Introduction
How many event first aiders do I need for a road running race? It’s one of the most common questions organisers ask, especially when you’re putting on a 10k and you want the right balance: safe, credible, and also not over the top.
With road races, the planning bar is higher than many organisers realise. You’re not just covering a static crowd; you’re supporting a moving field of runners spread over a course, often with limited vehicle access, variable mobile signal, and predictable “pinch points” (the start, the finish, and anywhere the course narrows). Add heat, cold, traffic management, hydration stations, and a wide range of participant fitness levels, and you’ve got a pretty challenging environment.
Getting the cover right isn’t just about reassurance. It’s part of your duty as an organiser to manage risks and put appropriate arrangements in place. HSE is clear that event organisers must manage overall safety so people are not exposed to health and safety risks, and that event planning should include practical arrangements like first aid and emergency procedures.
This guide explains what the recognised guidance says for 10k first aid and broader road race provision, how to interpret it, and how to turn it into a simple plan you can hand to stakeholders.
What we'll cover
Why event first aid is essential at road running races
Road running isn’t inherently “high risk” in the way motorsport is, but it carries a unique blend of foreseeable issues:
Time-critical collapse events
Road races plan explicitly around rapid access to BLS + AED. UKA’s road race medical guidance sets an expectation that sufficient mobile resources are in place so that (as a minimum) BLS plus defibrillation capability can reach a casualty anywhere on the course within 8 minutes of the incident being reported to the event team.Spread-out incidents
Unlike a stadium, runners are distributed. Your medical plan must cover the course, not just the finish line.Predictable spikes at the finish
Finish areas often see an uptick in collapses, falls, and exacerbations of existing medical conditions. UKA’s Race Directors’ Handbook also expects organisers to plan for foreseeable injuries and to build a medical plan around what you identify in your medical risk assessment.You can’t just rely on 999
The UKA small-race executive summary is explicit: sole reliance on NHS emergency ambulance response will not meet the duty of care required of a road race organiser. The expectation is that you have on-site capability and a coherent response system, with escalation to NHS where appropriate.
Factors that decide how many event first aiders and event medics you need
There is no single “legal ratio” that fits every road race. HSE’s approach across first aid is that provision must be “adequate and appropriate” based on the circumstances, and the organiser must ensure medical/ambulance/first aid assistance is available as appropriate.
In practice, for road races your provision is driven by a medical risk assessment and the recognised guidance you’re working to (commonly UKA road race medical guidance for licensed races, plus broader event guidance such as the Purple Guide).
Key drivers to consider:
1) Runner numbers (not just spectators)
UKA’s matrix tables scale staffing and assets by the number of finishers. That matters because clinical demand tracks participation.
2) Distance and event type
A 10k behaves differently to a 5k or a half marathon. UKA separates its minimum recommendations by distance band (including a specific table for 6–10km inclusive, which includes 5 mile races).
3) Course configuration and access
Is it one lap, two laps, or a simple start to finish run? Can an ambulance get near most of the route? UKA guidance expects consideration of vehicular access for treatment and transportation on the course and in the finish area
4) Communications coverage
If you have mobile signal “black spots”, you must design a robust communications plan. UKA’s Race Directors’ Handbook explicitly includes communications availability as a factor in the medical risk assessment.
5) Time of year and weather (hot/cold/windy, and unseasonable conditions)
The handbook explicitly flags anticipated weather conditions as a medical risk assessment factor for road races.
6) Participant profile and medical history risk
A “club race” with experienced runners behaves differently to a charity 10k full of first timers. UKA highlights participant profile and age as factors to assess.
7) Hydration, welfare, and finish management
Provision of drinking water and shelter is referenced as part of the risk assessment considerations in UKA’s Race Directors’ Handbook.
UKA Road Race Medical Services: the minimum baseline explained
If your event is UKA licensed (common for road races), you’re working in a framework that expects:
a medical risk assessment,
a medical plan derived from that assessment, and
cover that meets the recommended minimum standards (with justification if you depart).
The UKA “Road Race Medical Services” Good Practice Guide is the most practical document because it translates runner numbers and distance into a baseline set of resources, and then tells you to adjust for your local risks.
The single most important operational requirement: rapid BLS + AED on course
UKA expects that sufficient mobile resources exist so that a minimum of BLS plus defibrillation capability can reach a casualty anywhere on the course within 8 minutes of the injury report being received.
That has direct implications for how you deploy your team:
you need mobile responders positioned to cover the full route (not just the finish), and
you need a reporting system (marshals → control → deployment) that actually achieves the time standard in the real world.
What about CQC registration for running race medical cover?
A common misconception is that every event medical provider must be CQC registered. In reality, CQC registration is only required when a provider transports patients to hospital as an independent ambulance service. If your provider is not conveying patients off-site in an ambulance, CQC registration is generally not required.
For most 10k races, especially those where any hospital transfer would be handled by NHS ambulance services, the key question isn’t whether your provider is CQC registered, it’s whether they have the right clinical governance and safety systems in place.
When selecting a provider, the things that matter most are:
Robust clinical procedures and clear escalation pathways
Adequately trained, vetted, and insured staff
Competent first responders and clinicians working within recognised scope
A strong medical plan aligned to UKA guidance
Effective communication, record-keeping, and incident reporting systems
Appropriate equipment, including AEDs where indicated
Clear arrangements with the NHS ambulance service for any required transfers
A non-CQC provider can absolutely be the right and safe choice for a 5 or 10k, provided they demonstrate the same professional standards, governance, and preparedness expected across the industry.
In short: choose a provider based on competence, governance, and readiness – not just on whether they hold CQC registration.
Real world examples
Example A: Village 10k, 180 runners, single lap, good access
Baseline expectation from the UKA 6-10k matrix (151-500 runners) is:
minimum 4 first responders (2 per 150),
a covered finish first aid post,
at least 1 on-course covered first aid post,
a mobile resource trained to provide BLS with an AED
a medical manager
2 beds/cots in the medical centre
and a sweeper vehicle.
Operationally, your focus should be on:
a finish treatment area that can manage the predictable finish line spike, and
a mobile response that achieves the BLS/AED time expectation across course.
Example B: Town centre 10k, 850 runners, multiple pinch points, road closures
Baseline expectation from the UKA matrix (501–1,000 runners) includes:
minimum 6 first responders (1 per 125),
finish covered post required,
minimum 1 on course first aid post,
at least 1 mobile resource able to provide BLS with an AED
ambulance & crew at 1 per 500,
1 bed/cot per 300 people (at least 2)
plus a sweeper vehicle.
At this size, a credible plan typically hinges on:
clear medical access/egress routes (including for transport), and
strong comms (because city routes often create signal dead zones and noise). UKA expects communications availability and vehicular access to be considered within the medical risk assessment.
ensuring the provider delivering the ambulance service is CQC registered
Common mistakes organisers make (and how to avoid them)
Using just “first aiders” – In today’s world of many clinical qualifications, it’s vitally important that you understand the difference in terminology between a first aider and a first responder. Most private event medical providers no longer provide “first aiders” as they do not have the appropriate training. For (often) the difference of a few pounds per hour, you can bring a first responder with access to wound splinting, oxygen and more.
Assuming 999 fills the gap – UKA’s own small race summary states that relying on a 999 response does not meet your duty of care for a road race. It is vitally important that you bring in a qualified team of professionals to deliver a full road race medical service.
Not verifying provider competence – Too many organisers take what their prospective medical providers say at face value. It is your duty to investigate and complete your own due diligence on your chosen provider. Don’t be afraid to ask for proof of insurance, policies and procedures, proof of qualification for their staff and make sure to check whether your provider needs to be CQC registered.
Treating the finish line as the whole event – Often times the race medical team will be based at the finish line only. This can result in serious harm if a patient is to fall ill at the start of the course. The UKA’s guidance requires suitable services at the start, end and throughout the course.
How LightMed can help
At LightMed, we build road race medical cover the way it’s meant to be built: from the risk assessment outward, with the UKA matrix as the baseline, and practical deployment designed to achieve (and exceed) the response expectations on the day.
What you get:
A clear medical plan aligned to what UKA expects organisers to produce (risk assessment inputs, course configuration, comms, access/egress, and foreseeable injuries).
Right-sized staffing: event first responders, paramedics, and mobile responders positioned to cover the full route.
Credibility for stakeholders: cover that maps cleanly to recognised guidance used by local authorities/SAGs and ambulance trusts, including the checks they expect organisers to apply to medical providers.
If you’re planning a 10k, get in touch and we’ll help you to design a medical plan that matches the guidance and the reality of your route.
Frequently Asked Questions
How many event first aiders do I need for a 10k?
or UKA-licensed road races, the clearest baseline is UKA’s Matrix Table 2 (6-10km inclusive). For example:
151–500 runners: 2 first aiders per 150 (minimum 4), finish covered post required, and minimum 1 on course post.
Is it a legal requirement to have first aid at a road race?
HSE is clear that for events, it’s the organiser’s responsibility to ensure medical/ambulance/first-aid assistance is available as appropriate for all those involved, and that organisers have duties to manage health and safety risks.
Can I use 999 instead of on-site first aiders?
No. UKA’s small-race executive summary states that sole reliance on NHS emergency ambulance response will not meet the duty of care required of a road race organiser.
Do I need an AED at my race?
UKA’s matrix notes recommend AED provision for all road races, with limited circumstances where smaller races might consider not providing AEDs (linked to local NHS ambulance reliability, A&E access, and emergency access).
Do I need a CQC-registered provider?
Not necessarily, the UKA recommends the use of first aiders from an external CQC-registered provider for road races. However, your priority should foremost be to choose a provider that meets the correct standards as explained in our post.
