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Strict medical provisions at UEFA EURO 2020

We explain how UEFA has left no stone unturned in its medical activities and comprehensive medical requirements for the tournament, and look at how UEFA’s measures in recent years have helped raise standards in this crucial area of modern football.

Mario Fernandes (Russia) receives medical treatment during the EURO group stage match against Finland
Mario Fernandes (Russia) receives medical treatment during the EURO group stage match against Finland Getty Images

Every four years, UEFA sets out a medical framework for European national team football’s premier event.

This year’s EURO 2020 final tournament has brought a unique challenge, owing to the format featuring eleven venues across Europe, as well as the ongoing pandemic, which has added another dimension to medical logistics around the finals.

A variety of elements are included in the EURO medical framework:

- UEFA’s Medical Regulations

- specific medical requirements that must be implemented by each Local Organisation Structure (LOS) for the various UEFA target groups.

Medical regulations

UEFA published the latest edition of its Medical Regulations at the beginning of 2020.

The first part of the regulations (Articles 3 - 8) focuses on the mandatory medical examination for players, which must be completed by all players registered in all UEFA competitions.

For each EURO tournament, players are requested to undergo the highest level of these examinations, which include special cardiological examination based on guidelines drawn up by the European Society of Cardiology, as well as neurological baseline screening of brain functions to further improve the assessment of potential head injuries and concussions.

Minimum medical requirements

The medical team are given advice prior to the EURO group stage match between Denmark and Belgium in Copenhagen
The medical team are given advice prior to the EURO group stage match between Denmark and Belgium in CopenhagenUEFA via Getty Images

The second part of the regulations (Articles 9 - 16) centres on Minimum Medical Requirements (MMRs) for players, team officials, the referee team and match officers, which must be provided for all UEFA competitions including the EURO finals.

These requirements are checked on the day before the match for official training sessions at the stadium, as well as on the matchday itself from the moment the teams arrive at the stadium.

They include the provision of detailed pitchside emergency equipment, the presence of an advanced life support (ALS) ambulance, as well as a pitchside emergency doctor and stretcher crew who must hold a valid ALS qualification recognised in their country of employment.

Chief Medical Officers

For every UEFA final tournament, including the EURO, UEFA requests the host association to appoint a Chief Medical Officer (CMO) to take charge of all medical services and facilities provided during the tournament.

The medical team sit next to the players' bench during the EURO encounter between Austria and North Macedonia in Bucharest
The medical team sit next to the players' bench during the EURO encounter between Austria and North Macedonia in BucharestUEFA via Getty Images

UEFA EURO 2020’s specific format involving matches at 11 venues meant that 11 CMOs were appointed to take care of each host venue. They were tasked with providing UEFA with a Medical Care Concept, including all medical provisions to be provided during the tournament.

The 11 concepts include important information such as the national health care system, the specificities on importing medicine and the right on practising medicine for participating associating team doctors, as well as all identified medical facilities and services provided for the various UEFA target groups.

Return to Play Protocol

The pandemic and the postponement of EURO 2020 for a year meant that for this year, CMOs also had to factor in the specificities of the UEFA Return to Play Protocol (RTPP) with regard to Covid-19 preventions.

UEFA provided each host venue with a specific EURO 2020 Medical Operational Concept (MOC) aiming to confirm and validate with the local authorities the framework of medical, sanitary and hygiene measures for EURO 2020.

COVID test checks as the Portugal team arrives at a EURO venue
COVID test checks as the Portugal team arrives at a EURO venueUEFA via Getty Images

In addition, UEFA organised individual meetings with each of the competent local authorities in the 11 venues to define the various precautions that will be applicable in each host venue. This was an extremely challenging task, as different local laws were applicable in each country, such as entry procedures, testing programmes, treatment of positive cases, potential repatriations, etc.

