Transfer Deadline Day: How club medics are set for a late shift tonight

With each prospective signing needing at least a five-hour examination, clubs' physios and local hospitals expect to be busy

David Beckham having his medical at Real Madrid back in 2003 (Getty Images)

If you enjoy the drama that only transfer deadline day can provide, spare a thought for Alex Manos. Having seen previous manager Ian Holloway sign 16 new players in the last window, including three on the final day, the Crystal Palace physiotherapist is not expecting to make it home for his dinner this evening as current incumbent Tony Pulis desperately tries to add to his squad.

Luckily for Manos, help is close at hand. With all signings required to pass a number of strict medical tests before their transfers can be ratified by the Premier League, Palace have established a close relationship with Alliance Medical to use their facilities at BMI The Sloane Hospital – less than five minutes' drive from the club's training ground in Beckenham, Kent – at a moment's notice.

"You are waiting to be given the go-ahead on certain players and sometimes it can be a last-hour thing," Manos explains.

"When time is tight, you could do a medical before the deal has been confirmed so everything is in place, but usually the clubs agree everything first and the medical is the last stage. When the players go home [from training], we'll stay here and wait to see if we're needed.

"I'm only local so it's no problem for me to stay on a bit later and Alliance will already have some slots in place for us to have scans. That can be crucial because we can end up going down there at any time of the day. We'll be here until midnight because it's our busiest time of the year."

Blood tests are now a mandatory part of all medicals but that is only the start of a process that usually takes at least five hours to complete. Working with club doctor Bill Jasper, Manos must first undertake thorough checks on a player's history of injuries before sending them to The Sloane for detailed MRI scans on those crucial parts of a footballers' anatomy – feet, ankles and knees.

The results are then emailed to a radiographer in central London, who will report back with their findings within two hours. "It's normally at that point where we have to make a decision whether they need any further examination," says Manos. "It's not that common but if a player has a history of injuries in a certain area then we may have already set up a meeting with an external doctor or specialist.

"Once all the results have been analysed, it's about presenting the case to the manager and the coachng staff and sometimes to the board as well to see if there's anything that needs to be taken further. It's about weighing up whether to take a calculated risk or not but there's rarely massive surprises."

Back in August, a frantic final day saw Palace line up several potential transfers that ended up not being completed. Manos refuses to confirm the Arsenal striker Nicklas Bendtner was one of those but, with discretion of paramount importance, Alliance's imaging department manager Lesley Harmes admits there is no time to be starstruck.

"They're just other patients to us and deserve the same care as the old lady down from the road," she says. "The nice thing is they are young so they don't need any help getting down off the table like some of our usual patients."

Palace's South London rivals Millwall also share the same facility so it could be very busy this evening given their new manager is Holloway with his penchant for signing players. Yet with clubs eager not to reveal their hands for fear of being gazumped, Manos admits he is often left in the dark until the very last minute. "It's exciting to see what happens like any other fan but it's our job so you try not to get too caught up with the media attention," he says. "We do watch Sky Sports News in the office and follow what is happening but for us it's just about doing what needs to be done."