Following the 2010 IRB Medical Conference, Dr Colin Fuller (IRB Safety Consultant) identified that regulating, directing or having exacting policies in the sports medical area that were applicable in all Member Unions was not practical or appropriate. Member Unions were noted to work within different levels of legal, economic, social and medical expertise that impacted on each Union's ability to deliver a single uniform medical policy.
Following the recommendation by Dr Fuller, the IRB approved a move from mandating Medical Regulations and Policies to providing Medical Guidelines. The Guidelines produced on medical matters would be based on best practice but their application within individual Member Unions would be based upon the unique social, economic and health provision environment(s) in which individual Unions existed.
This moved the emphasis away from mandating specific actions to identifying best practice that could be used by each Union to develop their own local 'good practice' model (see below).
Traditionally, medical policies had been developed within World Rugby by first world medical personnel for first world medical environments and these were imposed on non-first world Member Unions whether or not national healthcare facilities were compatible with the requirements of the policies. The role of World Rugby is to identify medical risks within the Game, develop 'best practice' Guidelines and disseminate these Guidelines to all Unions for adaptation to each Union's unique environment. World Rugby Medical Guidelines now recognise that strategies may be different in the various jurisdictions.
Although the exact implementation strategy may vary from country to country, the underpinning World Rugby philosophy of player welfare should be the same across all countries. Each national governing body for Rugby has a responsibility to review the guidance prepared by World Rugby and to implement the guidance in a way that is demonstrably appropriate to the circumstances within that country.
It is also possible that strategies not only vary from country to country but may also vary within different sectors of the game within a single country. For example, an appropriate strategy in professional Rugby may be different from an appropriate strategy at the community level of Rugby.
In summary, each Union has the responsibility to adapt the 'best practice' guidelines developed by World Rugby to the local environment with a view to implementing 'good practice' within their jurisdiction.