Practitioners and the public should be encouraged and have the opportunity to be able to report complications more easily
The past few months have been a rollercoaster ride, as medical clinics have reopened and the demand for non-surgical aesthetic treatments have risen to an all-time high, without showing any signs of dwindling. Everyone seems to be getting used to the new normal, and many are continuing with the use of masks and visors and increased cleaning, which can only be a benefit to normal practice.
In addition to this, the medical aesthetics industry has been very much in focus with the Government and a call for greater regulation. Earlier this year, the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 was passed, banning cosmetic treatments for those under the age of 18 years. More recently, the All-Party Parliamentary Group (APPG) proposed recommendations, including a national licensing regime and minimum qualifications required for people carrying out medical aesthetic treatments. However, it did fall short of stating that higher risk and invasive procedures should only be performed by a registered and insured healthcare practitioner.
The Medicines and Healthcare products Regulatory Agency (MHRA) also had a stakeholder meeting, specifically looking at safety, regulation and reporting of complications related to soft-tissue fillers. The UK having left the EU may provide the MHRA with a new mandate that means that some positive change may finally be seen within the sector. Finally, the Health and Care Act 2022 is also eagerly awaited to see if there is any provision made for the regulation of medical aesthetic practice to be mandated in law.
» Reporting of complications helps us to highlight trends, allowing us to identify specific problems with products, training, techniques and possibly counterfeit goods, as well as providing more evidence to the Government and regulatory bodies as to why certain treatments should only be conducted by healthcare practitioners «
At the heart of it
With all these changes, the role of the Joint Council for Cosmetic Practitioners (JCCP) at the heart of these matters has not been well known. The JCCP and its trustees and committees have been leading the way and providing advice and guidance and steering the profession for greater regulation and patient safety. Personally, I was honoured to be appointed as Vice Chair of the JCCP earlier in the year and have been very impressed with the work that it is doing and its associations with so many stakeholders. In my 20 years of working within medical aesthetics, I do not remember a time when so many practitioners were united than in the response to the JCCP's 10-point plan. Additionally, when reading and reflecting on the 10-point plan, it can be seen that several of the points are already being put into practice.
Reporting and managing complications
The Aesthetic Complications Expert (ACE) Group has recently entered an association with the JCCP, as there are many common goals shared between the two organisations. Our key priorities are education and training, patient safety, maintaining standards and complication management. Aesthetic medicine is largely unregulated, and many practitioners are working in isolation, so it is essential that they have an organisation that they can seek expert advice from and which can offer support when needed.
One of the areas of focus for the JCCP and ACE Group is the reporting of complications. We do know that complications are hugely underreported in the UK, and practitioners and the public should be encouraged and have the opportunity to be able to report them more easily. Reporting of complications helps to highlight trends, allowing us to identify specific problems with products, training, techniques and possibly counterfeit goods, as well as providing more evidence to the Government and regulatory bodies as to why certain treatments should only be conducted by healthcare practitioners who have the relevant knowledge, skills and experience to be able to manage them correctly. As previously stated, the number of non-surgical aesthetic treatments being carried out has increased vastly since clinics have reopened, which has also led to a much greater incidence of complications occurring. In addition to this, as practitioners have had several months of not working in aesthetics, there is a risk of becoming deskilled. Meanwhile, colleagues who also work in the NHS may be suffering with an element of burnout.
As with all aspects of medicine and nursing, it is a requirement to maintain skills and knowledge and continuing professional development. I would certainly encourage all practitioners to have refresher training where needed and to read the latest guidelines on the management of complications, as well as having the appropriate equipment and medication at hand to deal with a problem. A face-to-face consultation is essential when a potential complication has been identified, and photographs or video calls are not a sufficient substitute, as they can lead to an incorrect diagnosis and mismanagement. For non-prescribers, having an experienced prescribing practitioner to help in the management is certainly advisable.
The membership of the JCCP continues to grow, and we are investing in a patient-facing website to provide greater benefit to the membership. The JCCP is also a registered charity, and the vast majority of its board, trustees and committee members give their time and work freely and out of goodwill to promote the standards and ethos of the organisation. Although the JCCP is a voluntary register, on a personal note, I would encourage anyone working in medical aesthetics to join and support the great work that is being done on behalf of the industry in regulation, patient safety, driving standards up and promoting high-risk and invasive treatments to be only performed by healthcare practitioners. The JCCP works tirelessly on behalf of all practitioners to protect our patients from harm from unqualified and lay people who bring the medical aesthetics sector into disrepute.