Presentations
This isn’t guesswork. It’s based on:
- Event type and activity level (active participation vs passive attendance)
- Duration (presentations increase markedly after 6 hours)
- Environmental factors (temperature, weather, terrain)
- Audience demographics (age profile, alcohol consumption, camping)
- Historical data from similar events
Step 2: Predict Peak Demand
Most events see 10-20% of their daily medical presentations in a single hour. Your medical provision must handle this peak, not just the average demand.
Step 3: Match Resources to Predicted Demand
This means having the right skills, equipment, and capacity for your predicted presentations – not just bodies in high-vis vests.
Critical Risk Factors Most Organisers Miss
A proper medical needs assessment must identify and address these often-overlooked risks:
Environmental Hazards
- Uneven ground and trip hazards that cause ankle injuries and falls
- Steps and level changes that become dangerous in crowds or poor lighting
- Weather exposure – both heat exhaustion and hypothermia risks
- Site accessibility for emergency vehicles and stretcher access
Event-Specific Risks
- Moshing and crowd dynamics at rock concerts
- Alcohol and substance use at festivals (significantly increases medical presentations)
- Physical participation in sports events or adventure activities
- Camping complications (doubles presentation rates for camping attendees)
Vulnerable Groups
- Age demographics (elderly attendees have different medical needs)
- Disability access and specific support requirements
- Intoxication levels and associated risks
- Mental health considerations for high-stress or emotional events
Real-World Examples: Why Context Matters
Outdoor Music Festival (3,000 attendees):
- High alcohol consumption expected
- Uneven grass terrain with temporary structures
- Hot weather forecast
- Camping element
- Result: Higher medical presentation rate, need for intoxication management, trip hazard mitigation
Indoor Corporate Conference (3,000 attendees):
- Minimal alcohol, professional environment
- Climate-controlled venue with level access
- Older demographic (higher cardiac risk)
- Result: Lower presentation rate but need for cardiac emergency capability
Sports Ground Event (3,000 attendees):
- Physical activity increases injury risk
- Spectator areas with steps and barriers
- Weather exposure
- Result: Focus on musculoskeletal injuries and crowd safety
Each requires completely different medical provision, despite identical attendance numbers.
What Your Medical Needs Assessment Must Include
A compliant medical needs assessment should address:
Site Risk Analysis
- Ground conditions and trip hazards
- Access routes for emergency vehicles
- Lighting levels and visibility
- Weather protection and shelter
Event Risk Factors
- Activity type and participation level
- Expected alcohol/substance use
- Duration and timing
- Camping or overnight elements
- Treatment facility specifications
- Communication and coordination systems
Common Mistakes That Create Liability
Using Last Year’s Assessment Without Review Every event is different. Weather, lineup changes, site modifications, or timing changes all affect medical risk.
Generic Template Approach Downloading a template and filling in attendance numbers isn’t a medical needs assessment – it’s a compliance exercise that won’t protect you when something goes wrong.
Not Involving Medical Professionals Your assessment should be created or reviewed by someone who understands both event dynamics and medical emergencies – not just event management.
Ignoring “Reasonably Foreseeable” Presentations The Purple Guide requires you to plan for medical situations that might “reasonably” occur – not just the most likely scenarios.
Questions Your Assessment Must Answer
Before finalising your medical provision, your assessment should clearly answer:
- What medical situations might reasonably occur at this specific event?
- What environmental and site risks could cause injuries?
- Do we have the right clinical skills for our predicted presentations?
- Can emergency vehicles access all areas of the site?
- How will we handle peak demand periods?
- What happens if our primary medical facility is overwhelmed?
The Legal Reality: Duty of Care
Creating a proper medical needs assessment isn’t just about Purple Guide compliance – it’s about fulfilling your legal duty of care to attendees. If someone is seriously injured at your event and your medical provision is found to be inadequate, the courts will examine whether you conducted a proper risk assessment.
A generic, template-based assessment won’t protect you. A comprehensive, event-specific assessment created by competent professionals will.
Getting It Right: Professional Medical Needs Assessment
A proper medical needs assessment requires:
Medical Expertise: Understanding what medical presentations are likely and what resources are needed to manage them safely.
Event Experience: Knowing how different event types, weather conditions, and site factors affect medical demand.
Purple Guide Knowledge: Understanding the regulatory requirements and how to demonstrate compliance.
Site-Specific Analysis: Evaluating your unique venue, risks, and circumstances.
Frequently Asked Questions
Who should create my medical needs assessment? Someone with both medical knowledge and event experience. Many event organisers lack the clinical understanding to predict medical presentations accurately.
How often should I update my assessment? Any time event factors change – weather, lineup, site layout, timing, or capacity changes all require reassessment.
Can I use the same assessment for different events? No. Each event requires its own specific assessment based on its unique risks and circumstances.
Protect Your Event with Professional Assessment
Don’t risk your event’s safety or your legal compliance with a generic medical needs assessment. Every event is unique, and your medical provision should reflect your specific risks, audience, and site conditions.
We provide comprehensive medical needs assessments that consider all aspects of your event – from crowd dynamics to environmental hazards to regulatory requirements. Our assessments are created by experienced clinicians who understand both Purple Guide requirements and real-world event medical demands.
Ready to ensure your event is properly protected?
Contact us for a professional medical needs assessment that meets Purple Guide requirements and protects your duty of care obligations.
Because when it comes to medical emergencies, proper planning isn’t optional – it’s essential.
Marches Ambulance Service provides Purple Guide compliant medical needs assessments and comprehensive event medical cover across Herefordshire, Worcestershire, and beyond. Contact us at hello@marchesambulance.co.uk or 01568 605110.
