England U20s doctor found guilty of Six Nations misconduct charges

The England U20s doctor who was the subject of a concussion controversy during the Under-20s Six Nations has been suspended.

Dr Nigel Rayner's behaviour and actions on the night were described as both 'grave' and 'unacceptable' in the report.

Dr Rayner was England's team doctor during the game in which an England player received a head knock. Wing Deago Bailey fell to the ground having competed with an opponent for a high ball during the 77th minute of the match.

The Independent Match Day Doctor (MDD) assessed that Bailey needed to leave the field to undertake a Head Injury Assessment (HIA), which was reported to the referee and to Rayner.

Rayner challenged the need for the player to leave the field to undertake the HIA and his interactions with referee were heavily criticized at the time and led to a Six Nations review of the incident.

Dr Rayner was charged with; A: Allowing a player to return to the field of play, when an HIA had been called; B: interfering with the HIA process and challenging those in a decision-making position; and C: disrespectful conduct towards officials.

A statement reads: 'The Committee noted that in respect of Charge A and B, Dr Rayner’s actions were grave and found that the HIA protocol is mandatory and must be complied with by all concerned. The independent Judicial Committee was unanimously of the view that an entry point of eight weeks would be appropriate regarding Charges A and B.

"Regarding Charge C, Dr Rayner’s actions towards the MDD were found to be unacceptable and not in the spirit of the game, and the Judicial Committee decided upon a two-week suspension, those two weeks to run concurrently with the eight-week suspension for Charges A and B.

"The independent Judicial Committee applied full mitigation (50%) based on Dr Rayner’s previous impeccable record and acknowledgement of culpability, leaving a total suspension of four weeks.

"It was accepted by the independent Judicial Committee that Dr Rayner had been stood down for three weeks in which he would otherwise have been Team Doctor for the England U20s, participating in the Six Nations U20’s Championship, and therefore determining that he had already served three of the four-week suspension.

"The suspension from any involvement in the game of Rugby Union, will end at 00:01 hours on Friday 29 April 2022.

"Dr Rayner was advised of his right to appeal the decision."

The report also found that while shortcomings in the HIA process on the night, ultimately the correct actions were taken.

"The HIA Review Panel concluded there were no “Category 1” indicators that would have led to the immediate permanent removal of the player from the field. However, ‘Category-2” events; “mechanism of injury and post-event actions” were such that the Match Day Doctor (MDD) was correct to call for an HIA-1 assessment.

"It was also noted that it is the MDD who has the final say in calling for an assessment and not a team doctor. The correct result was achieved; the Player’s need to undergo HIA-1 assessment, but this was against a backdrop in which the applicable protocols and regulations were implemented in a manner a long way short of what they were designed to achieve."

"The HIA Review Panel examined the role of the Referee in this incident and determined that she (they) dealt appropriately with the incident itself, stopping play promptly and not restarting until everything had been resolved."

The panel suggested - among other things - that Pre-Match Medical Meetings are "vitally important to the efficient and effective performance of all match day medical personnel".