Sports Events

We have had many enquiries about General Practitioners providing services as Medical Officers at the sports events. GPs cannot agree to provide services at such events without giving due consideration to the possible implications of their role. We advise our members that they should ascertain exact duties and responsibilities before agreeing to provide such services. The Medisec Master Policy covers members for these events provided the work undertaken is that of a GP and not as an Event Doctor who is responsible for crowd control, ambulance cover, provision of appropriate medical equipment etc.

Here are our Best Practices for General Practitioners and participation in sporting events/fixtures:

Being a nation with eclectic sporting interests and events, many GP's have been asked, (or will be asked in the future), to provide medical assistance and advice at sporting events at various levels, be it a local team or a large scale sporting event. It goes without saying that GP's have provided such a service to the benefit of all concerned - except, perhaps, to the GP's themselves!

We raise this question for a number of reasons, (excluding the obvious where GP's may provide this service free of charge rather than for financial benefit). Such services can be requested and agreed to without due consideration of the exposure. Into the future many GP's are likely to receive such requests again and it may form an integral part of a GP's career or service to a community and should be addressed in a formal manner.

Providing such a service can immediately increase the GP's duty of care requirements and the GP's consent to such an activity should be an informed one. The GP's duty of care will depend mainly on the responsibilities and duties agreed to which can vary greatly. As mentioned there are numerous sporting pastimes and events and also various roles for the medical practitioner, e.g. team doctor, crowd doctor, event doctor. There are also those medical practitioners involved in sports medicine as opposed to the provision of immediate care at sporting events.

The under noted comments are designed to assist GPs involved in the provision of immediate care at sporting events to make an informed decision and to ensure that they are aware of their duty of care and are indemnified accordingly.

Duties & responsibilities

If GP services are requested by a particular team or by an organising body of a particular event, it is imperative that the GP ascertains the duties and responsibilities before he/she agrees to provide such services.

Each sport or sporting event will, or should have, its own specific requirements and responsibilities. Some are quite advanced and professional (e.g. The Turf Club) whereas others are more relaxed and in reality quite difficult to formalise e.g. GP cover to the local underage football team. However, regardless of the event the GP will be extending their duty of care and accordingly they should only do so on an informed basis.

The GP must ascertain the following:

  • Are you responsible for the participants and competitors only, or are the spectators included?
  • Are you the Event Doctor i.e. responsible for ensuring correct supports in the event of emergencies, ambulance cover, responsible for the planning and procedures etc?
  • Are you responsible for a medical team and/or delegation of activities to other persons, have you ensured that such persons are competent for the tasks required? (i.e. only Chartered Physiotherapists should be used) (GP's cannot confer with Non Medical staff)
  • Have you carried out a risk assessment and agreed equipment, ambulance and personnel requirements or is this somebody else's responsibility?
  • What about the communication procedures (personnel? two-way radio? mobile phone black spots?). Is this your responsibility or have the organiser put such procedures and equipment in place?
  • Does the event require knowledge of the County's Major Incident Plan?
  • Do the responsibilities and duties fall within the scope of normal General Practitioner duties?

As one can see the duty of care can vary greatly depending on the responsibilities and duties, as can the exposure and the GP's indemnification requirements.

Competencies

Once a GP has ascertained their duties and responsibilities it is important to self-audit and confirm that they have the required competencies e.g:

  • attend a Pre-Hospital Trauma Care course (mandatory for Racecourse Medical Officers) every three years
  • attend an ATLS course three years
  • have a basic knowledge of the sport and its rules and potential risks
  • have a basic knowledge of the fitness levels to participate safely in the sport
  • have the appropriate knowledge, experience and equipment to deal with the common, possible or probable injuries
  • be familiar with and adhere to the Code of Practice (if available) for the Sport in question
  • trained in Event management and knowledge of Safety in Sports Arena 1996 as published by the Government. (this is usually the responsibility of the event organiser but there may be a need to check that this has been done)? Is this type of service covered by the GP's indemnity policy?
  • knowledge of the communication systems and procedures?

In the event of an adverse incident or an allegation of malpractice the courts will test the competencies of the GP against what is reasonable amongst a GP's peers in respect of the service provided. In Dunne v National Maternity Hospital and Jackson (1989) Chief Justice Findlay said " General and approved practice need not be universal but must be approved of and adhered to by a substantial number of reputable practitioners holding the relevant specialist or general qualification" It is therefore important that the GP considers the area of required competencies before consenting to the provision of a service.

