Social media images and celebrity influencers have impacted on the number of both women and men seeking out non-surgical cosmetic procedures in the UK. Alongside that surge in treatments, there has been a rise in the number of injuries reported in what is a largely unregulated sector. In recognition of the risk to public health, the Scottish Government has launched proposals to licence non-surgical cosmetic procedures provided by non-health professionals. We take a look at the current regulatory position, the Government's proposals and the implications for treatment providers.
The focus of the Scottish Government's current proposals is non-surgical treatments such as Botox, dermal fillers and lip enhancements, which account for nine out of 10 cosmetic procedures in the UK and generate £2.75 billion in revenue annually. It is believed that tens of thousands of people receive these types of treatments in Scotland every year.
What is the current regulatory position in the cosmetic treatments sector and what further proposals does the Government have in mind?
At present, injectable treatments are either offered by regulated healthcare professionals such as doctors, dentists or nurses in independent clinics or by non-regulated companies who offer the treatments in premises such as aesthetic clinics, beauty salons and hairdressers. Despite the potential complications and injuries associated with the treatments; there are currently no rules about who can inject the treatments, nor what training they should have received.
The Scottish Government wants to ensure that anyone providing non-surgical cosmetic procedures that pierce/penetrate the skin is competent and appropriately trained to do so, and that the treatment is provided from hygienic premises that are fit for purpose.
The Scottish Government plans to introduce regulations later this year and is seeking views from the public and interested parties in a consultation that will run until 30 April 2020.
If a regime is introduced in Scotland, it would be the first part of the UK to have a licensing scheme.
Since April 2016, independent clinics run by a doctor, nurse, dentist, dental nurse, midwife or dental care professional in Scotland must register with Healthcare Improvement Scotland (HIS) before they can legally provide cosmetic procedures. The position will not change under the new proposals and healthcare professionals in this group who provide cosmetic treatments will continue to be regulated by HIS.
In addition, a number of pharmacy professionals have now entered the market and are providing non-surgical cosmetic procedures in independent healthcare settings. The Government proposes that they too should be added to the group of healthcare professionals regulated by HIS.
In Scotland, tattoo parlours and skin piercing are subject to licensing by local authorities. The Government proposes that licensing should also be required for non-qualified healthcare professionals who provide non-surgical cosmetic procedures through piercing or penetrating the skin e.g. dermal fillers and lip enhancements.
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 current lack of clarity around obligations of providers in this area has led to inconsistency in standards of care. Regulation in this sector should assist treatment providers in understanding the duties of care they owe to their clients and enable them to implement appropriate measures, both to protect clients and demonstrate compliance should an injury occur. It will also aid the assessment and resolution of claims when they arise.
What should providers do in the meantime?
Whilst we await the outcome of proposals, treatment providers should continue to implement measures to prevent injury to customers such as:
- Ensuring that they are fully aware of product safety risks before offering the type of product or treatment, and by contacting the supplier or manufacturer if necessary;
- Carrying out patch tests on new customers and repeat patch tests as and when required e.g. if they are using a different product or piece of equipment;
- Ensuring that customers are fully informed of the risks associated with a particular treatment and that they have given informed consent prior to the treatment;
- Only permitting trained and competent staff to carry out the treatment in question.
It may also be useful for providers who are not regulated by the HIS to nevertheless familiarise themselves with the HIS standards.
Treatment providers should always keep a paper trail to demonstrate compliance in the event of a customer complaint or injury claim. The successful defence of a claim or handling of a complaint often turns on the adequacy of documentary evidence.