More than half of the people who used a free concussion screening service had been injured more than five years earlier, according to data published today by Concussion Testing.
Of 759 people who completed a clinically validated symptom questionnaire on the service’s website between July and October 2026, three in four had been injured more than a year earlier. The median gap between injury and screening was five years and three months. At least 274 people, more than a third, had been injured nine or more years before, and at least 135 had been injured twenty or more years before.
The findings arrive against an established evidence base showing that follow-up after head injury is close to absent. The 2022 Lancet Neurology Commission, drawing on the Europe-wide CENTER-TBI study, found that only 6% of patients discharged from emergency departments after a traumatic brain injury received a follow-up appointment, and only 26% received written information when they left. [1]
A national audit published in the British Journal of Neurosurgery in 2025 assessed 99 head injury discharge leaflets from across eligible NHS England trusts against NICE guidance. Not one fully complied. The mean compliance score was 0.42 out of 1.0, against a target of 0.95. [2]
“The people using this tool are mostly not recently injured,” said Dr Richard Newland, former GP and director of Concussion Testing. “Many of them went to hospital, were reassured and sent home, and nobody followed up. Years later they are still struggling with exhaustion, memory and concentration, and they are still looking for an explanation.
“A CT scan is very good at finding bleeding and fractures. It was never designed to detect the functional effects of a concussion, and a clear scan does not mean nothing happened. The problem is that people are told the scan is fine and hear that as you are fine.”
The scale
NICE guidance NG232 states that over one million people attend emergency departments in England and Wales each year with a recent head injury. [3] Around 85% of traumatic brain injuries presenting to hospital are classified as mild. [1]
Long-term outcome data suggests a substantial proportion of those people do not recover as expected. The TRACK-TBI cohort study, published in JAMA Neurology, found that 53% of patients with mild traumatic brain injury still reported functional limitations twelve months after injury, compared with 38% of matched trauma controls. [4]
A white paper published in October 2026 by Coulthursts Solicitors, The hidden scale of under-recognised traumatic brain injury and concussion, applies these published figures to national attendance data. It estimates that approximately 250,000 people a year in England and Wales are living with persisting symptoms after concussion or mild traumatic brain injury, within a range of 200,000 to 300,000. [5]
Not a sports story, and not about headaches
Two findings in the screening data run against the public picture of concussion.
Falls were the leading cause, reported by 41% of respondents, more than five times the number injured playing sport (8%). Road traffic accidents accounted for 14% and assaults 13%.
And headache, the symptom most associated with concussion, ranks ninth among the 16 symptoms measured. Fatigue leads, reported at a moderate or severe level by 72% of respondents, followed by poor concentration (66%), poor memory (64%) and slowed thinking (63%). More than half reported low mood or tearfulness.
“The symptoms that dominate are the ones hardest to see and easiest to dismiss,” said Dr Newland. “You cannot point to exhaustion on a scan. You cannot show someone your concentration. That is precisely why people go unheard for years.”
More than half of respondents (53%) say they have never had a brain scan for their injury. A third of those who attended A&E at the time say they came away without one. NICE guidance recommends CT scanning where specific risk factors are present, so not every head injury needs a scan.
Concussion Testing’s screening tool is free, takes around ten minutes and needs no GP referral. It uses the Rivermead Post-Concussion Symptoms Questionnaire, a clinically validated instrument used in neurology and rehabilitation settings.
