Explainer: Event first aid planning in New Zealand

Event organisers must match first aid and medical cover to site risks, from crowd size and weather to access, alcohol and event activities. 

WorkSafe has put a more structured framework around a question that event organisers have long had to answer: how much first aid and medical support is enough? Its 2026 guidance introduces a risk-scoring model that links an event's circumstances to an indicative level of medical cover. The approach builds on earlier guidance that treated first aid as one part of a wider system for managing event risks. 

Legal baseline

The starting point is the Health and Safety at Work Act 2015. A Person Conducting a Business or Undertaking, or PCBU, must ensure the health and safety of its workers so far as is reasonably practicable. It must also ensure that other people are not put at risk by work carried out as part of the business or undertaking. For an event organiser, those other people can include spectators, customers and other members of the public. 

Workplace first aid has a more specific requirement. The Health and Safety at Work (General Risk and Workplace Management) Regulations require adequate first aid equipment at a workplace. Workers must also have access to facilities for administering first aid and to an adequate number of trained First Aiders. 

That requirement does not mean the specific workplace first-aid duty automatically applies to every spectator. WorkSafe nevertheless says an event organiser must consider whether providing an event health service is a reasonably practicable way to minimise the risk of serious harm to visitors. That distinction matters. The question is not simply whether an organiser has met a numerical staffing rule for workers. The wider risks created by the event also have to be managed. 

Responsibility cannot simply be handed to an ambulance or medical contractor. WorkSafe says PCBUs cannot transfer their health and safety duties to another PCBU. Event organisers, venue operators, contractors and service providers may have overlapping duties. Where they do, they must consult, co-operate and co-ordinate their activities so far as is reasonably practicable. WorkSafe uses a concert venue as an example of a workplace where several businesses may share first-aid responsibilities. 

Risk first

WorkSafe's May 2026 quick guide makes the risk-based approach more practical. It provides a sample two-stage method for assessing relative risk and then identifying an indicative minimum level of medical cover. The four resulting categories are Low, Moderate, Elevated and High. They correspond to scores of zero to three, four to seven, eight to 11, and 12 or more respectively. 

The model is a planning aid rather than a substitute for an event-specific assessment. That reflects WorkSafe's earlier guidance. Its 2023 event health guide says organisers should consider the expected crowd, site layout, activities, previous medical incidents and the types of injuries or illnesses that could reasonably occur. Crowd characteristics also matter. Age, mobility, alcohol, drugs, violence and mental health emergencies can change the demands placed on the medical service. 

Health New Zealand takes a similarly broad view. Its public-health guidance identifies audience type and size, location, duration, time of year and the nature of the activity as factors in event risk. It also asks organisers to consider infectious disease, sanitation, food, alcohol and other drugs, weather and injury. The guidance recommends identifying hazards, analysing their likelihood and consequences, prioritising the resulting risks, then eliminating or reducing them where reasonably practicable. 

This means two events with similar attendance can require different medical arrangements. A seated indoor performance close to emergency services presents different problems from a summer music festival with alcohol, camping and restricted vehicle access. A mass-participation sporting event creates another risk profile again. The combined guidance makes crowd size an input to the decision, not the decision itself. 

Cover levels

At the Low tier, WorkSafe's 2026 model calls for a named First-Aid Coordinator, at least one First Aider per 500 attendees, stocked first-aid posts and a radio or telephone link to the organiser and emergency services. WorkSafe describes that level as suitable for small, low-risk gatherings and says a clear ambulance route should be maintained. Cover should be escalated if conditions change, including where outdoor weather risk increases. 

Moderate events move beyond a single coordinator. WorkSafe indicates a team of two to four First Aiders distributed across the site, with a treatment post, an automated external defibrillator and roving cover during busy periods. 

At the Elevated tier, the model moves into professional event medical provision. WorkSafe specifies event medics, a clinical lead supported by first responders, one or two treatment posts and roving teams. A dedicated plan for ambulance access and escort is also part of the arrangement. 

The High tier calls for a contracted medical provider with clinical governance and onsite treatment-centre capability. It also includes liaison with local emergency departments or urgent-care services. This reflects the greater likelihood that a high-risk event will need to operate as part of the wider health system rather than as an isolated first-aid operation. 

