If your organisation provides healthcare or medical treatment at festivals, concerts, sporting events or other sporting and cultural events, there has been an important change to CQC registration requirements.

Following changes to the law, Treatment of Disease, Disorder or Injury (TDDI) provided at events is now being brought within the scope of CQC regulation. This means that if your organisation provides treatment that falls within TDDI at an event, you may need to be registered with the Care Quality Commission (CQC).

The change does not mean that every organisation providing first aid at an event needs CQC registration. The distinction between first aid and regulated healthcare treatment is important.

For care providers, the changes are particularly relevant if your organisation provides healthcare alongside its care services, employs healthcare professionals who provide treatment at events, or works with another provider to deliver medical support.

 

What has changed?

The Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2026 have removed previous event-related exceptions from the regulations. This brings qualifying healthcare treatment provided at sporting and cultural events within the scope of CQC regulation. The CQC updated its guidance in August 2026 to reflect the changes.

The change follows recommendations from public safety reviews, including the Manchester Arena Inquiry, which identified issues around emergency preparedness and medical provision at major events. The aim is to bring qualifying event healthcare under the same CQC regulatory framework that applies to comparable treatment provided in other settings.

 

Could the changes affect your organisation?

The first question to consider is whether your organisation provides any healthcare or treatment at events.

This could include services provided directly by your organisation or services delivered by healthcare professionals working on your behalf.

TDDI can cover a range of treatment, including:

• urgent and emergency treatment
• treatment of physical or mental health conditions
• treatment relating to learning disability
• ongoing treatment for long-term conditions
• vaccinations and immunisations
• palliative care

The activity already applies in settings such as hospitals, clinics, ambulances, community services and care homes. Following the 2026 changes, it can also apply where qualifying treatment is provided at an event.

This means it is worth looking at the actual treatment your organisation provides, rather than assuming that an event-based service is automatically exempt.

First aid is not the same as TDDI

One of the most important parts of the change is understanding the difference between first aid and regulated treatment.

CQC describes first aid as the initial response to a sudden illness, injury, condition or worsening of an existing condition. It is intended to preserve life, prevent deterioration, provide comfort and reassurance, and support someone until further assistance becomes available.

First aid can include recognised interventions such as CPR and the use of an automated external defibrillator (AED).

If your organisation is providing only first aid, this does not mean that you automatically need to register for TDDI.

However, some activities go beyond first aid.

CQC states that first aid does not include activities such as:

• making a clinical diagnosis of a disease, disorder or injury
• treatment requiring the professional judgement of a listed healthcare professional
• interpreting clinical investigations
• prescribing prescription-only medicines
• using patient group directions or patient-specific directions
• providing ongoing healthcare management or treatment.

Where a listed healthcare professional uses the skills, knowledge, judgement or competencies gained through their professional registration, CQC considers this to be TDDI rather than first aid.

For care providers, this distinction is important when considering what your staff are being asked to do.

 

What if your organisation employs nurses or other healthcare professionals?

Having a registered healthcare professional involved in event healthcare does not automatically mean that your organisation needs CQC registration.

The role they are performing matters.

CQC gives the example of a registered nurse working solely as a first aider. If the nurse is acting only within the scope of recognised first aid and is not using their professional registration to provide clinical treatment, the service does not need to register for TDDI.

The position changes if the nurse uses their professional title or their nursing skills, knowledge and experience to provide treatment. In that situation, the provider may need to register.

If this applies to your organisation, consider:

• Who is providing the care?
• What qualifications and professional registrations do they hold?
• What are they actually being asked to do?
• Are they working within first aid competencies?
• Are they using professional clinical judgement?
• What treatment is available?

The answer should be based on the actual service being provided, rather than simply the person’s job title.

Not every healthcare professional is covered by TDDI

It is also important to remember that the regulations do not place every healthcare profession within the definition of TDDI.

CQC’s guidance states that certain professions are not included, including clinical psychologists, occupational therapists, physiotherapists, pharmacists, opticians, dietitians, nursing associates, emergency care assistants, first responders in emergency care and ambulance care assistants.

However, the position can become more complicated where someone has more than one qualification or professional registration.

For example, CQC gives the example of a physiotherapist who is also a qualified and registered paramedic. If they are working solely as a physiotherapist, they do not need to register for TDDI on that basis. If they use their paramedic skills and knowledge, or their professional title as a paramedic, the position can change.

For care providers, this means it is important to consider the capacity in which the professional is working, rather than simply listing all of their qualifications.

 

What about ambulance and transport services?

If your organisation provides patient transport alongside healthcare at events, this is another area to review.

CQC has separate regulated activity requirements covering Transport services, triage and medical advice provided remotely.

