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The Ask Simplified:

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1. Ensure Medical Provision is included on Event Terms of Use

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2. Ensure that event organiser are required to organise event medical

staffing to the recommended Purple Guide standard

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3. That checks are undertake to ensure that events use appropriate 3rd party medical suppliers, with the correct:

  • public liability insurance

  • medical indemnity insurance

  • employers liability insurance

  • Appropriately trained staff with in date and suitable qualifications

  • fleet insurance for vehicles (where appropriate)

  • Governance in place for data protection, safeguarding, infection prevention and control, DBS checks on all patient facing staff

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4. That event medical plans and risk assessments are produced

Championing all Councils in Greater Manchester to abide by the Purple Guide for Event First Aid

The Purple Guide is a guide offering health, safety and welfare advice for event organiser, particularly for outdoor events and festivals. It covers best practices for planning, risk management, crowd safety and emergency procedures. The Purple Guide is not legally mandatory, but it is considered best practice within the UK events industry. It supports compliance with legal duties under the Health & Safety at Work act 1974 and related regulations. In the event of an enquiry or investigation, organisers who have followed the guidance are likely to be viewed more favourably, as it demonstrates they took reasonable steps to ensure safety. Conversely, deviating from the guide without justification could raise questions about negligence or insufficient planning.

The Medical Chapter focuses on ensuring appropriate medical provisions for attendees and staff. It outlines how to assess medical needs based on event size, type, and risk profile; guidance on medical staffing, facilities, first aid and coordination with local NHS and emergency services.

Each event is graded according to the Purple Guide in to 5 Tiers. Our ask of the Councils is that they will commit to ensuring that event organisers follow the Purple Guide when planning their events to ensure that each and every event delivered in Greater Manchester is delivered to the highest possible standards. 

Tier 1

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Tier 1 events are the smallest and simplest events. The presence of some of these factors indicates than event maybe Tier 1

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  • duration of a few hours or less

  • no activities carrying a risk of injury

  • no or minimal alcohol consumptions

  • no or minimal recreational drug us

  • fewer than 500 attendees

  • hospital referrals very unlikely

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Cover Level

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  • provisions of  suitable first aid kit and someone to use it

  • location of the nearest defibrillator and how to access it

  • ensuring the appropriate people know how to access emergency assistance

Tier 2

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Tier 2 events are somewhat larger events which often fall within the scope of authority licensing. The presence of some of these indicate that an event maybe in Tier 2

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  • duration more than few hours but no longer than a day

  • low risk of illness or injury from activities

  • social drinking of alcohol

  • no more that isolated drug use

  • up to 2,000 attendees

  • hospital referrals unlikely

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Cover Level

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  • a nominated lead who is responsible for the delivery of service on site

  • supporting first responders of healthcare professionals

  • an ambulance with suitably qualified crew if hospital transfers are expected

Tier 3

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Tier 3 events are normally larger events with greater potential for illness and injury. The presene of some of these indicate that an event maybe in Tier 3

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  • duration more than one day

  • moderate risk of illness or injury from activities

  • alcohol intoxication likey

  • drug intoxication likely

  • up to 5,000 attendees

  • hospital referrals foreseeable

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Cover Level

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  • a clinical lead, who should be a registered healthcare professional with pre-hospital experience

  • other healthcare professionals, such as doctors, paramedics and nurses

  • first responders

  • ambulance(s) with suitably qualified crew if hospital transfers are expected

Tier 4

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Tier 4 are larger and more complex events, where more medical presentations maybe expected. The presence of some of these indicates that an event may be in Tier 4

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  • durations one to several days

  • significant risk of illness or injury from activities

  • alcohol intoxication expected

  • drug intoxication expected

  • up to 10,000 attendees

  • hospital referrals likely

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Cover Level

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  • a clinical lead, who should be a registered healthcare professional with pre-hospital experience

  • healthcare professionals, such as doctors, paramedics and nurses

  • first responders

  • ambulance(s) with suitably qualified crew 

Tier 5

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Tier 5 are the largest or more complex events, including all mass gatherings, as well as smaller events that have higher risks. The presence of some of these indicates that an event may be in Tier 5

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  • duration several days

  • high risk of illness or injury from activities

  • alcohol intoxication expected

  • drug intoxication expected

  • more than 10,000 attendees

  • referrals to hospital expected

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Cover Level

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  • a clinical lead, who should be a registered doctor, preferably an emergency medicine specialist

  • registered healthcare professionals, including doctors, paramedics and nurses

  • first responders

  • ambulance(s) with suitably qualified crew 

  • control staff

  • Organisers should ensure that sufficient medical resources are provided to deliver the level of cover throughout the event. If an ambulance and crew are required to undertake a hospital transfer, this should not compromise the cover left on site

  • Prospective medical providers should submit a specific Medical Needs Assessment which should be used to determine the extent and level of cover required. This will then be used to create a detailed medical plan

Who is qualified to be a First Responder?

Organisers should obtain assurance from the medical provider that all staff working at the event hold current and appropriate qualifications and certification for their designated roles. Some roles have protected titles such as:

  • Doctors

  • Paramedic

  • Registered Nurse

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Medical Providers might use a range of titles to describe their medical staff. Below is a list of qualifications and which fall in to 8 categories from A to H based on competency and capability. The minimum qualification level for working unsupervised at licensed events is D or higher

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Which Councils have agreed to ensure that all events, from smallest to large abide by the Purple Guide for Medical Provision

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Salford City Council

Salford City Council replied very quickly. They informed us that they work with representatives from North West Ambulance Service to review the safe levels of medical cover at outdoor events across the city. They use this advice along with the Purple Guide.

The event medical provision planning section of Salford City Council website is the same guidance and advice that the Purple Guide sets out.  


In terms of the ask:

1. Salford City Council DO have clear medical provision requirements in their Terms of Use documents

2. Salford City Council DO have process with NWAS and utilising the Purple Guide to ensure best practice is followed.

3. Salford City Council REQUEST that event organiser check for the required documentation from Medical providers, however it is not certain if this information is required to be supplied as part of the application process.

4. Salford City Council DID NOT state if they require event medical plans and risk assessments to be submitted as part of the event planning.

Which Councils are we waiting on a response from

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Bolton Council

We have reached out to the Council and they have yet to respond to our enquiry

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Bury Council

We have reached out to the Council and they have yet to respond to our enquiry

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Manchester City Council

We have reached out to the Council and they have yet to respond to our enquiry

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Oldham Council

We have reached out to the Council and they have yet to respond to our enquiry

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Rochdale Council

We have reached out to the Council and they have yet to respond to our enquiry

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Stockport Council

We have reached out to the Council and they have yet to respond to our enquiry

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Tameside Council

We have reached out to the Council and they have yet to respond to our enquiry

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Trafford Council

We have reached out to the Council and they have yet to respond to our enquiry

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Wigan Council

We have reached out to the Council and they have yet to respond to our enquiry

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