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Select committee: Digital, Culture, Media and Sport Committee

Concussion in sport

Closed Opened 3 Mar 2021 Closed 23 Mar 2022 15 recommendations 6 conclusions

Digital, Culture, Media and Sport Committee Inquiry on parliament.uk ↗

Inquiry scope (the committee's words)
MPs will examine links between sport and long-term brain injury. The concussion in sport inquiry will consider scientific evidence for links between head trauma and dementia and how risks could be mitigated with two sessions, the first taking place on Tuesday 9 March.

Where it stands

The inquiry is closed, opened 3 March 2021.

The committee has published 1 report, most recently Third Report - Concussion in sport on 22 July 2021.

The government's response

Published 10 December 2021. The deadline was 3 December 2021.

Summary written by Accountability Index from the government's response. It is not the government's own words.

The government states that the Committee's recommendations "largely align with the Government's own ambitions", agreeing with some in full and in part, and setting out its own action plan.

  • On a UK-wide concussion protocol, the government "agrees with this recommendation", saying the four home nations have "agreed in principle" to develop shared protocols based on the Scotland model, with completion expected by the end of 2022.
  • On a single research fund, it agrees with the intention but does not "believe it is necessary" because medical research funds already exist; it will instead convene a "sports concussion research forum".
  • On a national injury reporting framework run by the Health and Safety Executive, it "agrees in part", saying other organisations are "better placed" to collate the information, and that it "will look into the feasibility of a national register of concussion incidents".
  • It sets timed actions: the research forum to be convened "by the end of January 2022", Oxford study findings "by the end of March 2022", and shared protocols completed with communication started "by summer 2022".

Read the government's response ↗ Report an error

Recommendations and conclusions

All 21 recommendations and conclusions

Reports

All reports

Evidence

  • 5 oral evidence sessionsLatest 25 May 2021
  • 29 witnesses
All evidence

Recent activity

Recommendations and conclusions 21 shown

Conclusion 1

Conclusion · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Concluded (the committee's words)
Despite the need for acquired brain injury to be taken seriously by sport, the detail of which we will come onto later in this Report, both written and oral evidence to this inquiry support the health benefits to people through mass participation in sporting activity. An active lifestyle promotes overall good health, including reducing the risk of dementia in later life.

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Recommendation 2

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
The reality is that, for most people playing sport, there is no one to stop them except themselves, their friends, teammates, and family. That is how far down the knowledge and awareness of concussion and how to respond to it must reach to ensure people seek the necessary help and treatment rather than returning to the field to the detriment of their long-term health.

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Recommendation 3

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
Doctors may not be able to rely on patients to remember previous concussions or head traumas, especially if these happened at different times playing different sports. They must instead be able to rely on robust information that should be collated on a patient’s records.

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Recommendation 4

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
We recommend that NHS England reviews the way in which it collates data about concussion and concussion-related brain injury and ensures that doctors have a full history available to better inform patient treatments.

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Conclusion 5

Conclusion · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Concluded (the committee's words)
We are also 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.

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Recommendation 6

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
We recommend that NHS England, in collaboration with the Faculty of Exercise and Sport Medicine, within the next twelve months, prepares a learning module on the best practice for treating and advising those who present with concussive trauma and ensure that all General Practice and Accident & Emergency practitioners take this module within the next 2 years. The module, and the updating of practitioners, should be repeated every 2 years thereafter.

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Conclusion 7

Conclusion · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Concluded (the committee's words)
The current organisational structures in sport mean that 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 fact that concussion does not occur at high frequency within the elite sport community means that little effort is made to drive numbers down even further. This means that, some preventable brain injuries are suffered, with the potential for long-term consequences for individuals.

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Recommendation 8

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
It is no longer acceptable for concussion to be addressed in this fashion. We recommend that the Government mandate UK Sport to take a governance role in assuring that all sports it funds raise awareness on the dangers of concussion effectively. Those sports should not only have good protocols to mitigate the risks of such injury but proactively implement those protocols.

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Recommendation 9

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
We are concerned that UK Sport, uniquely in our evidence base, considers the Consensus Statement by the Concussion in Sport Group as a satisfactory basis for concussion protocols. We recognise the value in the Consensus Statement that provides a baseline for what the science can say for certain and identifies a gold standard for science in this area of research. Scientific certainty is a worthy ambition, but it should not be a prerequisite for changing sporting rules to improve safety.

