Steve Borthwick is to have the final say on all medical and sport science matters affecting England players given 'hybrid contracts'.
An eight-year Professional Game Partnership has been announced by the Rugby Football Union, Premiership Rugby and Rugby Players’ Association that enshrines how the elite game will be run over the next eight years.
The RFU will pay the ten Premiership clubs €39m per season for the first four-year cycle, with a profit share dictating the funding for the second four-year cycle.
As part of the arrangement, England head coach Borthwick will have the freedom to select up to 25 players who will be paid as much as €190,000 annually in return for greater control of how they are managed on club duty.
This includes deciding on medical issues such as when a player undergoes surgery, potentially affecting his availability for club matches and thereby leading to possible flashpoints with directors of rugby.
The RFU insists the new system will "ensure optimum preparation for key international fixtures".
"The England national team benefits by having control over the individual development programmes, medical and S&C of the best players in England at the peak of their form and in the best shape to play for their country," RFU chief executive Bill Sweeney said.
"This eight-year commitment will reshape the rugby landscape and reset the professional game to support, showcase and fund our game for the next decade and beyond.
"Despite the RFU having £150m [€178m] revenue losses through Covid and a £30m [€35.6m] increase in operating costs over the last four years due to inflation, we are in a stable financial position.
"Today we have reached a significant milestone in turning our spend into the professional game into a true investment partnership with shared strategy, goals, and risks."
While Borthwick will not be able to dictate selection for fit England stars on hybrid contracts when they are playing for their clubs, medical decisions he makes could affect their availability for Premiership and European matches.
Exeter boss Rob Baxter (above) insisted it would only become clear in time if the arrangement suited the clubs.
"My concerns are around how the medical intervention part works. The proof of the pudding of this agreement will be down the line," Baxter said at the Premiership launch at Twickenham.
"If we look in two or three years and they are all playing England games and not playing club games, the clubs will say that outcome doesn’t work for us. None of us will know until we get down the line.
"It’s for me as a DOR [director of rugby] to decide when I select a player outside the rest periods which are already in agreement.
"That kind of thing is not an issue, it’s more when a medical intervention is decided and maybe a disagreement between my medical staff and the England medical staff. That’s more when will a game happen or will it not happen for a club player."
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