Distinguishing duties of care of sports coaches in a UK context

The concept of duty of care is under unprecedented scrutiny in the context of sport, and more specifically, with regard to sports coaching. Existing academic scholarship offers limited detailed analysis of the duty of care incumbent upon coaches, the majority of whom are volunteers. Moreover, Baroness Tanni Grey-Thompson’s recent and impressive ‘Duty of Care in Sport: Independent Report to Government’ adopts ‘a deliberately broad definition of “Duty of Care”’. However, should the concept of duty of care assume both a legal and extra-legal meaning, it is contended that this may result in conflation of moral and legal duties of care. The impact of this when defining the standard of care may expose coaches to a greater risk of legal liability by potentially extending the legal obligations of amateur coaches beyond current limits. Accordingly, by analysing the duty of care incumbent upon modern-day sports coaches, within the context of the classic jurisprudential debate surrounding the relationship between law and morality, this article uncovers serious unintended ramifications of failing to more precisely distinguish between legal and moral duties of care in this area. Furthermore, at a time when the concept of duty of care appears ever more deeply engrained in everyday language, the insights revealed here appear likely to transcend the specific circumstances of sports coaching and be of more widespread legal relevance, not least, in the burgeoning field of professional negligence

Duty of care in sport: time for a sports ombudsman?

Discusses the proposal, made in the report "The Duty of Care in Sport" published by the Department of Digital, Media, Culture and Sport in April 2017, for a Sports Ombudsman to be established with powers to hold national sports governing bodies to account for the duty of care they provide to sportspersons and others associated with sport. Examines four possible models for the operation of this Ombudsman, and suggests aspects of its mandate

Modern sports coaching and the law: analysing, clarifying and minimising negligence liability

This thesis critically considers the emerging intersection between the law of negligence and sports coaching. It seeks to analyse, clarify and minimise the negligence liability of modern sports coaches. More specifically, the core research question addressed is whether or not the ordinary law of negligence, and in particular the control mechanism of breach, affords coaches reasonable protection from negligence liability

Negligence in sport: context vs principle

Analyses the issue of negligence liability in the context of sport with particular regard to Quick v Nottinghamshire County Council (County Court, Nottingham). Discusses the ‘enhanced duty’ owed by schoolteachers, limitations of the doctrine of in loco parentis and the importance of conducting suitable and sufficient risk assessments. Argues that considerable latitude should be afforded to the discretionary decision making of teachers such that there should be no breach of duty when the decisions made by teachers fall within a reasonable range of options. Submits that Quick represents a potentially modest, but important, development to the area of sports negligence

Beyond the ‘Tomlinson Trap’: analysing the effectiveness of section 1 of the Compensation Act 2006

One of the intentions underpinning section 1 of the Compensation Act 2006 was to provide reassurance to individual volunteers, and voluntary organisations, involved in what the provision called ‘desirable activities’ and including sport. The perception was that such volunteers, motivated by an apprehension about their increased vulnerability to negligence liability, and as driven by a fear of a wider societal compensation culture, were engaging excessively in risk-averse behaviour to the detriment of such socially desirable activities. Academic commentary on section 1 of the Compensation Act 2006 has largely regarded the provision as unnecessary and doing little more than restating existing common law practice. This article argues otherwise and, on critically reviewing the emerging jurisprudence, posits the alternative view that section 1, in practice, affords an enhanced level of protection and safeguarding for individuals undertaking functions in connection with a desirable activity. Nonetheless, the occasionally idiosyncratic judicial interpretation given to term ‘desirable activity’, potentially compounded by recent enactment of the Social Action, Responsibility and Heroism Act 2015, remains problematic. Two points of interest will be used to inform this debate. First, an analysis of the then House of Lords’ decision in Tomlinson and its celebrated ‘balancing exercise’ when assessing reasonableness in the context of negligence liability. Second, a fuller analysis of the application of section 1 in the specific context of negligence actions relating to the coaching of sport where it is argued that the, albeit limited, jurisprudence might support the practical utility of a heightened evidential threshold of gross negligence

The impact of a team-based intervention on the lifestyle risk factor management practices of community nurses: outcomes of the community nursing SNAP trial

BackgroundLifestyle risk factors like smoking, nutrition, alcohol consumption, and physical inactivity (SNAP) are the main behavioural risk factors for chronic disease. Primary health care is an appropriate setting to address these risk factors in individuals. Generalist community health nurses (GCHNs) are uniquely placed to provide lifestyle interventions as they see clients in their homes over a period of time. The aim of the paper is to examine the impact of a service-level intervention on the risk factor management practices of GCHNs.MethodsThe trial used a quasi-experimental design involving four generalist community nursing services in NSW, Australia. The services were randomly allocated to either an intervention group or control group. Nurses in the intervention group were provided with training and support in the provision of brief lifestyle assessments and interventions. The control group provided usual care. A sample of 129 GCHNs completed surveys at baseline, 6 and 12 months to examine changes in their practices and levels of confidence related to the management of SNAP risk factors. Six semi-structured interviews and four focus groups were conducted among the intervention group to explore the feasibility of incorporating the intervention into everyday practice.ResultsNurses in the intervention group became more confident in assessment and intervention over the three time points compared to their control group peers. Nurses in the intervention group reported assessing physical activity, weight and nutrition more frequently, as well as providing more brief interventions for physical activity, weight management and smoking cessation. There was little change in referral rates except for an improvement in weight management related referrals. Nurses’ perception of the importance of ‘client and system-related’ barriers to risk factor management diminished over time.ConclusionsThis study shows that the intervention was associated with positive changes in self-reported lifestyle risk factor management practices of GCHNs. Barriers to referral remained. The service model needs to be adapted to sustain these changes and enhance referral

