Ein cyf/Our ref MB/HL/1480/14
2 October 2014
Local Authorities education and health departments
Boards of Governors of all maintained schools
Further Education Colleges
Private schools
Sport Wales
Sports Governing Bodies
Education and Library Boards
Chief Executives Health Boards and Trusts
GPs
Wales Ambulance Service Trust
School Nurses via LHB Directors of Nursing
BMA, RCN, CPHVA, RCPCH, CEM
SPORT RELATED CONCUSSION AND BRAIN DAMAGE
Many of you will be aware of the tragic death of Benjamin Robinson who was only 14 years old when he died on 31 January 2011 following a head injury sustained during a rugby match for his school in Northern Ireland. Benjamin sadly died because he was allowed to play on with concussion, and sustained a second head injury, which was fatal.
Last November, Benjamin Robinson's father met with the Minister for Education and Skills to ask for support in his campaign to help prevent further fatalities and brain damage amongst children and young people. He sought Welsh Government action to raise awareness and highlight the signs and symptoms of concussion and its potential dangers.
Concussion is a brain injury which can happen in any sport or recreational activity. Most often concussion arises as a result of a direct blow to the head, but it can also occur when blows to other parts of the body result in rapid movement of the head e.g. whiplash type injuries. It can cause a wide range of symptoms reflecting disturbance of brain function, such as headache, dizziness and visual impairment. Of note, loss of consciousness occurs in less than 15% of cases.
Though a fatal consequence is rare, all concussion is serious and, while most people recover within 7-10days, recovery can take longer.
It is important that all school staff, and anyone brought into a school to play, referee, or deliver sporting activities, are aware of the signs of concussion, the associated risks, and know what action to take. Governors and Principals, in meeting their statutory duties to safeguard and protect children, will want to ensure that relevant staff are aware of that advice.[1]
The following principles should be applied to anyone with suspected concussion, and apply to all children and young people under 19 participating in school or community sport:
· any player with suspected concussion must be removed from play immediately
and must not return to play or training that day;
· where there are any features of concussion, the player must undergo
the compulsory rest and follow the Graduated Return to Play protocol;
· when a child or young person is on the Graduated Return to Play protocol,
it is important that the school, any team mates, parents/guardians,
coaches, referees and supervisors understand that this means restrictions to levels of exertion and physical contact should be applied to all sports and learning activities, including organised trips;
· there should be a graduated reintroduction to schoolwork, in most cases within
a day or two if there are no continuing symptoms such as headache. Return to
education should be successfully completed before considering return to play. Healthcare advice should be sought after any concussion.
The existing Programme of Study for Physical Education in Wales ensures all children and young people have opportunities as part of the school curriculum to learn about safety in sport – to be mindful of both their own safety and others. However, Professor Graham Donaldson is currently undertaking a review of the national curriculum and assessment arrangements and will be reporting to the Minister for Education and Skills early next year; Professor Donaldson will be asked to give consideration to this issue of concussion awareness as he develops his recommendations.
In addition, in January an early advice note was published on Learning Wales (and also included in the pre 11 and Dysg e-newsletters issued to all maintained schools and local authorities) drawing attention to the latest guidance on concussion management and prevention. Some sports clearly carry higher risks than others, but we recognise that concussion can happen in any sport or recreational activity, and schools have been asked to share the guidance as widely as possible.
Across Welsh Government we are committed to working with all of our partners to ensure co-ordinated action to promote the guidance and raise awareness of this important issue. To support this joined up approach, we have produced the attached leaflet, with thanks to colleagues in Scotland and Northern Ireland who have helped inform development of this advice, and also the Football Association of Wales (FAW), the Welsh Rugby Union (WRU) and the International Rugby Board (IRB).
Please ensure this leaflet is circulated as widely as possible so that key messages are conveyed to all education, sports and health professionals, as well as being widely available to the general public – particularly to parents and to children and young people themselves.
The tragic death of Benjamin Robinson is a reminder to all of us of the importance of concussion prevention, and the need to ensure that all young people in Wales are aware of the risks and responses.
Yours sincerely
Huw Lewis AM
Minister for Education and Skills
John Griffiths AM
Minister for Culture and Sport
Mark Drakeford AM
Minister for Health and Social Services
Dr Ruth Hussey OBE,
Chief Medical Officer
Professor Jean White,
Chief Nursing Officer
[1] Governing Bodies of maintained schools, for the purposes of meeting their duties under section 175 of the Education Act 2002, must exercise their functions in a way that takes into account the need to safeguard and promote the welfare of children. Governing Bodies are accountable for ensuring that their school has effective policies and procedures in place to do so. These responsibilities are outlined in the draft Welsh Government guidance ‘Safeguarding Children in Education’ which is in the process of being updated and will be published in due course.