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British Horseracing Authority Enhances Concussion Management Protocols

The British Horseracing Authority (BHA) has announced a series of enhancements to its concussion management protocols, in order to ensure that riders are better protected and prevented from riding while under the influence of a concussive injury.

The enhancements, which come into effect from 1 August 2016, are being implemented across the full concussion management process, from baseline cognitive testing, trackside diagnosis and care through to post-injury follow-up, assessment and treatment and return-to-riding clearance. Their implementation follows a review of the existing concussion management protocols led by the BHA’s Chief Medical Adviser Dr Jerry Hill, in consultation with relevant stakeholders, including most crucially the Professional Jockeys Association (PJA).

The headline elements of the enhancements include:

* Extension of trackside screening test to ensure all riders who are involved in a fall are assessed for testing with symptom scores, balance and short and long-term memory (previously only memory was tested)

* Doctors will be given authority to test riders who were involved in a heavy fall a second time, approximately 25-30mins after the initial test, even if the rider passed the initial screening test, in case of late-onset concussion

* Involvement of other members of the racecourse team in encouraging potentially concussed jockeys to attend for (re)-testing with the medical team both doctors and nurses.

* Further research and development of an active rehabilitation programme for riders who have suffered concussion, on top of the existing enforced period of rest

* Ensuring riders are asymptomatic before submitting themselves for return-to-riding tests.

* Enhancement of “Cogsport” baseline testing to ensure all baseline tests are reviewed and evaluated to ascertain any tests which may need repeating for technical or clinical reasons

* Inclusion of IJF almoners in baseline testing process in order to make testing more convenient for riders

In addition to these enhancements, further improvements to the process are planned for the near future. These include a rewrite of the “Head Injury Instructions” guidance given to jockeys who are diagnosed with concussion, enhancements to the “helmet bounty” system whereby jockeys are given a stipend in exchange for returning the helmet they wore when suffering a concussion, and an extension of the administrative support around the concussion process in order to accommodate all of these enhancements.

In the longer term the BHA is working on a program of education which will be designed to inform not only jockeys but any relevant individuals who work within the sport about how to diagnose concussion and the risks of continuing to ride when suffering from concussion.

Dr Jerry Hill, Chief Medical Adviser for the BHA, said:

“For some time British Racing has been recognised as pioneers when it comes to concussion management, as you would expect from a sport which carries an above average risk of concussion injury.

“However, it is essential that a sport should not be complacent about the management of such a serious issue as concussion. It is my intention that in British Racing we provide our jockey athletes with the appropriate guidance, treatment and care. This is why I am personally putting a renewed focus on the support these athletes receive in injury management as well as wellbeing, nutrition and mental health.

“The enhancements to our concussion management protocols will help reduce the risk of jockeys continuing to ride while suffering from a concussion. It will also aid their safe return to riding following a concussion injury.”

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