Lockdown 2 – What constitutes a "medical" treatment?

The Joint Council for Cosmetic Practitioners (JCCP) has issued a statement updating its guidance on the lockdown situation for aesthetic clinics in the UK.

Addressing the confusion over which clinics are allowed to stay open during the lockdown period, the JCCP updated its previous guidance from the first lockdown with more detailed advice on the stance it advises aesthetic healthcare practitioners to take when deciding whether or not to stay open.

The statement, signed by JCCP executive chair David Sines, begins, “During the second Government ‘lock down’ period, as ever, safety of the patient, public and the practitioner is central to all that we do. The JCCP believes that there should be no compromise in safety for financial gain. We advise that a full return to ‘unrestricted’ business can only officially and legitimately resume when the Government Administrations in the four UK nations advise that is legally safe to do so.”

It stresses that the following guidance should be considered in line with other local or professional regulatory restrictions that relate to practitioners on a personal basis.

In regards to what treatments should continue to be performed throughout lockdown and therefore which clinics may choose to stay open:

“The JCCP also advises that it is important for practitioners to understand that cosmetic procedures being performed by healthcare professionals are not automatically designated as being either ‘medical’ or ‘medically-related’ in nature, in fact many such procedures fall out with this definition.

“Rather, there must be a clearly defined, discernible and intended ‘medical’ benefit for the patient.

“The JCCP is of the opinion that if the practitioner is able to determine that they have applied a full diagnostic physical and psychological/emotional assessment of the patient’s presenting condition (and if they are of the opinion that both they and the patient consider that the treatment is actually urgent) and can justify that the provision of the proposed treatment would assist the patient to prevent and/or reduce the physical, psychological and psychosocial symptoms and effects associated with that condition, then the practitioner could justify that the treatment is ‘medically-related’.”

The statement outlines that under the above circumstances, practitioners would need to:

 

• Have regard to relevant CQC registration and compliance requirements (depending upon nature of the ‘medical procedure’ to be performed).
• Have a written treatment plan in place to confirm the justification for their professional opinion, supported by a written evidence-based rationale for the assessment, diagnosis and proposed treatment (including a statement of intended ‘medically-related’ outcomes). This is in accordance with expected best practice as set down by the Professional Statutory Regulatory Bodies (e.g. the GMC, GDC, NMC, HCPC and the GPhC);
• Be able to justify that the treatment they propose to deliver is ‘medically-related’;
• Ensure that the patient (and their associated treatment) has been risk assessed and deemed to be ‘urgent’ rather than either purely cosmetic or elective;
• Ensure that they practise ethically at all times with the spirit and context of their professional Code of Practice;
• Comply with guidance that has been published recently on how to practise safely during the covid-19 related emergency period;
• Confirm that their insurer would still cover them during the lockdown period for any aspect of their proposed function;

 

And, importantly:

 

• Ensure that they are not seen to be encouraging people to leave their homes to attend clinics for face-to-face assessment or treatment (since members of the public should be conforming to lockdown rules) unless they themselves consider that the treatment is urgent and have made an informed decision to attend the clinic.

 

While the JCCP said it would support members who meet this criteria in not considering these services to be elective or aesthetic “beauty-related” services, it summarises that the final decision whether or not to proceed to provide treatments is down to the practitioner themselves, “taking into account any restrictions on all but essential services and informed by the exercise of their clinical judgement following the provision of a clinical risk assessment, whilst mitigating the conflicts of interest between commercial and ethical practice and having thoroughly reviewed the advice provided by Government in its authorised statements.”

 

Read the JCCP's original guidance here and the full latest statement here.