Most medicine happens to people who chose you. Event medicine does not. The person in front of you did not book an appointment, has no notes, may not want to be there, and in a fair proportion of cases cannot tell you what day it is. You are treating them in a tent, in somebody else's field, with a crowd outside, and the record you make will be the only trace that any of it happened.
That combination puts governance where a clinic never does. The consent conversation is harder because capacity is genuinely in doubt rather than theoretically. The record matters more because nothing else exists. Safeguarding is operational rather than a policy in a folder, because events attract children and adults at risk in numbers. And the question of who indemnifies you has an answer you want before the day rather than after it.
Planning Event Medical Cover sets the framework and The Event Medical Team and Command covers the roles. This page is about what attaches to you personally once you are treating somebody.
Duty of Care and Indemnity
Where your duty comes from is worth being precise about. Some of it arrives with the contract: if you are booked as the event doctor, duties attach to that role before any particular patient appears. Some of it is professional rather than contractual, because you are expected to offer help in an emergency, taking account of your own safety, your competence and whether other care is available. And once you have started caring for someone, what matters is that care continues safely, either because you continue it or because you hand over to somebody who can.
Indemnity is the part people assume. Working for a provider does not automatically mean the provider indemnifies you, and your usual arrangements may not cover event medicine, which is a different activity from your day job and may sit outside what you declared. It is a question with a specific answer and a phone number attached. The Green Guide makes appropriate professional indemnity an explicit requirement for an Event Doctor, which tells you how seriously it is taken.
Scope is the other half. What you may do is set by your current competence, your registration, the governance you work under and your indemnity, exactly as it is for a pitchside bag. A long queue does not enlarge it.
Red Flags
•You do not know who indemnifies you for this work.
•The organiser is asking for clinical detail about a patient.
•A child has been treated and nobody knows who brought them.
•The only account of a serious incident is somebody's memory.
Consent and Capacity
The General Medical Council's guidance on decision making and consent applies in whatever setting your interaction with a patient takes place, and a medical tent is a setting like any other. What an event changes is not the law. It is how often the law gets difficult.
Start from the presumption. Every adult is presumed to have capacity, and it is never for an adult to prove their own. You must not assume a patient lacks capacity because of their age, their disability, their appearance or their behaviour, and that includes the fact that they have been drinking. Intoxication is not incapacity. A drunk spectator who can understand, retain, weigh and communicate a decision can refuse you, and your disagreeing is not evidence that they cannot.
Capacity is decision-specific and time-specific. Assess it for the particular decision, at the time it has to be made, and take all practical steps to support the decision before concluding it is absent: move somewhere quieter, wait if waiting is safe, explain it differently, treat the hypoglycaemia. Somebody who cannot decide about transfer at ten o'clock may decide perfectly well at midnight.
A capacitous adult may refuse treatment even where refusal will lead to serious harm or death, and that refusal must be respected whether or not you agree with it. This is where event clinicians come under most pressure, because a crowd is watching and the patient is walking away. Keep the conversation open, offer again, and write down what you told them.
Where capacity is genuinely absent, check first whether anything already answers the question: a valid and applicable advance refusal, or somebody with legal authority to decide. If neither exists, you act in what would be of overall benefit. Capacity legislation and terminology differ across the UK, so work to the framework of the jurisdiction you are standing in.
Children need more than a sentence. A child under sixteen may be competent to consent for themselves if they have sufficient understanding of the decision. A sixteen or seventeen year old is generally presumed able to consent to their own treatment. Where a child cannot consent, someone with parental responsibility can, and the adult standing beside them at a festival may not be that person. And in an emergency, where treatment is immediately necessary to save life or prevent serious deterioration, you may treat without consent while you find the person who has it. The detail varies by jurisdiction.
Consent at an event: the law does not change, it just gets harder.
Records and Confidentiality
The record is the thing. In a clinic there are notes, a letter and a system. At an event there is what you wrote, and it will be read by a hospital within the hour and possibly by a coroner within the year.
Write it at the time. Legible, timed, dated and signed, with what you found, what you did and what you advised, including the advice somebody declined and the words you used to explain the risk. A refusal that is not documented is indistinguishable afterwards from a patient you never saw.
Confidentiality does not soften because the setting is informal, and the boundary sits further back than people expect. Confirming that an identifiable person was treated is itself a disclosure. What the organiser needs is the minimum operational information required to run the event safely, shared with the patient's consent or another lawful justification, which is a different sentence from telling them what happened. Team management, sponsors and the press are the same problem in different clothes, and a club may assume an access to its own player's information that it does not automatically have.
The record is a health record and it is special category data under UK data protection law. Who controls it depends on who decides the purposes and the means of processing it, so the provider and the organiser may be separate controllers or joint ones. That is not a question to work out in a van at midnight. Settle the controller, the storage, the transfer, the access and the retention before the event.
What the organiser may be told, and what stays in the record.
High-Yield
•Intoxication is not incapacity; assess the decision, at the time.
•A capacitous adult may refuse, even where refusal risks serious harm.
•Share the minimum operationally necessary, with consent or a lawful basis.
•A refusal you did not document is a patient you cannot prove you saw.
Safeguarding
Events attract children and adults at risk, often unaccompanied, sometimes intoxicated, occasionally separated from whoever is responsible for them. That makes safeguarding operational rather than theoretical.
Two things belong in your head before the day. Who the event's safeguarding lead is and how you reach them. And what your own threshold is for escalating, because the pull on a busy afternoon is always towards not making a fuss.
Disclosure clearance is one of the Green Guide's requirements for an Event Doctor. It is a check on you rather than a safeguarding system, and it does not replace knowing the procedures or following them.
Two situations recur. A child treated alone raises the question of who is responsible for them, and what you do about it turns on their age, their competence and the risk in front of you rather than on a rule. And an adult at risk who wants to leave needs a capacity assessment rather than an assumption in either direction. Where you suspect serious harm, escalate promptly, and share information where sharing is justified.
Key Evidence and Guidelines
•The General Medical Council's guidance on decision making and consent sets the professional standards and applies in whatever setting the interaction takes place, with principles written to be consistent across the UK while the underlying legislation differs by jurisdiction.
•Capacity legislation and terminology differ across the UK, with the Mental Capacity Act 2005 covering England and Wales and separate frameworks in Scotland and Northern Ireland.
•The General Medical Council's guidance on children and young people is read alongside the consent guidance for any patient under 18, and its confidentiality guidance sets the framework for disclosure.
•Under UK data protection law, health records are special category data, and controller status depends on who determines the purposes and means of processing rather than on who is holding the paperwork.
Exam Tips
•Every adult is presumed to have capacity, and it is never for them to prove it.
•Intoxication is not incapacity; assess the specific decision at the time it arises.
•Support the decision before concluding capacity is absent, and check for an advance refusal or proxy.
•A capacitous adult may refuse treatment even where refusal risks serious harm.
•Share the minimum operationally necessary, with consent or another lawful basis.
•Document what you advised, including what was declined, at the time you advised it.