The AFL has today advised all Clubs the AFL Commission had approved a recommendation to introduce a Medical Substitute for each team during matches played in the 2021 Toyota AFL Premiership Season.
The Medical Substitute will require AFL teams to name an additional Player on the interchange bench who can only be activated once a Player is determined to be medically unfit to continue to participate in a match by the Club doctor.
AFL Executive General Manager Football Operations Steve Hocking said the decision was made to ensure the league continued to best protect the health and safety of all players in the AFL competition.
“The health and safety of each player in the game remains the priority and the introduction of a medical substitute ensures that player safety remains paramount in our game,” Mr Hocking said.
“Over recent years we have continued to take action to strengthen match-day protocols and amend the Laws of the Game to improve safety.
“We continue to listen and learn and where we can reasonably make our game safer at any stage of the season, we will.
“On behalf of the AFL, I thank all Senior Coaches, the AFL Doctors’ Association and the AFLPA for their input and consultation as part of this decision.”
The Medical Substitute process is detailed below:
AFL Teams will be required to name an additional Player on the Interchange Bench referred to as a “Medical Substitute”.

  1. A Medical Substitute will be selected from the Emergency Players listed in the Team list, which is lodged with the AFL the day prior to the scheduled match.
  1. The Medical Substitute will be permitted to warm up with the Team on the Playing Surface prior to the commencement of the match.
    1. The other three Emergency Players are not permitted on the Playing Surface at any stage as per current AFL Regulations.
  1. A Medical Substitute can be activated immediately after it is determined a Player is medically unfit to continue to participate in the match and, due to the nature of the injury sustained, it is reasonably determined the player will be medically unfit to participate in any match for at least the next 12 days.
    1. Only the Club Medical Officer can determine a Player is medically unfit.
    2. A Medical Substitute can be activated at any stage during the match.
    3. A Medical Substitute can occur even after the Interchange Cap of 75 has been met as per current AFL Regulations when an injured player has exited the Playing Surface.
    4. On or before the first working day after the match, the Club Medical Officer must provide a Medical Certificate to the AFL certifying that the Player replaced by the Medical Substitute Player sustained the injury.
  1. The Medical Substitute Player will be permitted to participate in another match in another competition (e.g. a State League competition) in the equivalent round regardless of whether they are activated during the AFL match. 

A Concussed Player:
A player who is substituted out of the match with concussion will be sidelined for a minimum of 12 days as per current 2021 AFL Concussion Guidelines in place.

A Club that is found to be in breach of the Regulations relating to the Medical Substitute is subject to sanction under the AFL Rules, including, for serious transgressions, for a breach of AFL Rule 2.3 (being the prohibition on conduct unbecoming or prejudicial to the interests or reputation of the AFL or to bring the game of football into disrepute).
Team selection with the inclusion of the Medical Substitute will be as follows:
5.45pm day prior to match commencing – Final Team lodged (22 + 4 emergencies named)
60 minutes prior to match commencing – 22 players + 1 medical substitute named
The Medical Substitute will not be implemented in the 2021 NAB AFW, VFL, VFLW or NAB League Competitions.