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Given the average ambulance response time is about 30 minutes for a cat 2 response like broken legs and that at peak times and in rural locations response times may be a lot worse.
I would always consider extra clothing even if you are not far from home or near your car.
laying on the ground or doing first aid and looking after casualties you can get quite cold quite quickly.
I think its also important to acknowledge that as much as we say 'bag use for MTB riding' has changed over time, so has 'MTB riding'.
When I was going out on a MTB ride as a kid with my Dad, we will indeed have taken a big day sack full of clothes, bits, tools, equipment, spares etc. But the actualy act of MTB riding was different - it was effectively hiking, just with a bike. Over some moors somewhere, using a map, the bikes would undoubtedly break, multiple puntures was the norm, we ate jam sandwiches and coffee from a flask.
A 'MTB' ride now can (Yes I know not always, not even for me, but *CAN*) be very different - ebike laps of a trail centre, never more than 2 miles from the car, bikes that dont break, I (I'm gonna kick myself) havent had a puncture or broken bike in years, etc etc...
Thus the requirements of what you need with you also change.
I will regularly take my biggest camelbak on a ride with me, with First Aid Kit, extra layers, 2 litres of water, snacks, tools, spares etc. But only If im going up into the Dales on my onw miles from anywhere.
I'f I'm going out the front door and blasting round the local for an hour after work, or doing laps of sherwood pines, i'll take pretty much nothing.
For shortish rides I tend to just take a Dakine Hotlaps 1L bumbag (I only got a small one as I’m happy to use a hydration pack if I need more) with a tube, levers, sticky patches, zip ties, multitool, Lezyne mini pump, tiny Leatherman and a water bottle on the frame. With a quick link taped to the brake hose. if I’m with the kids (7 years old) I have a little first aid kit pouch that can clip to the belt. Although I often just divvy up all the bits into their backpacks as they love carrying gear in their bags (like a real MTBer).
Bigger adventures I have an old Dakine hydration pack with a 2-3L bladder and chuck it all in that. If it’s a big day with the kids I just take a big 25L hiking backpack (or a Decathlon coolbag) full of spare clothes and packed lunches, snacks, sweets, extra drink, etc.
Oddly, I ride with even a small backpack on the road bike - its just has a pump, two tubes, patch kit, tyre levers, multi tool, waterproof and my phone/keys (actually sounds alot). Why, I broke my spine T12/L1 10 years ago, and I can't stand wearing anything in my pockets around the break - it's also to protect my back a little in an off. You don't want to be landing on a mini pump in your back pocket.
I have a small Decathlon pack for the road bike/CX rides, then a Camelbak for MTB (with foil blanket and survival bag) - in goes the bladder as well. What it does mean, I've got the right tubes/tools in each pack and don't need to pick any up.
That said, a bumbag might be the option for road biking !
Answering the OP, I ride in the Surrey Hills with friends. Can easily be five of us in a group without a single pack. What you can't see is that with frame storage, steerer tools & One up pumps we've got enough tools and spares to get our bikes through almost any mechanical issue.
Not had a ride ending mechanical in the group for a very long time.