Crowd medical services in the English Football League: remodelling the team for the 21st century using a realist approach
Leary, Alison Kemp, Anthony Greenwood, Peter Hart, Nick Agnew, James Barrett, John Punshon, Geoffrey
Leary, Alison
Kemp, Anthony
Greenwood, Peter
Hart, Nick
Agnew, James
Barrett, John
Punshon, Geoffrey
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Abstract
Objectives To evaluate the new model of providing care
based on demand. This included reconfiguration of the
workforce to manage workforce supply challenges and
meet demand without compromising the quality of care.
Design Currently the Sports Ground Safety Authority
recommends the provision of crowd medical cover at
English Football League stadia. The guidance on provision
of services has focused on extreme circumstances such
as the Hillsborough disaster in 1989, while the majority
of demand on present-day services is from patients with
minor injuries, exacerbations of injuries and pre-existing
conditions. A new model of care was introduced in the
2009/2010 season to better meet demand. A realist
approach was taken. Data on each episode of care were
collected over 14 consecutive football league seasons at
Millwall FC divided into two periods, preimplementation
of changes and postimplementation of changes. Data on
workforce retention and volunteer satisfaction were also
collected.
Setting The data were obtained from one professional
football league team (Millwall FC) located in London, UK.
Primary and secondary outcomes The primary outcome
was to examine the demand for crowd medical services.
The secondary outcome was to remodel the service to
meet these demands.
Results In total, 981 episodes of care were recorded over
the evaluation period of 14 years. The groups presenting,
demographic and type of presentation did not change
over the evaluation. First aiders were involved in 87.7%
of episodes of care, nurses in 44.4% and doctors 17.8%.
There was a downward trend in referrals to hospital.
Workforce feedback was positive.
Conclusions The new workforce model has met
increased service demands while reducing the number of
referrals to acute care. It involves the first aid workforce in
more complex care and key decision-making and provides
a flexible registered healthcare professional team to
optimise the skill mix of the team.
https://bmjopen.bmj.com/content/7/12/e018619.long
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
http://dx.doi.org/10.1136/bmjopen-2017-018619