Dr Philip Dobson discusses Care Quality Commission registration for thread lift treatments
There have been a number of instances recently where aesthetic practitioners have been approached by the Care Quality Commission (CQC) in relation to carrying out thread lift procedures and told that they were required to register in order to carry out these treatments. This has, however, been very inconsistent and other inspectors have categorically told other practitioners that no registration was required.
Regulation 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, as amended, states that the activities listed in Schedule 1 to the regulations are ‘regulated activities’. In England, regulated activities may only be carried out by a healthcare professional, where the provider is registered with the CQC.
Regulated activities cover a wide range of healthcare-related services, including the treatment of disease, disorder or injury, diagnostic and screening services, personal care and the management and supply of blood and blood-derived products. In addition, paragraph 6 of Schedule 1, which relates to ‘surgical procedures’, including all pre- and post-operative care carried out by a healthcare professional, states that the purpose of such procedures is for the treating of disease, disorder, injury, sterilisation or reversal thereof; for cosmetic purposes; or for purposes of religious observance (such as circumcision). On first reading of the above, it would seem this covers virtually all cosmetic procedures. However, when the regulations were drafted certain treatments were specifically excluded from the scope of the regulations, such as nail surgery on the foot, curettage, cryocautery for warts, verrucae or other skin lesions within certain limitations, piercing, tattooing or the subcutaneous injection of a substance for the purposes of enhancing a persons appearance (botulinum toxin and dermal fillers,) the removal of hair roots by the application of heat (laser and IPL hair removal). Thus, for a number of years, many aesthetic practitioners have carried on their practise without the need for CQC registration provided they were covered by the caveats from the requirement to register.
As is often the case, treatments move on in ways which were not foreseen when the regulations were drafted and in the case of thread lifts, a perfect case in point is identified. The insertion of thread lifts, where instruments, in the form of canulae, are passed under the skin introducing medical devices into the subcutaneous tissue for the purposes of changing the anatomy particularly of the face, is a relatively recent development, which on strict interpretation would fall under regulation as a surgical procedure. However, some have argued that the exclusion for ‘subcutaneous injection of a substance of substances for the purposes of enhancing a person’s appearance’ could also be applied causing them to fall outside the scope of regulation.
In order to address this, we contacted the CQC directly and posed the question, asking for a definitive statement in relation to thread lift procedures under the regulations. After many months and significant chasing, having consulted its registration team and legal department, the CQC has now given a formal response as below:
“Where the procedure of thread lift (i.e. involving the insertion of threads) is carried on by a healthcare professional, it falls within the Care Quality Commission (CQC) scope of registration, requiring the provider to register with CQC for the regulated activity of surgical procedures.”
What does this mean to aesthetic practitioners?
Because the CQC has now decided that this treatment falls within the scope of the regulations, all healthcare professionals carrying out these treatments must be registered, before they are legally permitted to provide this service to patients. Failure to obtain registration is a criminal offence and could render practitioners liable to prosecution for carrying on a regulated activity without CQC registration. In addition, practitioners should also be aware that where they carry out these procedures without registration and they are therefore acting illegally, their professional indemnity insurance may be invalidated in the event of a claim. Advice on CQC registration can be obtained from the author.
Dr Philip Dobson is medical director of LCS Healthcare, a company specialising in regulatory compliance in the healthcare sector. He continues to work as a cosmetic physician, carrying out a range of procedures and holds the postgraduate diploma in skin surgery. In addition, he holds the Graduate Diploma in Law, the Legal Practise Course (LPC) (with Distinction) and he has been awarded the degree of Master of Laws (with Distinction) in Professional Legal Practice. He practises law as a Notary Public.
There have been a number of instances recently where aesthetic practitioners have been approached by the Care Quality Commission (CQC) in relation to carrying out thread lift procedures and told that they were required to register in order to carry out these treatments. This has, however, been very inconsistent and other inspectors have categorically told other practitioners that no registration was required.
Regulation 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, as amended, states that the activities listed in Schedule 1 to the regulations are ‘regulated activities’. In England, regulated activities may only be carried out by a healthcare professional, where the provider is registered with the CQC.
Regulated activities cover a wide range of healthcare-related services, including the treatment of disease, disorder or injury, diagnostic and screening services, personal care and the management and supply of blood and blood-derived products. In addition, paragraph 6 of Schedule 1, which relates to ‘surgical procedures’, including all pre- and post-operative care carried out by a healthcare professional, states that the purpose of such procedures is for the treating of disease, disorder, injury, sterilisation or reversal thereof; for cosmetic purposes; or for purposes of religious observance (such as circumcision). On first reading of the above, it would seem this covers virtually all cosmetic procedures. However, when the regulations were drafted certain treatments were specifically excluded from the scope of the regulations, such as nail surgery on the foot, curettage, cryocautery for warts, verrucae or other skin lesions within certain limitations, piercing, tattooing or the subcutaneous injection of a substance for the purposes of enhancing a persons appearance (botulinum toxin and dermal fillers,) the removal of hair roots by the application of heat (laser and IPL hair removal). Thus, for a number of years, many aesthetic practitioners have carried on their practise without the need for CQC registration provided they were covered by the caveats from the requirement to register.
As is often the case, treatments move on in ways which were not foreseen when the regulations were drafted and in the case of thread lifts, a perfect case in point is identified. The insertion of thread lifts, where instruments, in the form of canulae, are passed under the skin introducing medical devices into the subcutaneous tissue for the purposes of changing the anatomy particularly of the face, is a relatively recent development, which on strict interpretation would fall under regulation as a surgical procedure. However, some have argued that the exclusion for ‘subcutaneous injection of a substance of substances for the purposes of enhancing a person’s appearance’ could also be applied causing them to fall outside the scope of regulation.
In order to address this, we contacted the CQC directly and posed the question, asking for a definitive statement in relation to thread lift procedures under the regulations. After many months and significant chasing, having consulted its registration team and legal department, the CQC has now given a formal response as below:
“Where the procedure of thread lift (i.e. involving the insertion of threads) is carried on by a healthcare professional, it falls within the Care Quality Commission (CQC) scope of registration, requiring the provider to register with CQC for the regulated activity of surgical procedures.”
What does this mean to aesthetic practitioners?
Because the CQC has now decided that this treatment falls within the scope of the regulations, all healthcare professionals carrying out these treatments must be registered, before they are legally permitted to provide this service to patients. Failure to obtain registration is a criminal offence and could render practitioners liable to prosecution for carrying on a regulated activity without CQC registration. In addition, practitioners should also be aware that where they carry out these procedures without registration and they are therefore acting illegally, their professional indemnity insurance may be invalidated in the event of a claim. Advice on CQC registration can be obtained from the author.
Dr Philip Dobson is medical director of LCS Healthcare, a company specialising in regulatory compliance in the healthcare sector. He continues to work as a cosmetic physician, carrying out a range of procedures and holds the postgraduate diploma in skin surgery. In addition, he holds the Graduate Diploma in Law, the Legal Practise Course (LPC) (with Distinction) and he has been awarded the degree of Master of Laws (with Distinction) in Professional Legal Practice. He practises law as a Notary Public.
