MPs call for fundamental changes in how concussion is managed and recorded in sport at all levels
Most clinicians are unlikely to know about the latest evidence on treating people with concussion because they come across the condition so rarely.
That is one of the conclusions set out in a report titled ‘Concussion in Sport’, which was published today (22 July) by the House of Commons digital, culture, media and sport (DCMS) committee.
In a section looking at what improvements are needed at a grassroots sports level, the MPs note: ‘We are … concerned that the relative infrequency with which clinicians encounter this kind of condition suggests that many of them are likely to be out of date with regard to the best possible practice in treating these patients and getting them the necessary specialist treatments.’
The report urges NHS England to review how information about concussion – and any brain injuries that may have ensued – is collated, so that ‘doctors have a full history available to better inform patient treatments’.
Change is vital because doctors need access to ‘robust information’ from patients’ records. At present, they have to rely on patients’ memories of previous concussions or head traumas – which may be particularly sketchy if they happened at various times while the person was playing different sports.
The report sets NHS England and the Faculty of Sport and Exercise Medicine UK a 12-month deadline to develop a best practice learning module on the topic. GPs and accident and emergency doctors treating and advising people with concussive trauma will then have to complete it within a two-year timeframe.
Turning to elite sport, the report makes some scathing remarks about how ‘current organisational structures’ mean ‘there is no overall responsibility to mandate minimum standards for concussion and head trauma or to assess whether protocols are followed’.
‘The system allows sports to be funded as long as their protocols look good on paper with no effort put into assessing how those protocols work in practice.’
The report notes: ‘We recommend a more precautionary approach is taken and a greater proportion of the money spent on elite sport is focused on protecting the athletes who are at the core of UK success in sporting endeavours’.
In a section on professional sport, the report says the government should mandate the Health and Safety Executive to collaborate with sports’ governing bodies to establish a national framework for reporting every event that might lead to an acquired brain injury.
Key findings and recommendations
The committee found there was ‘no overall responsibility within sporting organisational structures to mandate minimum standards for concussion and head trauma or to assess whether protocols are followed'.
The report states:
- the government should establish UK-wide minimum standard definition for concussion that all sports must use and adapt for their sport
- the Health and Safety Executive should work with sports’ national governing bodies to establish a national framework for the reporting of sporting injuries
- UK Sport should take a governance role in assuring that all sports it funds raise awareness on the dangers of concussion effectively
- UK Sport should pay for a medical officer at every major sporting event with responsibility to ensure the safety of participants and the power to prevent athletes at risk from competing
Sport has 'marked its own homework'
Julian Knight, the MP who chairs the DCMS committee, said: ‘We’ve been shocked by evidence from athletes who suffered head trauma, putting their future health on the line in the interests of achieving sporting success for the UK. What is astounding is that when it comes to reducing the risks of brain injury, sport has been allowed to mark its own homework.
'The Health and Safety Executive is responsible by law, however risk management appears to have been delegated to the national governing bodies, such as the FA. That is a dereliction of duty which must change.
‘The failure by these sporting organisations to address the issue of acquired brain injury is compounded by a lack of action by government. Too often it has failed to take action on player welfare and instead relied on unaccountable sporting bodies.'
Mr Knight added: 'As concerning is grassroots sport with mass participation where we’ve found negligible effort to track brain injuries and monitor long-term impacts.’
The Concussion in Sport inquiry took evidence from scientists, former athletes, chief medical officers, players' unions and various sports’ national governing bodies. MPs also received written evidence from many interested parties.
The DCMS report does not refer to cases of head injuries and rugby, which are the subject of current court proceedings.
For more information on the DCMS report, visit: https://committees.parliament.uk/committee/378/digital-culture-media-and-sport-committee/news/156748/sport-allowed-to-mark-its-own-homework-on-reducing-concussion-risks/
For information about the Faculty of Sport and Exercise Medicine UK, visit: https://www.fsem.ac.ukAuthor: Ian A McMillan