Champions League: Uefa to ignore calls to introduce independent doctors to deal with concussions

Exclusive: Following a series of high-profile controversies across the 2018/19 season the organisation announced in May that it had requested a review of the existing regulations

Uefa has drawn criticism after it emerged the governing body is set to ignore calls to introduce independent doctors to the game and continue to defer responsibility to clubs when dealing with players suspected to be suffering concussion.

Following a series of high-profile controversies across the 2018/19 season, which saw Uefa’s concussion protocols fall under scrutiny, the organisation announced in May that it had requested a review of the existing regulations.

Uefa asked both Fifa and the International Football Association Board (Ifab) to consider potential changes to the Laws of the Game – such as the introduction of medical substitutions – to reduce the pressure on club doctors and grant them more time to assess a potential concussion off the pitch.

Current Uefa protocol dictates that a referee must stop play if there are concerns of a concussion being suffered, but medical teams only have three minutes to assess whether an individual is able to continue.

After fears Jan Vertonghen had suffered a concussion during Tottenham’s Champions League semi-final against Ajax, with the defender returning to action following a clash of heads only to be eventually withdrawn, calls were subsequently made to introduce independent doctors to the sport.

Former England international Alan Shearer was one of many demanding action. “If anyone ever needed more evidence why we should have — and have to have — independent doctors, then that was it,” he said at the time.

“An independent doctor would have taken one look at him, seen he could barely walk and was hugely uncomfortable, and they wouldn’t have let him on. How many more lessons do we need?”

Although Uefa is aware “there is a clear problem in our protocol”, the organisation remains unwilling to entrust independent doctors with the responsibility of assessing potentially concussed players.

Speaking at a conference on concussion in London last week, Niki Papadimitriou, a medical coordinator at Uefa’s Integrity Division, said the body ‘disagrees’ with the proposal.

“Having an independent doctor or an independent solution on the pitch we disagree with to a certain extent in the sense that, especially because a concussion is so difficult to diagnose, I think a team doctor is the person who will know the player best and make that decision,” she said.

“I also think having an independent doctor, where does the independence lie? We have games being played everywhere around Europe. Do you have a home team doctor? A doctor from that country? Do you have an issue with language? Where does the responsibility lie? Will they take that risk? I think it’s an added layer having an independent doctor.

Vertonghen was unable to continue in the Champions League semi-final last season (Getty Images)

“I think there are various ways of improving the current situation which we’re really trying to tackle at the moment. I think for the time being Uefa cannot be held accountable. I think who we really put the responsibility on is the team doctor in concussions.”

Uefa also conceded it is running a legal risk with regards to the inadequate standards of its concussion protocols. When asked if this was the case, Papadimitriou said: “Yes, I think there is definitely.”

Uefa’s decision to continue deferring responsibility to clubs for assessing a potential concussion has been met with criticism.

Dr Philip Batty, a former head of sports medicine at Manchester City and team doctor for England Rugby, said he was “surprised” by the governing body’s stance on the matter. Speaking from personal experience, he added that pressure from club management can “affect decisions” made by medical staff.

“I do feel independent match day doctors should assess players for concussion,” Dr Batty told The Independent. “I have been in this position before and inevitably as a doctor there is a conflict. You do not wish to be in conflict with your team or the manager and this can affect decisions. I feel this may have contributed to some errors I have made in the past. None of us are perfect and removing conflicts of interest in an intensely stressful situation is wise.”

Of Uefa, he said: “They appear to be behind many sports, including rugby and even cricket in the use of concussion substitutes. I find this very surprising for the world’s most popular sport.”

When asked how to improve today’s concussion protocols, Dr Batty said: “Independent assessment and the acceptance that there is not currently a 100 per cent accurate test. It will be helpful if trials in the use of salivary testing prove useful.

“There needs to be a cultural change, however, to protect the player. He should be assessed and possibly replaced at the suspicion of concussion.”

Brain injury charity Headway also expressed its “disappointment” at Uefa, insisting that the governing body “must be prepared to make significant changes” if it’s “serious about doing more to protect against concussion”.

“We continue to see high-profile incidents where the sport’s concussion protocols are either not enforced or shown to be inadequate,” said Peter McCabe, chief executive of Headway.

“For many years we have been saying more needs to be done, but these calls have been ignored.

“Diagnosing concussion is notoriously difficult and the pressure on club medical staff is enormous and unfair.

“We believe the time has come for independent doctors with expertise in concussion and head injuries to make the ultimate decision as to whether or not a player is fit to continue.”