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Recommendation 10

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
We recommend a more precautionary approach is taken and a greater proportion of the money spent on elite sport is focussed on protecting the athletes who are at the core of UK success in sporting endeavours. We also recommend that UK Sport fund a chief medical officer to attend events, like the Olympics, who will hold over-arching responsibility to assess the application of protocols and make decisions on who should be allowed to continue to compete in the event of injuries, including head trauma, sustained in practice and competition.

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Conclusion 11

Conclusion · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Concluded (the committee's words)
Football’s engagement with the issue of concussion, both in England and internationally, has taken too long and its current prominence is due to the campaigning of organisations like the Jeff Astle Foundation and prominent spokespersons like Chris Sutton. We would have expected the Football Association, as the National Governing Body, to have taken a stronger, sustained interest in the issue after the coroner’s verdict of Jeff Astle’s death. We would also have expected the Football Association to have been publicly hounded by the Professional Footballers’ Association, whose key concern should be player welfare. Over the past 20 years neither the Football Association nor the Professional Footballers’ Association have fought hard enough, or publicly enough, to address this issue within the broader football community. They are, however, only part of a broader failure to address the issue of acquired brain injury in sport.

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Conclusion 12

Conclusion · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Concluded (the committee's words)
The problems faced by both football and rugby are common to a multitude of other sports which do not have the same media attention or the same resources to apply to possible solutions. One of the biggest problems is the apparent lack of clarity on who is responsible for driving change. Change has not happened quickly enough and while the science currently available to us describes the problem it does not provide solutions.

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Recommendation 13

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
The protections afforded by the state to workers apply as much to footballers and jockeys as they do to miners and construction workers. The Health and Safety at Work Act 1974 was a landmark piece of legislation to protect the health of workers and, along with subsequent Regulations, places a duty of care on employers. The 32 Concussion in sport extent of that duty has been established through numerous court cases in many other sectors. We are astounded that sport should be left by the Health and Safety Executive to mark its own homework.

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Conclusion 14

Conclusion · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Concluded (the committee's words)
Our inquiry into concussion has demonstrated that the long-term effects of acquired brain injury are not simply those events that lead to a diagnosis of concussion. Therefore, any impacts that impair clear thinking or involve a heavy impact could contribute to acquired brain injury.

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Recommendation 15

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
We recommend that the Government immediately mandate the Health and Safety Executive to work with National Governing Bodies of all sports to establish, by July 2022, a national framework for the reporting of sporting injuries. Within a year of the framework being published, all organised sports should be required to report any event that might lead to acquired brain injury.

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Recommendation 16

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
We recommend that the Government uses its power to convene interested parties and establish a single research fund that will co-ordinate and fund research. The allocation of funds should follow the model of the research councils to ensure it is seen to be independent and excellence-driven and to ensure that the available funding is coordinated to cover the research requirements most efficiently. All research funded in this way should be required to return all results and analysis to a central database that should be freely and publicly accessible. We also recommend that the Government incentivise sport and other groups to contribute to this fund by offering a degree of match-funding.

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Recommendation 17

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
We also recommend that the Government convene its own specialist group on concussion, drawing on campaign groups, relevant scientific expertise and sporting institutes to assess, every four years, the emerging science on this issue. This group should take a broader view of the existing science than the Concussion in Sport Group, with its priority on taking a precautionary approach to safety.

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Recommendation 18

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
We find it difficult to see any downside of a coherent UK-wide protocol for concussion and recommend that the Government look to the Scottish model and then work with the devolved governments in Scotland, Wales and Northern Ireland to develop, in the next 12 months, a UK protocol for concussion across all sport. This should be used by National Governing Bodies as the minimum standard in creating the rules for their sport and should take account of, and be consistent with, the national framework for the reporting of sporting injuries we recommended earlier in this Report. This protocol should be refreshed every two years.

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Recommendation 19

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
Once this protocol is in place we recommend the Government deliver a comprehensive communications campaign to ensure that everyone involved in sport, from the athletes to coaches and doctors, is aware of best practice. This campaign should signpost where people can find the most current, well-evidenced advice on what action to take in the event of head trauma.

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Recommendation 20

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
We are concerned that there is history of the Government looking into issues of sporting safety and failing to follow through with practical interventions that would Concussion in sport 33 make a difference to the safety and health of those participating. The reports of the 2002 Working Group and by Baroness Grey-Thompson in 2017 both suggested ways to address the issue of concussion in sport and yet the Government has not progressed these. We urge the Government to grasp the nettle this time, move past the concerns about how regulation may change sports, and take real and effective action.

