UK Concussion Guidelines for Grass-roots Sport

Commons Urgent Question

The following Answer to an Urgent Question was given in the House of Commons on Tuesday 2 May.

“The UK concussion guidelines for grass-roots sport mark an important step in making sport safer for millions of people. Taking part in sport has many benefits. It is great for people’s physical and mental health, and it brings friends and communities together. We want to protect that and encourage more people to enjoy being active and to play a sport.

As I set out in my Written Ministerial Statement published today, the vast majority of people participate in sport safely, but head injuries do occur. We want to reduce the risks associated with concussion and make sport even safer for everyone. Research has shown the importance of fast, effective, tailored treatment, and we are issuing this expert guidance to help people spot and treat head injuries. Our guidance is a tool for the thousands of people who enjoy sport at the grass-roots level. Whether it is used in a local leisure centre during a swimming lesson or in the second innings of a village cricket match, this landmark guidance has the chance to make a real difference to people across the UK.

The guidance was developed by a world-leading panel of medical experts, and I am grateful to the whole expert group for giving so freely of their time while drafting the guidance. I pay tribute to the efforts of the group and to the valuable input of the Sport and Recreation Alliance, which has worked tirelessly to produce this excellent guidance. All that builds on the world-leading work conducted in Scotland by raising UK-wide awareness of the issue of concussion and making sport safer for all who take part. Fundamental to the guidance is an overriding simple message: “If in doubt, sit them out”.

Finally, this guidance is an essential but first step. The Government remain committed to working with the industry to help to make sport safe and enjoyable for everybody, including on technological solutions and the prevention of concussion.”

My Lords, we on these Benches strongly welcome this guidance and hope the Government will ensure that anyone suffering from a head injury is able to get swift access to the treatment and continuing support that they need. In the Commons yesterday, the Minister said he was “sure” that his Department of Health and Social Care colleagues would make announcements “in due course”. I wonder whether the Minister can be any more specific on timings today.

The introduction of concussion protocols in many elite sports has undoubtedly helped increase awareness of the subject, but we sometimes see players ignore the advice of medical professionals and attempt to play on. Indeed, I remember my son as a teenager being fouled and a penalty being given, and he was badly concussed. He was determined to take the penalty spot kick, and his mother and I had to wrestle him off the pitch.

We know that these things are important, so does the Minister agree that governing bodies need to keep their own protocols under review and that players themselves should be mindful of their status as role models? What more do the Government plan to do to ensure that this advice gets the profile it needs at all levels of sporting endeavour? These are important moves forward, and we broadly welcome them.

My Lords, I am grateful to the noble Lord for the support of the party opposite. World-leading experts have informed this guidance and it is important that we give it to the many people who are engaged in recreational sport across the country. The example that the noble Lord gives from his own family is illustrative of the issues that we need to make people aware of, so that people can intervene where needed and make sure that there is support for those who require it.

As my right honourable friend the Sports Minister said yesterday in another place, he has committed to continuing to work with his colleagues in the Department of Health and Social Care to ensure that the relevant advice is given to people, including those who want to contact the NHS through the 111 service. Many health experts from lots of sporting backgrounds have been involved in the preparation of this advice.

The noble Lord is right to point to the role of financial governing bodies in disseminating the advice that is appropriate in the context of their sports. Last year the English and Scottish Football Associations banned heading the ball in training for primary school-age children, an example of work that has been taken on. We are working with national governing bodies to make sure that the guidance is disseminated to everyone who needs to see it.

My Lords, will the Minister clarify one or two points? First, as is said in the document and is well-known, the younger you are, the more serious concussion can be. The school-aged people that we are primarily talking about tend to play a lot of sports. There must be thousands of people who have the experience of the child who plays in three school teams and maybe also on a Saturday.

What is the responsibility of the parent to make sure that, if you have been banged on the head playing rugby, you do not simply go off and play something else? Swimming is a good example. You can injure you yourself when swimming; diving carries a risk of concussion. What is the reference across that they are giving out to parents and coaches in all these sports about all the people involved? Are they going to make sure that everyone knows they have to talk to each other and who the conduit is for passing on that information? That is an important factor.