May Measurement Month 2019: An analysis of blood pressure screening results from Argentina

The Argentinean Society of Hypertension, in agreement with the May Measurement Month (MMM) initiative of the International Society of Hypertension, implemented for the third consecutive year a hypertension screening campaign. A volunteer cross-sectional survey was carried out in public spaces and health centres during the month of May 2019 across 33 cities in Argentina. Hypertension was defined as systolic blood pressure (BP) ≥140 mmHg and/or diastolic BP ≥90 mmHg based on the mean of the second and third BP measurements, or in those on treatment for high BP. A total of 94 523 individuals (53.9 ± 17.8 years old, 55 231women and 39 292 men), were evaluated. The age and sex standardized mean BP was 124.7/77.2 mmHg. Among participants, 34.7% were overweight (25-29.9 m/kg2) and 28.7% had obesity (≥30 m/kg2). Individuals identified as being overweight had BP 3/2 mmHg higher and individuals with obesity 6/4 mmHg higher than those with normal weight. The prevalence of hypertension was 52.5%. Although 81.1% were aware and 77.7% were on antihypertensive treatment, only 46.0% of all individuals with hypertension had their BP controlled. Moreover, 19.8% of those not on any antihypertensive medication were found with raised BP. The low level of control of hypertension generates the critical need for the development of community-based prevention strategies reinforcing strategies to increase the awareness and control of hypertension.Fil: Salazar, Martin Rogelio Enrique. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Garcia Vazquez, Fortunato. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Espeche, Walter. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Marquez, Diego. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Becerra, Pedro. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Martinez Marissi, Evangelina. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Sorasio, Viviana B.. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Staffieri, Gustavo J.. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Kalbermatter, Arnoldo. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: De Cerchio, Alejandro E.. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Beaney, Thomas. Imperial College London; Reino UnidoFil: Partington, Giles. Imperial College London; Reino UnidoFil: Poulter, Neil R.. Imperial College London; Reino UnidoFil: Marín, Marcos. Sociedad Argentina de Hipertensión Arterial; ArgentinaFil: Ennis, Irene Lucia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigaciones Cardiovasculares "Dr. Horacio Eugenio Cingolani". Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Investigaciones Cardiovasculares "Dr. Horacio Eugenio Cingolani"; Argentina. Sociedad Argentina de Hipertensión Arterial; Argentin

Is there scope for community health nurses to address lifestyle risk factors? : the community nursing SNAP trial

Background: This paper examines the opportunity and need for lifestyle interventions for patients attending generalist community nursing services in Australia. This will help determine the scope for risk factor management within community health care by generalist community nurses (GCNs).Methods: This was a quasi-experimental study conducted in four generalist community nursing services in NSW, Australia. Prior to service contacts, clients were offered a computer-assisted telephone interview to collect baseline data on socio-demographics, health conditions, smoking status, physical activity levels, alcohol consumption, height and weight, fruit and vegetable intake and 'readiness-to-change' for lifestyle risk factors.Results: 804 clients participated (a response rate of 34.1%). Participants had higher rates of obesity (40.5% vs 32.1%) and higher prevalence of multiple risk factors (40.4% vs 29.5%) than in the general population. Few with a SNAPW (Smoking-Nutrition-Alcohol-Physical-Activity-Weight) risk factor had received advice or referral in the previous 3 months. The proportion of clients identified as at risk and who were open to change (i.e. contemplative, in preparation or in action phase) were 65.0% for obese/overweight; 73.8% for smokers; 48.2% for individuals with high alcohol intake; 83.5% for the physically inactive and 59.0% for those with poor nutrition.Conclusions: There was high prevalence of lifestyle risk factors. Although most were ready to change, few clients recalled having received any recent lifestyle advice. This suggests that there is considerable scope for intervention by GCNs. The results of this trial will shed light on how best to implement the lifestyle risk factor management in routine practice

Defining early health technology assessment: building consensus using Delphi technique

Although early health technology assessment (HTA) is increasingly being used to guide and inform decisions on product development, a consensus definition is currently lacking. A working group under the Health Technology Assessment international society (HTAi) was established to develop a consensus-based definition of early HTA. The working group developed a definition using an iterative process, which comprised five stages of work and included a two-round Delphi survey with 133 respondents in the first round and 99 respondents in the second round of the survey, with various backgrounds and levels of expertise. Following this process, the working group reached the first consensus-based definition of early HTA, which is “a health technology assessment conducted to inform decisions about subsequent development, research and/or investment by explicitly evaluating the potential value of a conceptual or actual health technology.” In total, eighty-six (87 percent) of the ninety-nine panellists who participated in the second round of the Delphi survey either strongly agreed or agreed with this definition. This consensus definition represents an important milestone in early HTA. It will enhance uniformity of terminology increasing the visibility of research and policy in this field. We also hope that it will act as a catalyst, sparking further research and development in this discipline