Wales Six Nations controversy erupts as public letter slams 'clear and flagrant breach' during England match

Wales are coming under increased scrutiny over the circumstances that allowed Tomas Francis to return to the field at Twickenham despite suffering what appeared to be a serious head injury.

In an open letter to the Welsh Rugby Union, World Rugby and Six Nations bosses, lobby group Progressive Rugby, which is made up of a number of former and current players, as well as medical experts, described what unfolded as "a clear and flagrant breach of HIA protocol".

TV footage captured Francis staggering near his own try line in the 20th minute after a clash of heads with team-mate Owen Watkin, appearing to have to use the pads of the posts to hold himself up.

All the fallout from England v Wales

He initially remained on the pitch after being checked by a medic before being removed to undergo a HIA, which he duly passed before returning to the pitch around 10 minutes later.

But, under World Rugby laws, any player who shows visible signs of balance disturbance/ataxia after a head blow should be removed immediately and permanently from a match without a HIA.

Francis continued to play before being replaced by Leon Brown in the 56th minute.

Watkin was left bloodied by the incident but underwent a HIA and passed.

In the strongly worded open letter, which has been made public, Progressive Rugby say: "Francis attempts to stand and falls back and struggled to get to his feet. He is seen holding his head. He is then seen using the post for support. He displays clear signs of ataxia and of being dazed. He is seen by a physio/medic – it is not clear which because they all insist on tabards wearing Medic.

"Francis displayed clear symptoms/indications under of the World Rugby Head Injury Assessment protocol that necessitate the immediate