Secondly, when it comes to the governing bodies—which will be the way that information will be disseminated to people in the individual sports—what role does the Department of Health have in making sure that the guidance is technically correct and follows a consistent pathway? Any one of three Ministers could have answered this Question, and it just happens to have fallen to the noble Lord. What co-ordination is there to make sure that we have a consistency of approach across all departments?

The noble Lord is right that this is work that engages other government departments and many institutions in education and healthcare. A range of government departments and representatives from the education sector and medicine have been engaged in the process, and the guidelines will be published through all those channels to make sure that schools, teachers and doctors are aware. As I say, it is for the national governing bodies of each sport to make sure that this baseline guidance is tailored to the specific context and setting of their sport, and we would like to see that built on. It is for them to give any additional messages. The guidance is an essential first step, and fundamental to it is the simple overriding message: if in doubt, sit them out.

My Lords, I have returned from a three-day rugby tournament, excellently organised by the Birmingham Bulls, which involved 47 teams participating this weekend. I am interested by the use of the word concussion or brain injury. Can my noble friend clarify why the term concussion is persistently used when, in effect, what we are actually talking about is potential brain injury?

I send my congratulations via my noble friend to the Birmingham Bulls and everyone involved in the Union Cup. We have chosen to use the word concussion because it is what is most widely understood. Certainly, as a non-medical and not particularly sport-playing person, it was the term which was most self-evident to me. As we want to get the guidance out to as many people as possible, using layperson’s terms such as that seemed like a good way to do it.

My Lords, it is over 20 years since the coroner recorded a verdict of death by industrial disease in the case of England striker and West Bromwich Albion legend Jeff Astle. That campaign has taken two decades for the Astle family; I am sure the Minister would congratulate them. This welcome guidance is testament to the campaign that they have run to convince parliamentarians in all Houses and on both sides that this is important. But does he agree that concussion is still not understood in schools and in amateur sport? Actually, concussion is a brain injury, and if we use that language, we might get that understanding of how serious these injuries really are for our young people.

I indeed congratulate all those who have campaigned on this from bitter personal experience. I hope that the guidelines, and the greater awareness and understanding that they will lead to, will help avoid more situations and heartache for families like theirs. The guidelines are clear that a concussion is a brain injury; we have used the term that is understood so that we can build on people’s awareness and bring in greater understanding. Scientific and medical knowledge of this is evolving, so the guidelines will evolve as it does, but the guidelines have been informed by medical experts from around the world and people involved in a variety of sports. I am glad that we have been able to get them out, and look forward to all noble Lords helping us to draw further attention to them.

My Lords, I am sure my noble friend will share with me a strong welcome for these concussion guidelines. Would he be able to speak to his colleagues in the Department of Health and Social Care and in the NHS to encourage them to direct those who look up concussion or sports injury with concussion on the NHS website to the guidelines themselves? What there is on the NHS website at the moment is perfectly accurate but does not include much of the additional information available in the guidelines, and it could direct people to that. The present website is updated only to October 2021.

My right honourable friend the Sports Minister has committed to continue to work with our colleagues at the Department of Health and Social Care to make sure that the relevant advice is available to those contacting the NHS through 111, online and in other ways. We have fully engaged with the NHS during the process, and it supports the approach taken in the guidance. The Department of Health and Social Care is also formulating the Government’s new strategy on acquired brain injury, and DCMS is engaged in that work to ensure that people who play sport are well represented in that process too.

Does my noble friend the Minister know whether the Government have any plans to outlaw boxing?

We do not, but we hope that the guidelines will encourage people who play sport, whichever sport it is, to do so safely.

I suffered a two year-long concussion while I was representing Barrow and Furness in the other place, and looking back, I was staggered by the lack of knowledge even among fairly senior professionals in the medical industry about this, so the guidelines are very welcome. Does the Minister not share my fear that we may be at the start, and not towards the end, of a profound period of change with these guidelines, and that future generations may look back with horror at the way in which people playing sport, particularly younger people, are subjected to risk of severe brain injury with practices at the moment?

We know that physical activity, playing sport, is good for people’s physical and mental health, and good for society. We want more people to be active and to play sports, but to do so in a way which is safe. The guidelines are an important first step and a baseline for national governing bodies to make sure that people who play sports, whichever sport it is, can do so safely and enjoyably.