14 February 2020
The Scottish Government has recently launched a consultation on the regulation of non-surgical cosmetic procedures. If a regime is introduced in Scotland, it would be the first part of the UK to have a licensing scheme. Responses to the consultation are invited by 30 April 2020.
Social media images and celebrity “influencers” have resulted in an increase in non-surgical cosmetic treatments which, in turn, has led to a significant rise in the number of injuries reported in what is a largely unregulated sector. The focus of the current proposals is on non-surgical treatments such as Botox, dermal fillers and lip enhancements. These procedures account for nine out of ten cosmetic procedures in the UK and generate £2.75 billion in revenue annually. It is understood that tens of thousands of people receive these types of treatments in Scotland every year.
It may come as a surprise that this growing sector is unregulated given the real risks related to the procedures, such as infection, blocked arteries, necrosis, blindness and stroke. Ken Stewart, the plastic surgery adviser to the Scottish government, has compared the existing system to the "wild west".
In Scotland, independent clinics run by a doctor, nurse, dentist, dental nurse, midwife or dental care professional who provides these procedures are now regulated by Healthcare Improvement Scotland. This will not change. However, non-surgical cosmetic procedures that pierce/penetrate the skin are not currently regulated and anyone is able to carry out such procedures.
Furthermore, a number of pharmacists have now entered the field of cosmetic procedures and are providing injectable procedures within premises that are currently not regulated by, and do not need to be registered with, Healthcare Improvement Scotland (HIS). It is proposed that they should also be regulated by HIS.
The governmental proposals aim to ensure that anyone providing non-surgical cosmetic procedures that pierce/penetrate the skin is competent and trained to do so. The procedures will require to be carried out from hygienic premises that are fit for purpose. As things stand, despite the potential complications and injuries associated with the treatments, there are no rules about who can inject the treatments, nor what training they should have received. In terms of the proposals, the applicant’s knowledge, skill, training and experience should be taken into account when deciding if they are a fit and proper person to hold a licence.
The licences would be akin to those required in tattoo parlours, where a licence will show that the practitioner has been adequately trained and has both the experience and skills to perform the treatment. Some will take the view that such procedures should only be carried out by regulated healthcare professionals. However, the consultation document states: "We consider that a blanket ban on non-medical professionals carrying out non-surgical cosmetic procedures could be difficult to enforce and might drive unregulated providers underground."
The Future
Regulation in this sector should help treatment providers in fully understanding the duties of care they owe to their clients and improve patient safety. It will also aid the resolution of claims when they arise. One question which is unresolved is whether those providing non-surgical procedures will be required to carry professional indemnity insurance.
In the meantime, it is suggested that treatment providers should keep records to demonstrate compliance in case of a customer complaint or injury claim. The successful defence of a claim often depends on the adequacy of documentary evidence. The scenario for practitioners to focus upon is to provide the beauty and avoid the beast of a claim...
Contact: Natalie McCartney, Associate nem@bto.co.uk T: 0131 222 2939