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Recommendation 21

Recommendation · Third Report - Concussion in sport · Addressed to Department for Culture, Media and Sport

Recommended (the committee's words)
It will never be possible to ensure that sport is one hundred percent safe. It should, however, be expected that participants are aware of the risks involved and that there is a precautionary approach to risk management. The Government cannot avoid taking a proactive role in ensuring that this occurs.

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Reports

1 report

Oral evidence sessions

5 sessions

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Date Session and witnesses Source
25 May 2021
Oral evidence session
Ben Dean · Department for Culture, Media and Sport, Nigel Huddleston MP · HM Treasury 		View ↗
18 May 2021
Oral evidence session
Dr Niall Elliott · Sport Scotland, Dr Rod Jaques OBE · English Institute of Sport, Phil Smith · Sport England, Professor Alistair Burns CBE · NHS England, Sally Munday · UK Sport, Stewart Harris · Sport Scotland, Tim Hollingsworth OBE · Sport England 		View ↗
27 Apr 2021
Oral evidence session
Damian Hopley MBE · The Rugby Players Association, Dr John Etherington CBE · Faculty of Sport and Exercise Medicine UK, Dr Richard Sylvester · Institute of Sport, Exercise and Health, Gordon Taylor OBE · Professional Footballers Association, Paul Struthers · Professional Players Federation 		View ↗
23 Mar 2021
Oral evidence session
Bill Sweeney · Rugby Football Union, Chris Sutton, Dawn Astle, Dr Charlotte Cowie · The Football Association, Dr Éanna Falvey · World Rugby, Dr Mike Loosemore · TeamGB boxing and TeamGB snow sports, Eleanor Furneaux, Kyran Bracken MBE, Monica Petrosino, Professor John Fairclough 		View ↗
9 Mar 2021
Oral evidence session
Dr Michael Grey · UK Acquired Brain Injury Forum, Peter McCabe · Headway, Professor Craig Ritchie, Professor William Stewart, Richard Oakley · Alzheimer's Society 		View ↗

Who gave evidence

29 witnesses

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WitnessOrganisationSessions
Ben Dean · Director, Sport and Gambling Department for Culture, Media and Sport 1
Bill Sweeney · Chief Executive Rugby Football Union 1
Chris Sutton Not recorded 1
Damian Hopley MBE · Chief Executive The Rugby Players Association 1
Dawn Astle Not recorded 1
Dr Charlotte Cowie · Chief Medical Officer The Football Association 1
Dr John Etherington CBE · Medical Director & Consultant Rheumatologist Faculty of Sport and Exercise Medicine UK 1
Dr Michael Grey · Reader in Rehabilitation Neuroscience UK Acquired Brain Injury Forum 1
Dr Mike Loosemore · Chief Medical Officer TeamGB boxing and TeamGB snow sports 1
Dr Niall Elliott · Head of Sports Medicine Sport Scotland 1
Dr Richard Sylvester · Consultant Neurologist Institute of Sport, Exercise and Health 1
Dr Rod Jaques OBE · Director of Medical Services English Institute of Sport 1
Dr Éanna Falvey · Chief Medical Officer World Rugby 1
Eleanor Furneaux Not recorded 1
Gordon Taylor OBE · Chief Executive Professional Footballers Association 1
Kyran Bracken MBE Not recorded 1
Monica Petrosino Not recorded 1
Nigel Huddleston MP · Financial Secretary to the Treasury HM Treasury 1
Paul Struthers · Director Professional Players Federation 1
Peter McCabe · Chief Executive Headway 1
Phil Smith · Director of Sport Sport England 1
Professor Alistair Burns CBE · National Clinical Director for Dementia and Older People’s Mental Health NHS England 1
Professor Craig Ritchie Not recorded 1
Professor John Fairclough Not recorded 1
Professor William Stewart Not recorded 1
Richard Oakley · Head of Research Alzheimer's Society 1
Sally Munday · Chief Executive UK Sport 1
Stewart Harris · Chief Executive Sport Scotland 1
Tim Hollingsworth OBE · Chief Executive Sport England 1

Correspondence

2 letters

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PublishedDirectionLetter
24 Mar 2022 To committee Letter from Gordon Taylor OBE, Chief Executive, Professional Footballers' Association, relating to concussion in sport, 4 May 2021
12 Mar 2021 To committee Letter from the Chair to Tim Davie, Director-General, BBC, re mixed martial arts on the BBC, 12 March 2021