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ENGLAND HOCKEY MEDICAL CODE THIS code has been adopted as January 2007 in order to set out the function of the England Hockey medical support services and to explain to members of our squads what to expect from the Doctors and other medical staff working with our players. Relationship with your GP The physicians engaged by England Hockey are not intended to be your Primary Care Practitioners; you should enrol with a General Practitioner as this is the recognised link to the comprehensive system of health care provided by the NHS, or indeed private medical services. Our physicians are here to support your development as an elite sports man or woman and to provide emergency treatment at events and training camps and specialist treatment in terms of prevention of injuries or illness and recovery from injury and illness. Our physicians operate within the sporting context and their role is limited and there will be times when you are asked to refer to your own General Practitioner for treatment and/or referral on to other specialist medical support. Basic services available to all athletes England Hockey will provide the following medical and physiotherapy support regardless of the funding status of the athlete. 1. 2. 3. All coaching staff will have up to date first aid qualifications and will be able to deal with injuries on a first instance basis which occur on the pitch or at another training venue under their supervision. At National training camps invited squads will have access to physiotherapy and to injury assessment and treatment to the extent that this falls within the competence of the medical staff in attendance. Outside of training camps, access to the physiotherapy staff employed by England Hockey and based at Bisham Abbey National Sports Centre. Note that for non-funded athletes England Hockey cannot provide access to EIS medical staff or rehabilitation facilities, nor support towards the cost of private physiotherapy or medical treatment. England Hockey recommend that all non-funded athletes take out some form of private health insurance, the insurance policy should cover the following (and you should check with your broker or the provider direct that this is covered under the policy); 1. 2. Sports physiotherapy and sports medial treatment with qualified sports and exercise medical practitioners. Access to orthopaedic surgeons and medical investigations such as MRI scans. Even though sports and exercise medicine has recently become a recognised specialist practice under NHS guidelines if you do not have access to EIS facilities and do not take out appropriate insurance you may be forced to wait a long time for appropriate treatment under the NHS. 1 Talented Athlete Sponsorship Scheme (TASS) Athletes The Department of Culture, Media and Sport (DCMS) promotes TASS. TASS athletes need to refer to the document they receive from the DCMS which sets out the level of medical provision that they are entitled to, and the way this is accessed. Prescription and supply of Medicines Our physicians are able to prescribe and/or provide medicines but this is at the limit of their responsibility to you. They do not have a sufficiently large budget to supply medication of a continuous or repeat basis and if this is what is needed you will be asked to see your own GP. English Institute of Sport (EIS) Medical Support The various EIS Centres provide differing degrees of medical (including physiotherapy) support to athletes registered with them. What the EIS provide, and where it is provided, is outside the responsibility of England Hockey. EIS medical support is a different level of medical servicing to high performance athletes and is not the responsibility of England Hockey. England Hockey and its physicians will help you liaise with the EIS in respect of any medical support you require. The amount of EIS support you are able to access will depend on your level of funding, as well as the Centre you are registered with. England Hockey Medical Insurance Plan. England Hockey have taken out Medical Insurance to cover squad members for certain treatment when they are away from the UK involved in official training camps, matches, tours or tournaments. A copy of this Policy is available on request from Ian Wilson ([email protected]) and you are strongly recommended to read it. The insurance and support services are provided by Royal & Sun Alliance and their wholly owned subsidiary FirstAssist Group Limited. In brief the insurance provides the following benefits; a. b. c. d. Advice and guidance before departure on such things as recommended inoculations. Liaison with local doctors and hospitals. Arrange and payment for visits and treatment from local medics. Repatriation back to the UK and in some circumstances transport of relatives to foreign destination to be with injured or ill player. European Union travel and Form E111. Form E111 is no longer valid; it has been replaced by the European Health Insurance Card (EHIC). As part of the reciprocal arrangements between member states of the EU (and for these purposes Switzerland) any citizen of the EU is entitle to access the public health care services of a Member State for the purpose of treatment ‘that becomes necessary’ while in that country. Note this does not cover illness or injury that was pre-existing for which treatment became necessary BEFORE departure from the UK. In order to be able to prove your entitlement when abroad within the EU it is essential that you obtain and carry with you an EHIC. Details of how to obtain your EHIC can be obtained from the Department of Health website at www.dh.gov.uk look for the pages concerning ‘health advice for travellers’. You will be asked to show a valid and in date EHIC to your team manager but if you don’t have one then you may become liable to pay for necessary medical treatment through the local heath care system, or provide some evidence of ability to pay and guarantee of 2 payment before treatment will be made available. Therefore it is STRONGLY RECOMMENDED that athletes obtain an EHIC before leaving for an overseas trip within the EU. There are reciprocal arrangements with a number of other countries such as New Zealand and Australia and details of the formalities and what is covered are also