In my article last month, ‘Looking to the future: professionalism and the role of the Joint Council of Cosmetic Practitioners’, I wrote ‘… nor has it [the aesthetics sector] found a common-sense professional identity’. Many people who work in the sector and write or speak to me claim to be passionate professionals. I do not disagree with their passion and, indeed, applaud their aspirations, but I do argue that their claims should be backed by behaviour that will earn the respect and description attributed to the term ‘professional’. Unfortunately, it has been my experience that some members of the aesthetic sector have more to do to confirm and demonstrate that their practice accords with the spirit, values and behaviours associated with professionalism.
Professionalism can be defined in several ways, and some of its core conditions are not met within the aesthetics sector, leading to a lack of professional practice and patient safety
Definitions of professional
So, what do I mean by ‘professional’? It is a term loosely used in conversation, so let us refer to some online definitions:
- ‘Having the type of job that is respected because it involves a high level of education and training’
- ‘The qualities that you connect with trained people are being organised and sharing a high standard of work’ (Wikipedia, 2020)
- ‘… with a reputation to uphold, trusted workers of a society who have a specific trade are considered professionals’ (Wikipedia, 2020)
- ‘… codes of conduct, agreed upon and maintained through widely recognised professional associations, are a key element of what constitutes any profession’ (Wikipedia, 2020).
Some key phrases within those definitions include ‘high level of education and training’, ‘sharing a high standard of work’, ‘reputation’, ‘trusted’, ‘codes of conduct’ and ‘widely recognised professional associations’—these are the elements of a true profession. The aesthetics sector is not there yet.
Professionalism in aesthetics
In my view, all these key points and tenets are already present in the sector, but a strongly divisive tribal tendency prevails within the aesthetics industry that is counterproductive. What is also confounding is the fact that, despite the existence of a ‘Government’-backed Code of Practice that explicates nationally held ethical principles, such as openness, duty of candour, honesty and practitioner accountability, and the publication of quality assured standards of proficiency and training, some practitioners fail to observe these core conditions that characterise the very essence of professional practice. For example, there are some aesthetic practitioners who lay claim to possessing a postgraduate standard of education when they do not, in fact, possess such qualifications. This is hardly the conduct of a sector that aspires to be called a profession.
Example reports of poor practice
However, there is worse to come. Here are some factual reports that have reached Joint Council of Cosmetic Practitioners (JCCP) in recent weeks.
Firstly, some examples of poor practice with regard to training for aesthetic practice and ensuring patient safety will be detailed.
» MPs have and will continue to invite stakeholders from across the sector to give oral evidence to the enquiry and will present a report to the Government with recommendations for how to ensure that consistent, robust and professional standards are in place «
Let's begin with Dr X (a well-known practitioner), who offers to train pretty much anyone, regardless of their recognised level of prior experience—for example, training someone with Level 3 qualifications to do a job requiring Level 7 skills. Where is the patient safety in that? Ironically, on their website is a section that sets out many of the issues the profession is facing with regard to the need for patient safety.
They have also branded their own products so that their graduates have a ready supply via their business.
Now, here is another example of an aesthetics business. In this case, the complainant was charged £1800.00 to attend a course to ‘prepare her to inject safely’, yet she had no prior qualifications or experience in the industry. Even the company's own training manual states the minimum requirement is Level 3. The manual goes on: ‘What will be achieved? – A working knowledge of Botulinum toxin and injectables to become a certified aesthetician in administering Botulinum toxin.’ The trainer also offered to do the complainant's insurance through their own insurance brokerage, and they wanted a £600 deposit. They claimed that they were registered on the Health Professions Council Register.
Here is another complaint, which was against another ‘School of Aesthetics’. The complaint to the JCCP about the school reads: ‘This training provider is totally unethical and a complete fraud. Promising non-medics and medics that they will provide a service and actually not providing it.’
The complainant paid for the training and went on to warn: ‘They sold the dermaplaning course as a practical course but, in fact, it is all online. No support, no help, no one to contact. Seems like all the content on the site is copied from an aesthetics book—this could be copyright infringement too. No certification provided on completion.’
In answer to the question, ‘have you complained to the provider?’, the complainant stated: ‘The provider has deleted their Facebook page. The mobile number is no longer in use, the landline is not active anymore and there has been no reply to emails. The company is now operating with a new name and is ‘scamming’ people out of money for a service they are not providing.’
For some of the practical courses, the trainer advised the student to complete case studies on friends and not to charge. When challenged about who will cover insurance, as certification is not provided, the trainer stated, ‘no one, as you are not charging’. This is totally unethical, as she has prescription-only drugs in her clinics and she is not a prescriber or General Pharmaceutical Council-registered.
At the time of the collapse of Thomas Cook, another person working in the sector complained: ‘It has come to my attention that a named training company (that was the subject of an upheld official complaint to the Advertising Standards Authority) are giving away £500 training vouchers redeemable against their training courses for people who can prove they work for Thomas Cook, on the pretence that they can have a new career in aesthetics. The advertisement on Facebook suggested that they're helping them out, especially with Christmas coming.’
In another complaint presented to the JCCP, the complainant reported ‘another case of remote prescribing to beauticians who are also training other people. They ran their own training course on 10 July. The beauticians themselves are providing and advertising Botox and fillers’.
Lastly – for the moment – a dental nurse published an advertisement for a training academy (name redacted), and has managed to obtain insurance at the same price as doctors, dentists and registered nurses. This dental nurse video calls her clients and prescribes Botox for them.
Moving forward
One might hope there is light on the horizon. The All-Party Parliamentary Group (APPG) on Beauty, Aesthetics and Wellbeing has launched its enquiry into non-surgical cosmetic procedures in the UK. The group, co-chaired by Carolyn Harris MP and Judith Cummins MP, will be investigating how standards for undertaking such treatments, and for their promotion, should be improved to support the beauty and aesthetics industry and protect public safety.
The APPG has already received written evidence that sought insight on:
- What procedures are being carried out, where, and by whom
- What qualifications and training are being completed
- Whether there should be age limits on such procedures
- The impact of advertising and social media
- Consumer safety and protecting vulnerable people
- The adequacy of current licensing and regulation.
MPs have and will continue to invite stakeholders from across the sector to give oral evidence to the enquiry and will present a report to the Government with recommendations for how to ensure that consistent, robust and professional standards are in place. The JCCP has already submitted 15 pages of written evidence to the enquiry team and will be presenting oral evidence next month at the APPG's third evidence session on the importance of statutory regulation.
Carolyn Harris MP and Judith Cummins MP said on the launch day:
‘In recent years, we have seen a rapid growth in the popularity of non-surgical cosmetic treatments. Yet, for too long, the lack of consistent standards has left consumers at risk and undermined the industry's ability to develop.
We are also increasingly concerned about the advertising and social media promotion of these treatments, and how to make sure vulnerable people, such as those at risk from mental health issues, are protected.’