World Rugby has issued a clarification in law that will mean that play must be stopped should a team or independent match-day doctor call for an immediate care team to attend to a player that is already being assessed on the field of play.

The clarification follows the recommendation of the World Rugby Immediate Pitch-Side Care Working Group and is designed to enable the immediate care team to access the field of play immediately and create a safe and stable environment to treat a player suspected or determined to have sustained a serious injury.

As is currently the case, play will not need to be stopped by the referee if the player requires attention for minor medical attention.

The Immediate Pitch-Side Care Working Group is one of a number of key player welfare and advisory groups that guide rugby’s evidence-based approach to injury education, prevention and management.

The working group met in London last week to review the current landscape, discuss the challenges and opportunities for player welfare education in a global context and make recommendations to the Rugby Committee or Head Injury Assessment (HIA) Working Group for advancements that will benefit players and medics alike.

Recommendations for elite rugby

Consistency of delivery of tournament player welfare standards is a key focus for World Rugby and with 22 elite competitions running the Head Injury Assessment protocol, the group identified the following recommendations further best-practice in injury identification and management:

  • Every elite competition should have an independent match-day doctor, mandatory from 1 July, 2019 with every match-day doctor needing to complete a World Rugby match-day doctor course
  • All match-day doctors should be qualified to at least World Rugby Level Two Immediate Care in Rugby (or equivalent) in line with team medic requirements within the tournament player welfare standards programme
  • If the immediate care team are called onto the field of play by the team or independent doctor, then the referee must stop play (now clarified in law)
  • Greater emphasis will be placed on HIA training (including technology) within the Immediate Care in Rugby Level Two course to ensure best-practice application

These recommendations will be elevated to the HIA Working Group and/or Rugby Committee for consideration.

Global education increasing in 2018

The cornerstone of World Rugby’s player welfare approach is global education and face-to-face education, delivered as stand-alone courses and within Rugby Ready, continues to grow, underpinned by a growing global workforce of trainers and educators.

This year, World Rugby is on target to achieve a 50 per cent increase in face-to-face course delivery and a 25 per cent increase in online course completions at playerwelfare.worldrugby.org.

A total of 108,000 people have completed World Rugby medical courses to date, with 12,700 completions in 2018 alone. These courses include recognise and remove concussion education for the general public, concussion education for medics, elite match-day doctor courses and Immediate Care in Rugby.

Workforce expansion key to best-practice

In order to support a growing, thriving global playing community of more than nine million, World Rugby requires a dedicated global network of trainers and educators to ensure that education can support the growth profile of the game.

In order to support such growth, the group agreed a re-shaping of the workforce delivery pathway:

  • First Aid Educators – to deliver Level 1 First Aid
  • Medical Educators – to deliver Level 1 First Aid. Level 2 Immediate Care in Rugby and Level 3 Advanced Immediate Care in Rugby
  • Medical Trainer – delivers Medical Educator courses to build capacity

World Rugby Head of Technical Services and Immediate Pitch-Side Care Working Group Chairman Mark Harrington said: “With player welfare a top priority for World Rugby, it is important that we continually review our process and practices to ensure that the have the workforce and capability to ensure excellent player welfare education at community level, while providing the pathway for doctors to attain the necessary qualifications to support the consistent standard of delivery at the elite level.

“This was a productive forum and the recommendations of the group are already being acted upon with the designated members approving a clarification in law that will mean that play has to be stopped when the immediate care team is called on to the field. The other recommendations will be presented to the HIA working group or Rugby Committee as appropriate for consideration.”

The Immediate Pitch-Side Care Working Group: Mutsuo Yamada (JRFU), Mike Hislop (World Rugby – lead on Activate Injury prevention), Isaac Boss (International Rugby Players); Andy Smith (RFU and PRL, Level 2 and 3 lead), Isabel Grondin (Rugby Canada), Jonathan Hanson (SRU, Level 1 lead); Warren MacDonald (Rugby Australia), Ben Gittus (EOSE- Qualification equivalency), Mark Harrington (Chairman and World Rugby Head of Technical Services), Didier Sirieix (FFR), Dr Martin Raftery (World Rugby Chief Medical Officer), Jock Peggie (World Rugby Training Manager).