Sharon King
It seems that 2020 is moving at a ferocious pace. While many are still recovering from the Yuletide festivities and gently easing themselves back in to the pace of work and planning for a prosperous year, it seems that we have been bowled not one, but several, curve balls that will probably have some considerable bearing on the businesses and practice of everyone working in the field of aesthetic medicine.
The development of the advanced Aesthetics National Occupational Standards (Professional Beauty, 2020) landed in my inbox the second week of the New Year, with a short window of opportunity during which we could have our say. I imagine it lay sleeping somewhere quiet and warm over the holiday period waiting to reign havoc. Hopefully, enough nurses will have taken the time to read and comment as its vitally important that our voice is heard.
As aesthetic practitioners take note of regulations regarding business and product promotion, it presents an opportunity to reflect upon the building block of the profession: duty of care
Now, let's try to get our heads around the next shot across our boughs, what we can or cannot say when it comes to promoting our businesses with the release of the Advertising Standards Agency (ASA) Enforcement Notice.
A large proportion of aesthetic practitioners may not realise that the Committee of Advertising Practice (CAP) write the advertising codes for non-broadcast advertising and direct promotional marketing. The CAP code is the rulebook that covers just about everything non-broadcast (or the ‘written word’), for example, sales promotions, direct marketing campaigns, magazines and pamphlets. They also write the rules for by which broadcasters adhere to through the medium of TV and radio. The ASA is the sister company of CAP, and it monitors advertising in all forms (in conjunction with Ofcom for TV and radio), enforcing the CAP codes. Those who break the codes can face prosecution and hefty fines (CAP and ASA, 2020).
The Medicines and Healthcare products Regulatory Agency (MHRA) is the Government body that regulates medicines, medical devices and blood components for transfusion in the UK. The MHRA prohibits the advertisement of prescription only medicines (POMs) to members of the public. This is not new regulation; it has long been so. The MHRA publishes a helpful Blue Guide on the advertising and promotion of medicines in the UK, which explains the requirements of the relevant legislation and provides additional clarification on the interpretation of the law and its application. What is different now is that the ASA, in conjunction with the MHRA, has issued an enforcement notice for the advertisement of botulinum toxin injections on social media. This includes adverts, unpaid marketing posts and influencer marketing. From Friday 31 January 2020, those who breach may be referred to the MHRA or a relevant professional body. Quite simply, care must be taken not to directly or indirectly promote botulinum toxin or any of the proprietary bands. Remember, this includes the use of hashtags such as ‘#Botox’. Furthermore, the ASA considers a reference to anti-wrinkle injections as relating to a POM. New monitoring bots will be used to scour social media platforms to identify non-compliance.
While aesthetic practitioners are taking stock of how businesses are promoted, it also provides the opportunity for us to reflect and to remember that we are firstly healthcare professionals with a duty of care. By this very virtue, nurses should be setting the precedent on how aesthetic treatments and services are conducted.
» At the last BACN conference, a vote by members showed overwhelming support for the motion that BACN members would not prescribe or train non-medical practitioners «
The Nursing and Midwifery Council adopted the General Pharmaceutical Council's Prescribing Competency Framework as its standards of competency for prescribing practice back in January 2019 and updated them in December 2019 (NMC, 2019). Independent nurse prescribers are reminded that they are responsible and accountable for the assessment of patients with undiagnosed or diagnosed conditions, and for decisions about the clinical management required, including prescribing. In practice, there are two distinct forms of non-medical independent prescriber:
- A specially trained nurse, pharmacist, optometrist, physiotherapist, therapeutic radiographer or podiatrist who can prescribe licensed medicines within their clinical competence. Currently, doctors and dentists aside, only nurse and pharmacist independent prescribers can also prescribe unlicensed medicines and controlled drugs
- A community practitioner nurse prescriber (CPNP), for example, a district nurse, health visitor or school nurse, can independently prescribe from a limited formulary called the Nurse Prescribers' Formulary for Community Practitioners, which can be found in the British National Formulary (BNF). Supplementary prescribing is a voluntary partnership between a doctor or dentist and a supplementary prescriber to prescribe within an agreed patient-specific clinical management plan (CMP) with the patient's agreement. Nurses, optometrists, pharmacists, physiotherapists, podiatrists, radiographers and dietitians may become supplementary prescribers and once qualified may prescribe any medicine within their clinical competence, according to the CMP.
Aesthetic practitioners are also responsible for those who they delegate tasks to and for those for who they may prescribe or offer a prescribing service, which has to be face-to-face. The BACN is the largest organisation for nurses working within the field of aesthetic practice and is working towards an educational and competency framework that will provide a pathway for nurses to flourish. At the last BACN conference, a vote by members showed overwhelming support for the motion that BACN members would not prescribe or train non-medical practitioners or those for whom aesthetics fell out of the scope of practice with their regulatory bodies. It looks like other organisations are to follow suit. Could it be that this year where we might finally get to feel the wind of change, and hopefully for the better? Here's to wishing you all a prosperous and happy New Year—whatever it may bring.