Introduction National Governing Bodies (NGBs) for sport in the United Kingdom (UK) are responsible for establishing standards and ensuring safe, inclusive participation for all athletes, including those living with chronic health conditions (CHCs). Despite recommendations to safeguard individuals with CHCs in sporting environments, the extent and quality of policy provision by UK-based NGBs remain unclear. This scoping review systematically examined the availability and content of health-related policies across NGBs, with a focus on support for athletes with diabetes and other CHCs.

Data Sources Policy documents of NGBs were accessed through publicly available materials on their official websites. All NGBs were contacted by email to confirm the existence of relevant policies, and to request any policy documents not currently included on their website.

Eligibility Criteria Sports were included if their NGB had a publicly accessible website.

Results Of 185 NGBs, 20 (11%) had policy documents that mentioned diabetes, 14 (7.7%) asthma, 12 (6.6%) epilepsy, 4 (2.2%) allergies, and 54 (29.7%) transgender. Of the 20 NGBs with documents mentioning diabetes only 4 had dedicated diabetes policies. The remaining 16 referred to diabetes in broader documents.

Conclusion Despite increasing emphasis on inclusion in sport, few NGBs have clear policies to support individuals with type 1 diabetes or other chronic conditions but a third of them have developed policies for transgender inclusion. We recommend the development of national policies for diabetes and other CHCs, which can be adapted by individual sporting bodies to suit the specific needs of their sport.

What is already known?

▯ Regular physical activity reduces long-term complications, and improves well-being in people with chronic health conditions, including diabetes, however many people with diabetes are not meeting recommended levels of physical activity.

▯ National Governing Bodies play a key role in encouraging and supporting people with chronic health conditions to participate in physical activity and to ensure their safety.

▯ Coaches often lack the necessary skills to support individuals with chronic health conditions.

What this study adds?

▯ Out of 185 National Governing Bodies in the United Kingdom, only four (2%) have dedicated policies to support people with diabetes.

▯ There is similar lack of support for people with epilepsy, asthma, and severe allergies.

How this study might affect research, practice or policy

▯ We recommend a national diabetes sporting policy is developed that can be modified by National Governing Bodies to reflect the needs of their specific context.

▯ Similar policies should also be introduced for other common chronic health conditions, including epilepsy, asthma, and severe allergies.

Equity, diversity, and inclusion statement The author group is gender balanced and consists of junior and senior researchers from a range of disciplines and ethnic backgrounds, based in the UK and one African country. Our study population included sports organisations in the UK; thus, findings may not be generalisable to settings with fewer resources.

The authors have declared no competing interest.

This research received no external funding.

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I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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The datasets generated and/or analysed during the current study are not publicly available but are available from the corresponding author on reasonable request.