Westminster briefing discusses Review of the Regulations of Cosmetic Interventions

BYLINE:Lorna Jackson,editor of ConsultingRoom.com

Director of the Independent Healthcare Advisory Services, Sally Taber, chaired a briefing at Westminster to examine the government’s response to the April 2013 Keogh report and ask those involved in shaping the future of cosmetic regulations in England to report on the ongoing developments and challenges as they work towards the agreed recommendations.

The intimate event saw six speakers, including representatives from the Professional Standards Authority (Christine Braithwaite), the Faculty of General Dental Practice (Trevor Ferguson) and the British Association of Cosmetic Nurses (Sharron Brown) give informative presentations. Noel Griffin, team leader of public health policy and strategy at the Department of Health, explained that a “programme of work” was now in place, and is being overseen by an advisory board, with individual projects reporting to a delivery board. The work programme, which is broken down into multiple projects with multiple partners, involves the Royal College of Surgeons, GMC, CQC and Health Education England looking at high quality care; the MHRA, EU, Clinical Practice Research Datalink and the CQC looking at safe products; the RCS, NHS England and the DOH being at the forefront of an informed and empowered public; the Committee for Advertising Practice and the ASA evaluating responsible advertising, professional regulators, insurers; the PSHO concerned with complaints and redress and the professional regulators, the CQC and local authorities addressing legislation. Some of the expected deliverables include cosmetic surgery training and practice standards from the RCS, (which will lead to approved credentials), alongside outcome measures and patient decision aids; a new code of ethics and an RCS credentials record system from the GMC; a training framework, accreditation system and course delivery from Health Education England for the non-surgical specialties; a breast implant registry (CPRD is running a pilot study) and long-term EU medical device regulation, via the MHRA, for dermal fillers, to include unique identifiers on all medical devices. No time frames were alluded to.

Simon Withey, who sits on the Royal College of Surgeons Cosmetic Surgery Inter-Specialty Committee, and chairs the sub-committee on Standards of Training and Practice, reiterated that credentials will be approved by the RCS and held on record by the GMC; they will not supersede the current specialist register but will provide more details on specific surgical training alongside the FRCS registration. When asked how cosmetic doctors (non-FRCS) who perform procedures, such as newer liposuction techniques, would fit into the RCS credentialing process, he gave no firm response. If precedent is to be used then we may look to the fact that the HEE is addressing hair restoration surgery as part of its remit, which the RCS didn’t want to cover as it is undertaken by both surgeons and non-surgeons. Carol Jollie represented Health Education England which has been challenged with reviewing the qualifications required to deliver non-surgical cosmetic interventions. She told the audience that the HEE is now coming to the end of phase I, which was to deliver a qualifications framework and indicative content.

Phase II involves more detailed content and training standards, recommendations for accreditation and course delivery. HEE has come up with treatment-specific training modules for botulinum toxin, dermal fillers, chemical peels, laser/IPL/LED treatments, hair restoration surgery and skin rejuvenation therapies such as micro-needling and mesotherapy, which include different learning levels (such as degree, masters, PhD), alongside apprenticeships at foundation learning. Entry requirements or ”accreditation of prior learning” for different aesthetic professionals have yet to be determined. There are common themes across modality-specific modules, meaning that subjects such as infection control, diagnostic skills, psychology and patient consent are addressed as a key basic for all. Carol concluded by showing the audience the draft qualification frameworks and their indicative content for each cosmetic intervention, which showed, for example, that some more advanced techniques with fillers and toxins would require demonstration and completion of learning at a Masters or PhD level. Future HEE meetings involving various stakeholders are planned for November 2014 and March 2015