available on the Dept. of Health website. Medical Confidentiality Anything you say to any one of the England Hockey medical team will be treated as confidential in the same way as any other health professional that treats you. In the same way information which the physician discovers about your health and fitness as a result of treating you will be kept confidential. You may waive this confidentiality by allowing the England Hockey medical team to pass on information about your health and fitness to members of the coaching staff, but you do not have to. There are very limited circumstances where a member of the medical team may disclose information about you without your consent; this is when the disclosure is necessary to prevent death or serious injury to yourself or others. This is a very rare occurrence. It is worth reminding those players who have signed the GB Hockey Performance agreement that these matters are dealt with at clause 6 in the following way; 6.1 The Athlete understands that in the high performance sport environment a fully integrated support system involves a range of support staff working together (e.g. doctors, physiotherapists, sports scientists, coaches). This is required not only to provide quality health and injury management support to the Athlete, but also to make assessments about the Athlete’s fitness to perform optimally in training and competition. For these purposes the Athlete consents to relevant details from consultations and treatments carried out by the GBOHPP Medical Officer and designated NGB physicians (including the results of any test carried out in relation to Clause 6.14) being released to the Performance Director/Head Coach and specified NGB support staff. The Athlete understands that refusal to give consent for the release of such details will not affect his access to medical care or treatment but accepts that it may be considered in relation to selection for the GBOHPP or representative teams. 6.2 The Athlete further understands that he may withdraw consent for the release of medical information at any time by notifying the physician carrying out the consultation and understands that only the notice of its withdrawal will be released to those specified. 6.4 The Athlete agrees to notify the Performance Director/Head Coach as soon as the Athlete becomes injured or ill during an event or competition or at other times if the illness or injury interrupts the Athlete’s training for two or more consecutive days. 6.5 The athlete agrees to immediately notify the Performance Director/Head Coach as soon as the Athlete suspects or realises that he is likely to or will be absent from any events or competitions (including organised training events) due to injury or illness. Such notification shall (if required by the Performance Director/Head Coach) include a written explanation from or on behalf of the Athlete, together with copies of any medical report(s) dealing with the injury or illness which the Athlete may have obtained. 3 Therefore there is an assumption that these funded athletes’ have already given a limited consent, WHICH THEY CAN WITHDRAW AT ANY TIME. Consent to treatment All medical treatment must be consented to, except where the patient is unable to give consent, for instance where they are unconscious following an accident. What this means is that you are entitled to understand the nature and possible effect of any suggested treatment, including the risk of unwanted side effects. Our medical team are obliged to explain these things to you before treatment begins. You can not properly give consent unless you understand what you are consenting to; if you don’t understand, ask! Camps and Tours The England Hockey medical staff are likely to have a greater role in the treatment of players during camps and tours. Our medical staff will endeavour to take a sufficient quantity of the most useful medicines based on past experiences. However there may be injuries or illnesses that are too serious for our physicians to treat whereupon you will be referred to the appropriate local hospital or other healthcare facility. This will be governed in part by where you are (in EU countries we will seek to make use of the EHIC scheme for emergency treatment) what treatment is needed and whether this falls within the scope of our medical insurance cover. InjuryZone by UK Sport As you may know, UK Sport manages a centralised electronic medical records system on which it records and stores medical information in relation to World Class Performance athletes and other elite UK athletes, specifically injury and illness histories and treatments. The System has been implemented and subsequently improved as a result of a lengthy consultancy process with senior medical staff from NGBs and the Home Country Institutes as a result of which the benefits of a centralised electronic medical records system were clearly identified and advocated. The core purpose of the System is to enable authorised Institute, NGB and other medical staff to provide more effective clinical management to elite athletes and to enhance the communication between sports medicine practitioners working across the UK and abroad. The System is a web-based tool facilitating enhanced communication between relevant authorised NGB, Institute and athletes’ personal sports medicine practitioners (including doctors and physiotherapists) to enable them to access up-to-date medical information regarding elite athletes. Information gathered during medical consultations will be placed on InjuryZone unless you object. IOC Medical Code, January 2006 England Hockey will ensure that our doctors and other medics work within the broad guidelines laid out in the IOC Medical Code which was adopted as of January 2006 and can be viewed and downloaded from the IOC website. This code is of general and broad application and covers much of the same issues as are set out above and also covers some of the basic obligations of any doctor. In this way it repeats standards that are already applicable under the law and medical ethics codes governing our practitioners. The code 4 cannot be seen as a legally binding document as we feel it is too general, but it is a very useful statement of the ethical and legal principles governing the medical treatment of athletes. January 2007 5