There is a specific distinction for event-based transport. Transport within the boundaries of an event site does not require registration under that particular transport regulated activity. However, transporting someone from an event site to hospital can be different and may require registration.

If your organisation provides both treatment and transport, it is therefore worth checking both areas.

 

What if you are already registered with CQC?

If your organisation is already registered with CQC for TDDI, you may not need to start the registration process again.

CQC advises existing providers to review their Statement of Purpose and update it where necessary to reflect event-based services.

It is worth asking:

Does our existing CQC registration and Statement of Purpose accurately reflect the healthcare services we provide at events?

If not, you should establish what changes are required.

The information held by CQC should accurately reflect the services your organisation actually intends to provide.

 

What should care providers review now?

If your organisation provides healthcare at events, now is a good time to review exactly what is being provided.

Start by looking at each part of the service.

First aid

What first aid interventions are your staff providing?

Clinical assessment

Are staff carrying out clinical assessments or interpreting clinical findings?

Medication

Are prescription medicines being administered? Are patient group directions or patient-specific directions being used?

Emergency treatment

Are staff providing treatment that goes beyond recognised first aid?

Ongoing treatment

Are staff managing existing conditions or providing continuing treatment during an event?

Vaccinations

Are vaccinations or immunisations being provided?

Ambulance transport

Does your organisation transport patients away from the event site?

Healthcare professionals

Which registered healthcare professionals provide or supervise treatment, and in what capacity?

Clinical governance

What arrangements are in place for clinical decision-making, escalation and patient safety?

Looking at these areas can help your organisation establish whether any of its event-based services are likely to fall within TDDI.

 

What are the important dates?

There are three dates that care providers should be aware of.

7 September 2026

CQC’s registration window opened on 7 September 2026.

Providers affected by the changes can submit applications, while existing registered providers can review and update their registration details where necessary.

1 March 2027

CQC is encouraging providers to submit their applications during the registration period rather than waiting.

Applications can still be submitted after 1 March 2027, but CQC warns that providers may not receive an outcome before the new requirements come fully into effect.

For care providers affected by the change, this makes 1 March 2027 an important date to work towards.

6 December 2027

From 6 December 2027, CQC’s regulatory monitoring, assessment, inspection and enforcement activity under the new requirements will begin.

Providers carrying out TDDI at events will legally need to be registered, where registration is required. CQC also states that carrying on a regulated activity without registration is an offence.

 

What should you do if you are unsure?

The difference between first aid and TDDI will not always be straightforward, particularly where your organisation provides several different types of healthcare.

If you are unsure whether your organisation’s services fall within the scope of registration, review the current CQC guidance against the specific activities your organisation provides.

It is also worth keeping a record of how you reached your conclusion and the guidance you relied on. If your service changes, the position should be reviewed again.

Where there is still uncertainty, you may need to seek appropriate regulatory or legal advice.

 

A message you can send to your healthcare provider

If your organisation uses another provider to deliver medical or healthcare services at events, you may want to ask them to confirm their position.

Subject: CQC registration and event healthcare provision

Dear [Provider Name],

As part of our planning for upcoming events, we are reviewing our medical and healthcare arrangements in light of the changes to CQC registration requirements for healthcare provided at events.

Please could you confirm whether the services your organisation provides at our events fall within the regulated activity Treatment of Disease, Disorder or Injury (TDDI)?

If CQC registration is required, please could you confirm:

• your current CQC registration details
• the regulated activities covered by your registration
• whether your Statement of Purpose reflects the event healthcare services you provide
• whether any relevant registration application is currently in progress
• the professional registration of the healthcare professionals providing or supervising treatment
• that appropriate insurance is in place for the services being provided.

If you consider that your services do not require CQC registration, please could you confirm the basis for this and the relevant exemption or CQC guidance that applies?

We are requesting this information as part of our planning and provider due diligence process.

Please could you provide the requested information by [date].

Kind regards,

[Name] [Organisation]

 

What do the changes mean for care providers?

The changes do not mean that every care provider, healthcare professional or first aid service working at an event automatically needs CQC registration.

Instead, the key question is what treatment is being provided and whether it falls within TDDI.

If your organisation provides event healthcare, it is worth reviewing the service now rather than waiting until the new requirements come fully into effect.

Check what your staff are providing, consider the role of any registered healthcare professionals, review your existing CQC registration and Statement of Purpose where applicable, and establish whether your organisation needs to take further action.

With applications already open, there is time to understand the requirements and address any issues before the 6 December 2027 implementation and enforcement date.

 

Further information

The main sources for this article are the Care Quality Commission’s guidance and the Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2026.

This article is intended as general information and is not legal or regulatory advice. Care providers should refer to the latest CQC guidance and legislation and seek professional advice where appropriate.