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Premiership Rugby to ramp up concussion surveillance with new 2019/20 matchday initiative

Clermont's Jamie Cudmore (right) leaves the field early in the first half due to concussion during the 2015 European Champions Cup final against Toulon at Twickenham (Photo by Stu Forster/Getty Images)

Premiership Rugby’s new 2019/20 season initiative will see independent matchday doctors in place at all Gallagher Premiership Rugby, Premiership Rugby Cup and European home matches.

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This initiative – funded by the 13 member clubs – has the support of the key stakeholders in English Rugby – Premiership Rugby, the RFU, the RPA and World Rugby.

The role of the matchday doctor is to be responsible for decisions on matchday regarding a replacement for blood and head injuries. As part of their role they oversee the implementation of the head injury assessment and will work in collaboration with team doctors and medical staff to support head injury decision making during the match.

Why are we bringing them in?

Player welfare is right at the top of the agenda and Premiership Rugby believes this is the next stage, building on from the introduction of Hawkeye – to help ensure the identification of head injuries on the pitch – and to support the head injury assessment process.

(Continue reading below…)

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Independent match day doctors have been operating on the international stage for a long time and therefore this will bring the domestic game in England closer in line with best practice and the international standard.

It is hoped the initiative will take some pressure off the team doctors. The introduction of independent matchday doctors means there will be another set of eyes and ears for them to collaborate with when it comes to their decision making around head injuries.

It gives the capacity to undertake more simultaneous head injury assessments (HIA) on players. At the moment there is a 10-minute minimum and maximum amount of time for the HIA to take place. If two or even three HIAs occur at the same time, it is a running clock and Premiership Rugby will now have the ability with more hands-on deck to handle multiple HIAs.

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How will it work?

For the 2019-20 season in all Gallagher Premiership Rugby, Premiership Rugby Cup and European home matches there will be: a team doctor, an immediate care doctor (appointed by the home team) who is there to support and undertake emergency care and a matchday pitch-side video reviewer (MPVR) who sits near the pitch reviewing the match through the Hawkeye system, and to aid decision making. 

In addition, now there will also be an independent matchday doctor who will sit with the matchday pitch-side video reviewer and the Hawkeye technician close to pitchside and will be able to keep his eyes on the match. Together as a team, they will look after head injury management of players.

The decision as to whether a head injury assessment is required and subsequently if a player can return to play sits with the independent matchday doctor. However, it will always be a collaborative and supportive process. All decisions will be made in discussion with the team doctors who know the players well and will be able to share these experiences and insights with the matchday doctor. They will always review the video together.

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In terms of who carries out the HIA, there are a couple of options. In the pre-match meeting, the team doctor will decide if they carry out the HIA with the matchday doctor observing or if they delegate to the independent matchday doctor. In either case in terms of the decision about whether the player returns to play this will always be a discussion and a collaboration between the team doctor and matchday doctor.

“This new initiative continues the evolution of our player welfare strategy, following on from the introduction of the head injury assessment and our use of the Hawkeye system to help better identify injuries during matches,” said Matt Cross, Premiership Rugby’s research and development manager.

“Our clubs are at the forefront of the latest player welfare initiatives and with us, will continue to drive world-class standards in the care of our players.”

WATCH: The RugbyPass documentary Knocked sees players, referees, medics and the sport’s bodies give a unique insight into concussion and what is being done to combat it

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Flankly 48 minutes ago
'Absolute madness': Clive Woodward rips into Borthwick in wake of NZ loss

Borthwick is supposed to be the archetypical conservative coach, the guy that might not deliver a sparkling, high-risk attacking style, but whose teams execute the basics flawlessly. And that's OK, because it can be really hard to beat teams that are rock solid and consistent in the rugby equivalent of "blocking and tackling".


But this is why the performance against NZ is hard to defend. You can forgive a conservative, back-to-basics team for failing to score tons of tries, because teams like that make up for it with reliability in the simple things. They can defend well, apply territorial pressure, win the set piece battles, and take their scoring chances with metronomic goal kicking, maul tries and pick-and-go goal line attacks.


The reason why the English rugby administrators should be on high alert is not that the English team looked unable to score tries, but that they were repeatedly unable to close out a game by executing basic, coachable skills. Regardless of how they got to the point of being in control of their destiny, they did get to that point. All that was needed was to be world class at things that require more training than talent. But that training was apparently missing, and the finger has to point at the coach.


Borthwick has been in the job for nearly two years, a period that includes two 6N programs and an RWC campaign. So where are the solid foundations that he has been building?

4 Go to comments
N
Nickers 57 minutes ago
Scott Robertson responds to criticism over All Blacks' handling errors

Very poor understanding of what's going on and 0 ability to read. When I say playing behind the gain line you take this to mean all off-loads and site times we are playing in front of the gain line???


Every time we play a lot of rugby behind the gain line (for clarity, meaning trying to build an attack and use width without front foot ball 5m+ behind the most recent breakdown) we go backwards and turn the ball over in some way. Every time a player is tackled behind the most recent breakdown you need more and more people to clear out because your forwards have to go back around the corner, whereas opposition players can keep moving forward. Eventually you run out of either players to clear out or players to pass to and the result in a big net loss of territory and often a turnover. You may have witnessed that 20+ times in the game against England. This is a particularly dumb idea inside your own 40m which is where, for some reason, we are most likely to employ it.


The very best ABs teams never built an identity around attacking from poor positions. The DC era team was known for being the team that kicked the most. To engineer field position and apply pressure, and create broken play to counter attack. This current team is not differentiating between when a defence has lost it's structure and there are opportunities, and when they are completely set and there is nothing on. The reason they are going for 30 minute + periods in every game without scoring a single point, even against Japan and a poor Australian team, is because they are playing most of their rugby on the back foot in the wrong half.

43 Go to comments
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Nickers 1 hour ago
Scott Robertson responds to criticism over All Blacks' handling errors

I thought we made a lot of progress against that type of defence by the WC last year. Lots of direct running and punching holes rather than using width. Against that type of defence I think you have to be looking to kick on first phase when you have front foot ball which we did relatively successfully. We are playing a lot of rugby behind the gain line at the moment. They are looking for those little interchanges for soft shoulders and fast ball or off loads but it regularly turns into them battering away with slow ball and going backwards, then putting in a very rushed kick under huge pressure.


JB brought that dimension when he first moved into 12 a couple of years ago but he's definitely not been at his best this year. I don't know if it is because he is being asked to play a narrow role, or carrying a niggle or two, but he does not look confident to me. He had that clean break on the weekend and stood there like he was a prop who found himself in open space and didn't know what to do with the ball. He is still a good first phase ball carrier though, they use him a lot off the line out to set up fast clean ball, but I don't think anyone is particularly clear on what they are supposed to do at that point. He was used really successfully as a second playmaker last year but I don't think he's been at that role once this year. He is a triple threat player but playing a very 1 dimensional role at the moment. He and Reiko have been absolutely rock solid on defence which is why I don't think there will be too much experimentation or changes there.

43 Go to comments
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