Hygiene Officers

Each venue was therefore asked to appoint a Hygiene Officer (HO) with detailed functional knowledge of the stadium and its operations, whose sole responsibility is to ensure that all the principles and appropriate hygiene measures set out in the host country are correctly implemented at the stadium.

It is essential that the Hygiene Officer has a good understanding of the local epidemiological situation and local measures in place. The officer is also responsible for implementing the defined protocol for entry to the stadium, as well as the EURO 2020 facilities in the stadium surroundings.

Team doctor briefings

UEFA has put comprehensive medical provisions in place for the EURO tournament
UEFA has put comprehensive medical provisions in place for the EURO tournamentGetty Images

UEFA organised several briefings with the team doctors of the 24 participating national associations. The first briefing was held in January 2021 to set out the pre-competition medical examinations, as well as to make sure that all players were in good health prior to being included on the player lists for the final tournament.

The second briefing took place at the end of April. Team doctors were informed about UEFA’s medical requirements and competition-specific medical provisions, such as replacement of players owing to injury or a Covid-19 infection, as well as cooling breaks procedures.

Covid-19 testing programme

UEFA also presented the overall EURO 2020 Covid-19 testing programme at the briefings. CMOs were tasked afterwards to organise an individual presentation for all 24 EURO team doctors to introduce the specificities in their country.

Concussion management

UEFA concussion awareness campaign
UEFA concussion awareness campaign

UEFA organised a specific briefing at the beginning of June on the management of concussions during the tournament. At the end of this briefing, the general secretaries, head coaches and team doctors of all the participating teams signed a Concussion charter, pledging their support and committing to recommendations set out by UEFA.

Other UEFA medical activities

UEFA Football Doctor Education Programme

UEFA has created a specific educational programme - the UEFA Football Doctor Education Programme (FDEP). The aim of the programme is to give doctors from all of UEFA’s 55 national training on essential skills in football medicine.

The programme is divided into three workshops which focus on different key elements:

A practical session at a UEFA Football Doctor Education Programme workshop
A practical session at a UEFA Football Doctor Education Programme workshopUEFA

- roles and responsibilities of the football doctor, and emergency pitchside treatment of players;

- diagnoses and treatment of football-specific injuries;

- broader topics related to players’ health, including modules on infectious diseases, nutrition, psychology and rehabilitation.

Each doctor who participates in the UEFA FDEP workshops must commit to the organise the same workshops at national level to cascade the knowledge within their national associations and clubs.

Medical webinar on head injuries

UEFA organises its FDEP workshops on an annual basis. However, the current pandemic has led to a pause in the programme, especially because it has a high amount of practical assessments.

Nevertheless, UEFA launched its first edition of its online Medical Webinar, which took place on 11 May and focused on the highly debated topic of head injuries. This webinar was attended by over 250 sports physicians from around the world.

Key viewpoints

UEFA Medical Committee chairman Tim Meyer
UEFA Medical Committee chairman Tim MeyerUEFA

Tim Meyer, UEFA Medical Committee chairman:

“The various regulations, requirements and educational programmes that UEFA have put in place over the past ten years have dramatically improved the medical standards in football across Europe.

The health and safety of all players participating in UEFA’s competitions is the core work of the UEFA Medical Committee, ensuring that the highest level of medical care is provided to all participating players.”

UEFA EURO 2020 chief medical officer Zoran Bahtijarević
UEFA EURO 2020 chief medical officer Zoran BahtijarevićUEFA

Zoran Bahtijarević, UEFA EURO 2020 Chief Medical Officer:

“The work of all eleven Chief Medical Officers for this year’s EURO has been extraordinary. The level of collaboration and coordination between UEFA and our local counterparts has contributed to the successful delivery of medical services for EURO 2020.

The additional level of complexity with the ongoing pandemic has made our collaboration even stronger than previous years, especially with the ever-changing epidemiological situation. UEFA and the CMOs have made a tremendous effort to deliver a EURO that is as safe and secure as possible.”