Background High match frequency in professional men’s football has been associated with injury risk. It is unclear how this is affected by the activities of club support staff.

Objective To determine whether the structures and processes adopted by a performance and healthcare team (PHCT) were associated with player availability (PA) during periods of match congestion, using the Integrated Team Effectiveness Model.

Design Sequential explanatory mixed method case study.

Setting A single English Championship football club.

Participants Ten PHCT staff from medical, sport science, and data analysis departments.

Interventions The PHCT completed validated team process/structure questionnaires twice monthly during the 2017–18 season. PA and match frequency data were provided by the PHCT, who also participated in a post-season focus group.

Main Outcome Measures Associations between PA, match congestion (i.e. ≤3 days between matches) and team structures/processes were assessed using Pearson correlation. Framework and content analysis were used to qualitatively explore PHCT perceptions of teamwork effectiveness.

Results Mean PA during match congestion was 78.1% (95% BCa: 76.2, 80.4) compared with 84.2 (95% BCa: 80.6, 87.3) during uncongested periods. There were significant associations between match frequency and PA (r= - 0.68; 95% BCa: 0.32, 0.93; p = 0.008) and PHCT processes and PA (r= 0.53; 95% BCa: 0.09, 0.89; p = 0.035). Having more PHCT meetings (r= 0.46; BCa 95%: 0.22, 0.82; p = 0.048) and greater satisfaction with those meetings (r= - 0.41; BCa 95%: 0.04, 0.07; p = 0.043) were associated with higher PA, irrespective of match frequency. During match congestion the PHCT reported issues relating to resources and task co-ordination that negatively impacted their processes.

Conclusion The structure and processes adopted by a PHCT in professional football are related to PA, reflecting the influence of teamwork effectiveness. These findings have implications for injury prevention and management in professional football.