Key opinion leaders push boundaries, make appearances in journals, speak at conferences and develop new theories, techniques or research
This time last year, the UK was going into another lockdown, so it is with huge joy that we have our clinics open and can work normally.
This month, it seems appropriate to discuss the hot topic of remote prescribing and standards of practice in medical aesthetics. We are challenged by the activities of some Nursing and Midwifery Council (NMC) nurse prescribers in the aesthetics arena, and also the reports of nurses providing services that fall well below the benchmark of safe practice. As chair of the British Association of Cosmetic Nurses (BACN), I recently met with NMC chief executive Andrea Sutcliffe, Geraldine Walters (executive director of professional practice) and Alice Hilken (general counsel). I was given the opportunity to share concerns with the NMC and discuss how we could work together to tackle these issues of public protection. The meeting allowed for a frank and open discussion in regard to remote prescribing and the complexities of this issue. The differences in terms of approaches from different regulators arose, and, in particular, the NMC was not being clear enough where remote prescribing and cosmetic practice were concerned. The NMC noted our request to reconsider its position in order to align with the other medical regulators. Additionally, I touched on the issue of nurses training non-healthcare practitioners in cosmetic injectables, stating that the BACN code of professional conduct does not permit this practice from its member nurses. We discussed aligning our two codes of practice and the importance of linking an agreement about standards to the revalidation and fitness to practice processes for nurses practising in aesthetics.
I was briefly able to bring the NMC up to date on the work that the BACN is doing in relation to updating its competency framework and standards for aesthetic nursing. The links to the role of the advanced nurse practitioner were also acknowledged. We both recognised the importance of issues around increased risk and patient protection, the rapid growth and change associated with aesthetic nursing and the added recent interest from the Department of Health and Social Care (DHSC) and politicians.
Fortuitously, the meeting was held a few days before The Sunday Times published a damning article looking at remote prescribing with undercover reporters and recordings. Nurses were highlighted in this article, so the timing could not have been better. While the NMC do say that it is unlikely that remote prescribing is appropriate in cosmetic practice, and, certainly, any nurse would have to justify the need for it, we look forward to a much clearer statement in line with the other regulators.
Both the General Medical Council (GMC) and the General Pharmaceutical Council (GPhC) have produced guidance in the past 18 months to confirm that they will not support remote prescribing and, more specifically, have advised that they will not accept their registrants prescribing remotely for cosmetic treatments. Both the GMC and GDC advise similarly, for example, as set out in the GMC guidance on good practice in prescribing and managing medicines and devices (GMC, 2021).
When a prescriber delegates treatment to other practitioners, the patient remains under the care and oversight of the prescriber, which requires that the prescriber must be familiar with the patient through an initial face-to-face consultation and diagnostic assessment of the patient's suitability for treatment. This also requires the prescriber to be available to deal with any complications or adverse events that might occur following the application of the medicine/product/procedure. This applies to the routine use of medicines for cosmetic purposes, such as botulinum toxins, injected local anaesthetic or topical adrenaline, and the use of emergency medicines, such as hyaluronidase.
Any time that a designated prescriber prescribes medicines or treatments, they must exercise their professional and clinical judgement, have adequate knowledge of the patient's health and be satisfied that the medication serves the person's needs. This applies to all medicines that are prescription-only medicines (POMs).
» By combining expertise with passion, an impression will be left on your audience «
Key opinion leaders
It is with great pride that we have some incredible nurses among our membership who are teaching and training for manufacturers, companies and themselves and developing their expertise and expert knowledge in different areas. The BACN is often asked how one can become a key opinion leader (KOL). It takes a variety of skills to do this well and be acknowledged, so I thought I would highlight some key areas that are pertinent to being a KOL.
Companies and brands often engage with a KOL to secure them as an advocate for their products—taking advantage of their prestige, expertise and popularity for the chance of increased visibility and revenue. To achieve such a status does not happen overnight, it takes a lot of time and dedication.
KOLs must responsibly invest in themselves, as well as their area of interest, and consistently work to develop their opinion by further investigating their subject in depth. KOLs can become experts through online research, meeting with others who are interested in their same field and receiving accreditation. A KOL is defined as someone of significant influence within their respective industry. They have built a reputation and gained the respect of their peers by pushing boundaries, making regular appearances in journals and popular press, speaking at conferences and developing new theories, techniques or research.
A person's value as a KOL is extremely limited if they do not possess the expertise to support their opinions. One must practice ethically and never stop learning, which is why time needs to be dedicated to continuously further knowledge, develop opinions and stay current. It is all about investing in yourself to maintain relevance by adapting yourself and your message to an ever-changing speciality and world.
Content is the key to validation. Having content published online or in credible magazines, journals and newspapers will support your expertise and strengthen your reputation. An expert is known for their theories and opinions. By combining expertise with passion, an impression will be left on your audience, more so than simply being an educated individual with no excitement or personal investment in their work. Social media can also be used to effectively demonstrate one's passion through regular posts, consisting of both original and existing content regarding the field.
Reliability is a key component of your reputation. It is vital to be consistent and stand by your promises and commitments. If you have promised to make an appearance at an event, make sure you attend and avoid lateness. Inconsistency leaves a poor impression and can easily ruin your reputation.
Conclusion
The BACN is here to support and encourage its nurses to shine, be rising stars and the next generation of KOLs. Opportunities are there for those who are prepared to put time and work into their subject.
From myself, the BACN board, Paul Burgess (chief executive officer), Gareth Lewis and our admin team we wish you all a very happy Christmas.