GP Action Points

Confirm the people for whom you are responsible, notwithstanding Good Samaritan responsibilities, and assess the requirements and competencies accordingly e.g.

  • Participants/Competitors - confirm you have the competencies noted above
  • Spectators/Attendees - assess the possible risks from the sporting event? Are you prepared for pre-existing conditions that may be exacerbated e.g. asthma, epilepsy etc? Assess if alcohol consumption is a likely factor that may effect on your duties/responsibilities. Is the potential capacity/attendance a factor that could give rise to incidents?

Responsibilities

  • Confirm the responsibilities of other people i.e. organisers, club, sporting association etc and that they have adhered to such responsibilities.
  • Equipment - ascertain if the provision is the GP's responsibility and confirm there is adequate equipment and facilities. Is the location of equipment correct and are you trained in the use of such equipment?
  • Safety Statement. - Check if there is a Safety Statement prepared by the event organisers and a Specific Plan, Code of Practice for the Sport, adherence to the Safety in Sports Arena 1996 Document.
  • Major Incident Plan - Check if there is a necessity to be familiar with the County Major Incident Plan?
  • Communication. - Procedures must be in place and this needs to be effective and efficient. The GP should be familiar with the agreed procedures, protocols and equipment to be used e.g. two way radios (know the language and procedures), Mobile phones (numbers and possible black spots), persons involved and chain of communication.
  • Record Keeping - are there people that will document details? What procedures are in place for the GP to document details? GP's should follow the same protocols as they would in their own practice in respect of patient records.
  • Doctor/Patient Confidentiality - The same ethical and legal rules apply as they would in all other areas of the GP's practice. The GP should ensure they are not being asked to deviate from this.
  • Disposal of sharps or clinical waste - Are responsibilities and procedures in place?
  • Be identifiable
  • Indemnity - Ensure that adequate indemnity cover is in place. Does the responsibility rest with the event organiser or is it the GP's responsibility? (Please be aware that Hospital Drs may not have indemnity under the Clinical Indemnity Scheme when offering services at sporting events. Supplementary cover is required).

Indemnity

As GP's you are well aware of the vast assortment of sporting clubs, associations and events with which you are being asked to assist. The briefing notes above are intended to encompass the broad spectrum and to draw the GP's attention to areas that they should consider and examine, but we appreciate the local underage soccer team may not require the same investment as a racecourse event or motor rally.

Notwithstanding this, as a GP the same process or "tests" should be applied to any event you are being asked to assist, in order to ensure you are making an informed decision and have the correct indemnity.

The definition of your Practice under the Allianz policy wording includes "any sports club or association...... by virtue of the Insured's General Practitioner professional involvement therewith". The Business Description on your policy also states "General Medical Practitioner"

Therefore cover only applies for General Practitioner duties. The Allianz policy will not indemnify GP's in respect of any liability arising from or directly or indirectly caused by advice and/or treatment not coming within the range of services normally provided by a General Practitioner. This could be an important consideration for you as the GP having due regard to the responsibilities, duties and competencies required for the particular event with which you are being asked to become involved. It is imperative that you adhere to the points made under Duties and Responsibilities and Competencies before consenting to the provision of services to sport events and fixtures.

It is also most important that you have the required competencies for the task (refer Dunne V National Maternity Hospital) and are acting within the scope of GP work. If a GP is a Racecourse Medical Officer they must have completed a Pre-Hospital Trauma Course (every three years) or ATLS course (every three years). The same will apply to GP's in attendance at other large events for which they have a responsibility for immediate care e.g. motor rallies, arena events or other large sporting events.

There are other conditions on your policy regarding reasonable precautions that need to be taken and it is also worth mentioning that if signing agreements, you should also be aware that your indemnity would not cover any liability that you may have assumed under any contract, agreement, warranty or guarantee which would not otherwise have attached.

GP’s travelling with Sports Teams outside the jurisdiction.

The Policy does not give automatic cover outside the jurisdiction.

The conditions for prior approval on a case-by-case basis are as follows:

  1. Medisec should be notified at least one week in advance of the nature, timing and location of the event.
  2. The work being carried out is that of a GP. The work being carried out is confined to the Team.
  3. The GP has the appropriate training and necessary equipment.   
In Medisec’s Best Practice for Sports Events – we advise our best practice recommendations are that General Practitioners providing services at a Sporting Event should have either the ATLS or Pre Hospital Trauma Course qualification and that they should attend a refresher course every three years.

Share this article: