Dear Ms Mutch RE: ALLEN Further to my letter dated Ihe 17t May 2019, write to provide you with a further update regarding our efforts lo address the concems raised in your Regulation 28 Report and letter t0 me of the 29* of April 2019. To date, the following work has been completed. A national review has been completed, examining content and provisions conlained within the guidance document enlitled 'National Ambulance Service Guidance for Preparing an Emergency Plan' with particular reference t0 the provisions contained within Annex B5 have briefed our parent body; NHS England, on your report and OUr planned actions. My Compliance & Quallty Team have drafted & number of amendments lo be included wilhin the guidance document to add clarity and address the specific concems raised within Regulation 28 report fndings The next stage will be for Ihat draft lext lo g0 out (0 consullation with relevant stakeholders We will then make the necessary changes and aim to publish a revised version of the guidance before the end of September 2019. Yours sincerely; Ike 8Pin Kelth Prior Director National Ambulance Resilience Unit Reg,28 ALLEN | 18/06/19 NARU-C+a CCIKP | Faye the findings the Page

Hcalh and Salely HSE Exccutivc Alison Mutch OBE HM Senior Coroner Coroners Court Mount Tabor St Health and Safety Executive Stockport Redgrave Court SKI 3AG Merton Road Bootle Merseyside L2o 7HS 4th June 2019 Dear Ms Mutch; Thank you for your letter dated 2gth May toL which has been passed t0 me as Head of HSE's First Ald at Work policy to respond. The Health and Safety Executive (HSE) leads on national occupational health and safety policy for the entertainments and lelsure sector; whilst Local Authorties are responsible for enforcing the law at individual events, such as festivals, in their geographical area. In addition to health and safety law, some events may also require licenses from local authorities Festival organlsers have responsibilities under Section 3 of the Health and Safety at Work etc: Act 1974 (HSWA) to ensure, so far as Is reasonably practicable; the safety and health of members of the public affected by their business. HSE guidance strongly recommends guidance that employers include non-employees in the first aid provisions; however; the speciiic requirements of the First Aid at Work Regulatlons 1981 apply only to the provision of first aid for employees: Both the National Ambulance Service Guidance (NARU) Annex B and Section 5 of the Purple Guide relating to medical provision operate a score and matrix system, but the figures are for guidance only and individual circumstances may require the figures to be modified from the tabular expectation depending on the event risk assessment: The key to any event is the pre-preparation and assessment of risk and this will include the medical provision: The purple guide is a live event specific document whereas the NARU document is for a wider focus of events: The numbers and arrangements of medical provision will depend on several factors such as crowd size, expected crowd behaviour; expected druglalcohol use and venue size (e.g. a Warehouse venue will require different planning and medical provision to that of a large festival site) it is for the organiser to

ensure adequate provision during the set-up, duration and breakdown of the event: The interpretation of need for many aspects of a large event, Including medical provision, Is the duty of organisers and the specifics of such planning will vary from site to site as will the suitability of roles and locations of the relevant tiers of medical provision Identifed . The Purple Guide is industry owned guidance; ad as such is open t0 inlerpretation and of course wilst good practice there is no legal duty to follow this if following assessment; the organlsers, as with any industry, decide t0 put in place different provision or practkes. Of course, such provision must be able t0 be shown to be as safe if not more s0 than that hekd within the guidance: HSE has ralsed your concems with representatives from the entertainment industry: We wili also arrange for your comments regarding general emergency planning procedures In place at this event, along with a copy of this letter to be sent to relevant Local Authority bodles, who have licensing and enforcement responslbilities for such activities