Numbers alone are not enough. WorkSafe's 2023 guidance says event health workers need qualifications suited to the service being provided. First-aid certification should be current and appropriate for the event. Larger or higher-risk events may require capabilities in advanced first aid, resuscitation, life support or other specialist care. Organisers hiring providers are advised to check qualifications, registrations, certificates, equipment, vehicles, insurance and experience with comparable events. 

Where someone is practising as a Paramedic, a separate professional framework applies. A Paramedic must be registered with Te Kaunihera Manapou Paramedic Council and hold a current practising certificate to practise lawfully in New Zealand. 

Site realities

Medical resources are only useful if they can reach patients. WorkSafe asks organisers to consider how quickly a medical team can move through an event, including into dense crowds, queues, car parks and areas with difficult terrain. Locked gates, one-way systems, mud and flooding can delay a response. The location of treatment posts and automated external defibrillators also needs to reflect how the site actually operates. 

Communications are another operational issue. A treatment team needs a way to receive calls, communicate across the site and connect with the event's wider command structure. Emergency vehicle routes need to remain usable. Plans also need to cover what happens when onsite capability is exceeded and a patient must be transferred to hospital. WorkSafe says an event health service should be capable of dealing with expected problems, unexpected illnesses such as heart attacks or strokes, and its role in a larger emergency such as a crowd crush. 

Planning also extends beyond treating injuries after they happen. Health New Zealand identifies dehydration, extreme weather, infectious disease, sanitation, alcohol and recreational drugs as public-health issues that can affect demand for medical care. Its guidance recommends setting weather-related trigger points and preparing for conditions including heavy rain, flooding and heat. It also notes that organisers should involve emergency and health services early because large events can put additional pressure on local resources. 

That wider approach is important because first aid sits near the end of the risk-control process. WorkSafe says having an event health service does not replace the duty to eliminate risks where reasonably practicable, or minimise those that cannot be eliminated. Good crowd management, water provision, safe structures, traffic controls and responsible alcohol management can reduce the medical workload before a First Aider sees a patient. 

System pressure

New Zealand has practical evidence of what properly planned onsite treatment can achieve. During major rugby events in Wellington in 2011 and 2012, pre-hospital treatment and triage facilities were established partly to reduce pressure on Wellington Free Ambulance and the city's emergency department. The events included the Rugby World Cup and International Rugby Sevens. 

Alcohol was a contributory or causative factor in 80% to 90% of presentations examined in the study. Researchers found that about 60% of the 121 patients treated during the last two events analysed would otherwise have required emergency-department transfer. The study estimated combined ambulance and emergency-department savings of about NZD $70,000 for the Rugby World Cup event and the 2012 Sevens. 

The significance goes beyond the financial estimate. The Wellington experience showed how the character of an event can shape demand. Alcohol-related illness and minor injuries created a workload that could often be treated safely onsite, freeing ambulances and hospital services for patients who needed them. That same principle now appears explicitly in WorkSafe guidance, which identifies reducing demand on local emergency services as one benefit of an effective event health service. 

Health New Zealand also warns that mass events can put pressure on health and emergency services, particularly during busy holiday periods. Emergency-service rostering can occur months ahead. Its guidance therefore recommends early contact, clear emergency plans, unobstructed access and alternative entry or exit routes where required. 

Closed loop

First-aid planning does not end when gates open. WorkSafe advises organisers to monitor whether the agreed number of staff and supplies are actually available, assess how the service performs and maintain contact with event health workers. Response times can be used as a performance measure. Conditions should also be reassessed if attendance, weather or other risks differ from the plan. 

The process continues after the event. Incident reports can reveal patterns that were not obvious during planning. Debriefs can identify access problems, staffing gaps or equipment that was heavily used. Records of treatments and supplies can then inform the next risk assessment. WorkSafe specifically recommends reviewing data, feedback, incident trends and equipment use after an event. 

That creates a feedback loop between one event and the next. A history of medical incidents is relevant to future planning, just as crowd behaviour, activities and site conditions are. The result is a model in which medical cover should develop from evidence about the particular event rather than from a generic assumption about what a crowd of a certain size requires. 

Taken together, the guidance reduces event first-aid planning to several practical questions. Organisers need to establish what injuries and illnesses are reasonably foreseeable, how quickly trained people can reach a patient, what level of care can safely be delivered onsite, and how a patient will be transferred when that capability is exceeded. They also need to decide how the plan connects with the venue, contractors and public emergency services. The answers determine whether an event needs basic first aid, a distributed response team or a clinically governed medical operation.