Supporting registration guidance for delivering Treatment of disease, disorder or injury at events

Paramedics running an independent ambulance company

I am a paramedic who runs an independent ambulance service that provides health care and treatment (not just first aid) to people attending and participating in events. My company is not currently registered with CQC as we only provide services at events and not in any other setting. Does my company now need to register?

Yes, you will need to register. The government has now updated the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 so that health care and treatment delivered at sporting and cultural events is now within scope of the regulated activity of Treatment of disease, disorder or injury. You will therefore need to register for this regulated activity.

Providers delivering health care at events across England

My company provides healthcare cover in sports grounds as well as under temporary arrangements at events. We have one base, but we provide health care and treatment at multiple different events across England. Will we need to register each event site as a separate location with CQC?

No. For the purposes of CQC registration, a location can be either the site at which the regulated activity is delivered or, for services that deliver care at a number of different locations – such as ambulance providers, the site at which the regulated activity is organised or managed from. Therefore, providers that deliver health care at events, and they operate from only one base, will usually just need to register one location, which is the base at which they manage the regulated activity from. See our guidance What is a location? for more information.

Physiotherapists at sporting events

I’m a physiotherapist specialising in sports injuries. I also prescribe medicine. I regularly attend sporting events where I’m on standby for treating participants who have sustained injuries. Do I have to register with CQC?

No. Physiotherapists are not included within the list of healthcare professionals who are required to register with CQC for the regulated activity of Treatment of disease, disorder or injury, so you will not have to register with CQC.

Medical practitioners volunteering at events

I’m a medical practitioner and I often volunteer at local horse racing events to provide health care and treatment (not just first aid) to participants and staff in case of injury. When called upon, I deliver treatment across an event. Do I have to register, even though I’m a volunteer and I’m not paid?

This depends on who is responsible for the delivery of the regulated activity.

If you are solely responsible for delivering the regulated activity, you will need to register with CQC. This is regardless of whether you receive payment as there is no exemption for voluntary services.

If you are commissioned by an organisation, for example a sports governing body, to deliver the regulated activity on their behalf, then it’s the organisation that will need to register with CQC. You must agree who is responsible for carrying on the regulated activity and ensure they are appropriately registered with CQC before doing so.

NHS GP providing treatment at events on an independent basis

I am a GP partner at an NHS GP practice that is registered with CQC. Outside of my NHS role I am contracted to provide GP services at sporting events and some festivals. I am always located in an equipped medical consulting room on the event site. Do I have to register with CQC in respect of my events work?

Providing it's only you (as the GP) who is delivering the GP service at events or festivals, and you only provide treatment in the consulting room on the event site, then you will be exempt and you will not have to register.

However, please be aware that the exception does not apply if you are treating patients who have treatment under anaesthesia or intravenously administered sedation, unless the treatment is restricted to nail bed procedures using local anaesthesia.

The exception will also not apply if treatment involves intravenous, intrathecal or epidural administration of medicines or diagnostic agents, the therapeutic or diagnostic use of x-rays, radiation, protons or magnetic resonance imaging or invasive cardiac physiology tests.

For more details, see the exception about Medical practitioners in independent practice on our Relevant exceptions to registering page.

Private first aid company that employs a pharmacist

I run a private first aid company and provide cover at local fetes and music festivals. The company also employs a pharmacist so that we can provide various medicines that the pharmacist prescribes, for example analgesia, antibiotics, hay fever medicines and asthma treatments in cases where participants forget or run out of their medication. Do I have to register with CQC?

No. Pharmacists are not included within the list of healthcare professionals who are required to register with CQC for the regulated activity of Treatment of disease, disorder or injury, so you will not have to register.

Providing treatment to professional sports people

My company provides care and treatment to professional sports people who are employed by a football club. We also provide treatment to young people who have a recognised arrangement to play for the club's youth team. Do I have to register my company with CQC?

No. As long as the professional receiving treatment doesn’t need to stay in hospital because of the disorder or injury, and the treatment is arranged by the football club on behalf of the professional sports people and youth team, then you don't need to register. But be aware that this exemption only applies to the professional sports person – it does not extend to their family or friends. 

First aiders seeking advice from listed healthcare professionals

My company provides first aid at events. We employ both listed healthcare professionals as well as trained first aiders. Our first aiders may sometimes ask for clinical advice from the listed healthcare professionals in the course of their duties. For example, if they are concerned about signs of infection and whether the person may need antibiotics or further treatment. Does the involvement of a listed healthcare professional in this instance mean we need to register for TDDI or is this still classed as first aid?

Yes, you would need to register for TDDI. In this scenario, the act of seeking advice from a listed healthcare professional means that the interaction has moved beyond the delivery of first aid and into the assessment and treatment of a disease, disorder or injury. In this case, the listed healthcare professional is providing clinical advice, specifically because of their expertise.

Multiple providers working together at an event

We host a regular, large-scale event. We have multiple providers of health care and first aid working across the event. Some are in scope of CQC registration and are consequently registered with CQC and some are out of scope and are not registered. In certain circumstances, some of the providers may work together to provide treatment or respond to a situation. Does this mean that all the providers must be registered with CQC?

Not necessarily. The fact that a number of providers work together in a team does not automatically mean they must all be registered with CQC. This is because the formation of a team does not alter or override any exceptions that already apply.

However, where treatment is delivered by a multi-disciplinary team comprising multiple professionals who are employed by, or volunteer for, a single provider (including at least one listed healthcare professional), that provider must be registered with CQC.