Dedicated health teams at football matches benefit crowd care

Matching services more precisely to need reduces hospital transfers

A smaller, dedicated healthcare team can improve care given to crowds at football games, research shows

Inside the Den Stadium, London. Picture: Stadium Bank/Alamy

Small, dedicated healthcare teams can improve care given to crowds at football matches, research shows.

A study of emergency service provision during 900 healthcare episodes at Millwall Football Club over a 14-year period, revealed a fall in referrals to hospital – even though crowd sizes have increased. 

Nurses were involved in 44% of episodes of care with many cases dealt with directly at the ground, taking pressure off local emergency departments, the study suggests.

Before 2008/2009, medical services at Millwall were composed of a safety officer, pitch-side medical team for players only, ambulance service for major incidents, a crowd doctor and St John Ambulance first aiders.

But since 2009/2010, they were replaced by a team of a safety officer, two registered clinicians and a medical coordinator, an ambulance service officer and one first aider per thousand spectators.

High turnover rates

Under the previous arrangements, there was a high turnover of healthcare professionals and a low threshold for referring to the emergency department.

Lead study author and chair of healthcare workforce modelling Alison Leary, has advised and worked with Millwall on deploying emergency medical healthcare teams for more than 20 years.

Professor Leary used the study to explore whether a mixture of first-aiders, nurse practitioners and doctors using a team-based approach could improve care, without increasing risk to fans and players.

The study said guidance on crowd medical cover at English Football League games has focused on extreme circumstances such as the Hillsborough disaster in 1989, when in reality most demand on present-day services is from patients who have minor injuries, exacerbations of injuries and pre-existing conditions.

A risk-based approach

Professor Leary said: ‘The principles used here can work across any setting. There is still a plan if there is a disaster, but it’s about gathering intelligence to understand demand and nurses supporting first-aiders via a risk-based approach through looking at the complexity of patients.

'In recent years, austerity measures in England have also placed resource constraints on providers such as the statutory ambulance service and the acute sector. Managing demand at source has become a fundamental necessity.’

The research from 2002-2016 was carried out by researchers at London South Bank University’s school of health and social care.

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