An evaluation of the implementation of the UK Concussion Guidelines for Non-Elite (Grassroots) Sport

There is growing awareness of the possible long-term impacts of concussion on brain health among former participants in youth and adult sports, such as cognitive impairment, neurodegenerative disease, and the rare, but devasting, second impact syndrome. This has led to increased focus on sports-related concussion as an important public health concern.

The Digital, Culture, Media and Sport Select Committee’s Report on Concussion in Sport (2021) noted that while the evidence of a causal link between particular sporting activities and dementia remains uncertain, what is known should provide grounds for sporting national governing bodies and the Government to take a precautionary approach when advising on concussion in sport.

In response to this report, the Government and the Sports and Recreation Alliance published the ‘UK Concussion Guidelines for Non-Elite (Grassroots) Sports’ in April 2023. The guidelines were developed by an expert panel of sports medicine specialists and builds on pre-existing guidelines in Scotland.

The guidelines are intended to provide a consistent approach across all sports in England, Scotland, Wales and Northern Ireland. They aim to help players, coaches, parents, schools, national governing bodies and sports administrators to identify, manage and prevent concussion affecting participants in grassroots sports. The strapline “if in doubt, sit them out”, makes clear anyone with a suspected concussion should be removed from play immediately and not return to sport within 24 hours. They apply to all participants of grassroots sport, at all ages.

The impact of the guidelines is not yet known, and evaluation is considered important to understand how to improve the efficacy of the guidelines. The overarching aims of the research are to understand:

1. how the UK concussion guidelines have been, or are being, implemented; and
2. the awareness, knowledge and understanding of the guidelines in grassroots sports.

Specific objectives are to:

• describe the concussion policies published by sporting national governing bodies and other national organisations involved in the development and/or distribution of the guidelines, including how easy they are to find;
• explore how sporting national governing bodies and other national organisations have circulated the UK concussion guidelines to the grassroots-level and what they have done to support the grassroots-level to implement them; and
• explore the attitudes to, awareness and use of the UK concussion guidelines among coaches, welfare officers, participants and (if applicable) parents.

This study will use a combination of document review, interviews with individuals representing organisations involved in the development and/or distribution of the UK concussion guidelines, and an online survey.

We will review the websites and other publicly available documents of national organisations identified as having been involved in the development and/or distribution of the guidelines. The review will examine whether the UK concussion guidelines are prominently displayed and easy to find, and whether additional material has been developed to support grassroots-level organisations and individuals in implementing the guidelines.

Interviews will be held to gain a better understanding of how the guidelines are anticipated to result in change at the grassroots level, including how they have been shared and what support is being provided to implement the guidelines.

The survey will initially be undertaken within one sport. It will be sent to coaches, welfare offices, participants and parents to examine whether they are aware of the guidelines, their understanding of the guidelines and if they have used the guidelines.

We will work with a public panel of up to six individuals involved in grassroots sports to advise on various aspects of the project, including participating in the research ethics process, interpreting data, contributing to reports and presenting findings. Our hope is that the group will include a coach, welfare officer, participants and parents, and we will support individuals in accessing training and development opportunities.