football medicine & performance The official magazine of the Football Medicine & Performance Association
Issue 26 Autumn 2018
Exclusive: Are we squeezing the life out of adductor monitoring
In this issue: Cardiac Screening Life After Football
Contents Welcome 4
The Barcelona Way Damian Hughes
Research and Development What you should know about R&D
Cardiac Screening Saves Footballers’ Lives – But We Can Do More David Oxborough
Are we Squeezing the Life out of Adductor Monitoring Gary Silk
CHIEF EXECUTIVE OFFICER The launch of the FMPA Register is the culmination of much endeavour by the FMPA team and we are delighted with the response to date and the momentum that is starting to build. The Register was largely designed as an initiative to support members who leave the game often at a time of real need, giving them a platform to showcase their experience, helping them to maintain a presence in the game and supporting their private practice ventures. The needs of these members are clearly different to members in full time posts, hence why the register was set up as a separate entity and viewed as a potential bolt- on to membership, to be used as required. Continued support for colleagues, whether currently in the game or not, is what the FMPA is all about. Our membership is hugely diverse, covering more than a dozen disciplines, with a variety of specific needs. While this can be challenging at times, our profound belief is that ALL disciplines providing health care services to players and Clubs have an important role to play and individuals therein are an invaluable part of our membership. The change of title to FMPA underpins this belief. It is in working together that we have strength as an organisation and a significant voice in the professional game.
What do sports medicine professionals working in football need to know about sport psychology? Dr Caroline Heaney
The Supply of Medicines to Sports Teams Roni Lennon Bsc
The FMPA Register
Life After Football – Rob Swire
A Commonly Misdiagnosed injury – Lisfranc Fracture Dislocation in a Professional Soccer Player Ashley Jones MSc Rodger Wylde BSc Richard Moss MSc
One of our main aims has always been to improve standards but there are many questions still to be addressed; areas such as governance, indemnity, safeguarding, fitness to practise and the increasing `brain drain` of skilled practitioners from the game, to name but a few. We should be very concerned that, in some areas, standards are actually falling Some of this is centred around cost saving measures at clubs who seem to think that as long as they have the minimum requirements in place, then everything is ok. Let me give one example for all to consider. If healthcare insurers determined long ago that their members (the public) can only be treated by practitioners who have a minimum of 5 years post graduate experience, why is it that `football` is happy for new graduates to treat professional players the day after graduation?
The (Return to Play) Times, They are a Changin’ Markus Waldén Clare Ardern
While the foundations of the FMPA are firmly in place, all Medical and Performance practitioners working in professional football should recognise the role that the FMPA is playing and grasp the opportunity, not only to take the organisation forward, but to be an even louder voice in the game, raising standards to the world class level that you all deserve.
Eamonn Salmon CEO Football Medicine & Performance Association Football Medicine & Performance Association 6A Cromwell Terrace, Gisburn Road, Barrowford, Lancashire, BB9 8PT T: 0333 456 7897 E: email@example.com W: www.fmpa.co.uk
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Executive Administrator Lindsay Butler Lindsay.email@example.com
Swansea City’s Martin Olsson on the ground after picking up an injury. Richard Sellers/EMPICS Sport/PA Images Football Medicine & Performance Association. All rights reserved. The views and opinions of contributors expressed in Football Medicine & Performance are their own and not necessarily of the FMPA Members, FMPA employees or of the association. No part of this publication may be reproduced or transmitted in any form or by any means, or stored in a retrieval system without prior permission except as permitted under the Copyright Designs Patents Act 1988. Application for permission for use of copyright material shall be made to FMPA. For permissions contact firstname.lastname@example.org.
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David Oxborough, Gary Silk, Dr Caroline Heaney, Roni Lennon Bsc, Ashley Jones MSc, Rodger Wylde BSc, Richard Moss MSc, Markus Waldén, Clare Ardern, Damian Hughes.
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THE SUPPLY OF
Recent headlines in the media highlighting perceived deficiencies in record keeping regarding the supply of medicines in professional sport would suggest that it would be an appropriate time to review procedures around the supply of medicines in the Club environment. The Human Medicines Regulations came into force in August 2012 replacing much of the Medicines Act 1968 and they set out a comprehensive regime for the authorisation of medicinal products for human use; for the manufacture, import, distribution, sale and supply of those products. The effects of the new legislation on the private supply of drugs to team doctors are as follows: Firstly, the regulations regarding the supply by pharmacies has changed to stipulate that a pharmacy which is privately supplying prescription only drugs to a doctor must obtain a Wholesale Dealers License, unless: “the supply takes place on an occasional basis, the quantity of medicines supplied is small, the supply is made on a not for profit basis, and the supply is not for onward wholesale distribution.” If you are currently obtaining drugs from a pharmacy, check they have a Wholesale Dealer’s License. Secondly, obtaining drugs from Wholesale Dealers would be the more common route used by Club Doctors in the UK, and while the legislation hasn’t made any significant amendments in this area the recent clarification by the MHRA has shone a light on what might be considered as some of the important areas of concern in the recent DCMS report Combatting Doping in Sport. “It is a legal requirement for wholesalers to verify that they are supplying to someone who is entitled to receive the medicines. Regulation 249 of the Human Medicines Regulations 2012 sets out that a wholesaler can only supply a prescription only medicine to a person who falls within a class specified in Schedule 22 of those Regulation. In the case of doctors, we have taken the approach that another health care professional can be authorised to place an order on the doctor’s behalf. However, for each supply the order needs to be signed by the doctor in question in order for the wholesaler to ensure that the supply is made to the doctor as required under the legislation. Anne Ryan - MHRA Policy Division It is my understanding through my experience of 20 years working as a pharmacist in the field of sports medicine that adherence to the MHRA’s statement of good practice has been not been universally adopted. While the MHRA has a programme of inspections of Wholesale Dealers, historically they haven’t drilled down too deeply into the area of procedures around the supply of medicines to Team Doctors, potentially resulting in a laxity in addressing processes in this area. Club medical departments must recognise that it is essential to have systems in place to ensure good governance with regards to obtaining, storing and supplying drugs to the athletes in their care, and for the protection of their professional integrity.
Roni Lennon Bsc Lead Pharmacist at Vivomed
football medicine & performance
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