Non-surgical aesthetics is a term which is used to encompass a wide range of cosmetic treatments not undertaken in a surgical setting, being minimally invasive. Commonly, procedures include anti-wrinkle injections with products such as Botox ® and dermal filler injections. Others include skin treatments such as chemical peels, Platelet-Rich Plasma (PRP) injections (know as the ‘vampire facelift’) and intradermal use of hyaluronic acid to promote skin tightening. While this is a rapidly expanding field with exciting advances and constant innovation, the regulatory framework to accompany this emerging ‘specialty’ has lagged somewhat behind. Referred to as a ‘specialty’, from a healthcare professional’s perspective, there is no recognised specialty training pathway to becoming an aesthetic specialist. Many clinicians may become highly experienced and talented injectors, with reputations and cohorts of loyal patients to match. Nevertheless, there are some clear differences between the non-surgical aesthetics industry and other areas of healthcare.
Who carries out non-surgical aesthetic treatments in the UK?
Health Education England (HEE) has published guidance on who should carry out aesthetic treatments in the UK. This was in response to the Keogh Report (2013). Sir Bruce Keogh was commissioned to look into this area in the context of growing concern about the lack of regulation and guidance for both injectors and patients. The recommendations that emerged from the years of consultation between 2013-2016 form the basis of best practice within the UK, and there are some important points summarised below:
It is clear that certain procedures can only be carried out by GMC-registered medical doctors (hair transplant surgery, permanent dermal filler). Other procedures such as the commonly carried out botulinum toxin and temporary dermal filler can be carried out by practitioners who have attained a postgraduate level of training, and ‘subject to oversight of an independent prescriber’. The level of oversight will depend on individual cases and the judgement of the practitioner and overseer. As such, there is a degree of ambiguity and variation in skill levels is possible here.
What is clear, is that it will be very difficult for non-healthcare professionals to reach the level stipulated by these guidelines. Nonetheless, there is no legislation governing who can carry out procedures and as such, these are best practice guidelines.
FAQs from the HEE recommendations
Individuals with a relevant healthcare degree follow by study to a post-graduate level (identified as Level 7)
Anybody – there is no legislation regarding this and as such it is not illegal to carry out these treatments without a relevant healthcare qualification.
Healthcare professionals are bound by codes of conduct and professional regulatory bodies (GMC, GDC, NMC) – this ensures that standards set out by HEE and general professionalism principles are followed
Non-healthcare professionals who do not pertain to any regulatory body are not subject to this oversight and code of practice. Complaints or poor practice will not be covered by the regulatory bodies governing registered healthcare professionals.
Non-prescribers can inject botulinum toxin, provided they have had the product prescribed by a permitted prescriber, and, importantly, that the prescriber has carried out a face-to-face consultation with the patient.
Dermal filler continues to be a ‘medical device’, and as such does not require a prescription.
There is discussion of reclassifying dermal filler at some point in the future; currently, it can be procured by non-prescribers.
There are serious issues regarding this, which will be discussed separately in a different blog.
I am a healthcare professional. How can I get into aesthetics?
A loaded question!
Whatever you reason for wanting to train in aesthetics, ensure that you take responsibility for the quality of your training by checking the credentials of your trainers and the format, practical content and accreditations of the course itself. At Interface Aesthetics, one of our expert trainers will be happy to discuss which of our courses may be right for you.