England's Rugby Football Union announced on Thursday a raft of changes to the way concussion will be managed throughout the professional game in the country.
Their decision was in line with similar moves made by SANZAR, which runs the Super Rugby competition and the southern hemisphere Rugby Championship, following the introduction of the International Rugby Board's Head Injury Assessment procedure.
The key game-day changes in terms of leading club matches will see memory tests enhanced and the balance test altered, with assessment period time extended from five to 10 minutes.
In addition, at all English Premiership grounds and Twickenham, England's national stadium in London, doctors will have access to live television feeds and replays when conducting a head injury assessment to assist them with decisions.
An independent review of injuries and management will be carried out by "two experienced independent medical practitioners" which will include them reviewing match footage. This review system will be linked to the RFU's disciplinary process.
Players, coaches and referees will also be required to complete a new mandatory online concussion module within a two-month period.
This will apply to all male-registered Premiership and Championship players over 18 and contracted England Sevens players.
In the women's game, England representative players over the age of 18, coaches and referees will be asked to complete the course.
The online program explains what concussion is, the symptoms, and how to deal with such injuries.
The RFU said there will be automatic fines if the module is not completed by the required date, and a player or coach can be made ineligible to play or coach until such time as they have completed it.
"These significant changes were driven by the Professional Game Board medical advisory group review of the 2013 concussion forum and continues the programme of work that we have been delivering over the last 10 years on concussion," said the RFU's chief medical officer, Simon Kemp.
"Working closely with Premiership Rugby and the RPA (England's Rugby Players' Association), we believe this will provide a comprehensive package of processes designed to enhance all elements of professional player concussion management."
Rugby Union authorities have found themselves speaking repeatedly about concussion in recent years given fears the increasingly brutal collisions that are so often a feature of the modern top-flight game could lead to long-term brain injuries.
Changes to existing procedures were made after widespread shock that Australia's George Smith was allowed to return to the field during the deciding third Test in Sydney last year when still dazed after a clash of heads with British and Irish Lions hooker Richard Hibbard.
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