The Joint Council for Cosmetic Practitioners (JCCP) met with the Right Honourable Maria Caulfield Parliamentary under secretary of state for primary care and patient safety on 14 June 2022 and discussed a range of key issues relating to the proposed new licencing scheme for non-surgical aesthetics in England. As a result of this meeting, the following recommendations were made.
Practitioner licensing
- Introduction of a system of local authority licensing of practitioners
- Care Quality Commission (CQC) to develop a memorandum of understanding with local authority licensing organisations to perform an integrated and enhanced scheme of regulation for aesthetics to avoid duplication for those healthcare professionals who are already registered with the CQC
- Licensed practitioners achieving all requirements and standards should be on a national professional register open to the public. This register should also feature information for the public about the risks of different procedures and where to log complaints about practitioners.
Premises
- 4 Introduction of a system of local authority licensing and periodic inspection of premises used for cosmetic procedures
- 5 Extended powers to be given to the CQC to inspect all premises where invasive procedures that are included in the license are to be performed.
Training standards
- 6 Implementation of a national register of approved qualifications and of approved education and training providers
- 7 To consider whether the Professional Standards Authority (PSA) could be given extended powers to oversee registers of approved education, training providers and qualifications in the sector in addition to their current statutory function of overseeing practitioner registers
- 8 Ofqual to be requested to ensure they only approve qualifications that meet the new Government standard for education and training for the aesthetics sector.
Prescribing drugs/fillers
- 9 The Minister is requested to write to all professional regulatory bodies with responsibility for prescribing to seek assurance that they will enforce guidance to ensure that prescribers do not perform remote prescribing in the aesthetics sector
- 10 Dermal fillers are to become a prescription-only device—this is to be agreed upon with the Medicines and Healthcare products Regulatory Agency (MHRA)
- 11 MHRA to take action regarding wholesale supplies of these drugs and fillers (MHRA are being receptive, which is excellent).
Procedures/treatments
- 12 Current local authority registration powers (Part 8, Local Government Miscellaneous Provisions Act 1982) should be revoked, and the five registrable treatments should be brought into the scope of the new licensing regime.
Other
- 13 Members of the public should be provided with access to a redress scheme.
» … the JCCP expects that the Government will seek to remove the duplication of inspection regimes. However, what is clear is that the new national licensing standard for aesthetic practice will be applied to all providers and practitioners, regardless of their professional background «
What readers need to know (frequently asked questions)
The new Health and Care Act 2022 gives the Government the power to introduce a licensing scheme for practitioners who operate in England. Work is now underway to decide what the licensing scheme will look like. This will then be introduced via secondary legislation. The timescale for this is yet to be outlined.
The reason for the legislation is to reduce the risk of harm that is associated with ineffectively performed non-surgical cosmetic procedures, also known as aesthetic procedures, to the public. Once in force, this legislation will make it an offence to perform particular procedures without a license.
The JCCP—in partnership with a range of other organisations—has produced a short Q&A paper to answer some of the questions you may have about what is to come.
Q&A: important information for practitioners
- When will the new law come in regulating non-surgical cosmetic (aesthetic) procedures? The Health and Care Act became law in England on 1 July 2022. The new Act places responsibility on the secretary of state for health and social care to introduce secondary legislation to support the design and implementation of the new non-surgical cosmetics licence. At this time, we do not know when the new secondary legislation will be enforced. Recent statements from Ministers within the Department of Health and Social Care show that the Government definitely intends to introduce legislation. However, the timeline for this has not yet been published.
- Are only medical professionals (doctors, nurses, dentists, allied health professionals, etc) allowed to offer non-surgical cosmetic (aesthetic) procedures? No. Medically trained and non-medically trained professionals can currently offer non-surgical cosmetic (aesthetic) procedures. However, we consider that all practitioners offering such procedures should be trained to an agreed national standard. However, we know that this is sometimes not the case. A key aim of the new licence will be to correct this public safety issue by requiring all practitioners who perform the specified non-surgical cosmetic (aesthetic) procedures to provide evidence that they meet a new (and yet to be defined) minimum standard of training, education and skill competence.
- Will practitioner insurance be mandatory? Yes. While the details of the licence are still to be decided, we understand that the Government's intention is to make it mandatory for practitioners to have some level of insurance and to provide members of the public with access to a formal complaints and redress scheme.
- As a practitioner, what is going to change in terms of what I can and cannot do? We need to wait for the drafting of the licence to learn exactly what will be included within the licence and what level of training will be required. However, we expect that, from a date to be agreed:
- Practitioners who perform procedures within the scope of the new license will have to demonstrate that they possess a nationally determined standard of knowledge and skill to perform those procedures safely and effectively
- Practitioners will be required to work from premises that meet a national standard in health protection and infection control which will be determined by local authority environmental departments
- Other standards are also expected to be included in the license around issues of product supply, storage of products and medicines, prescribing practice, complaints procedures, insurance and the information given to clients by practitioners.
- How will practitioners be able to obtain a licence? Practitioners and premises owners will be able to apply for a licence via their local authority as soon as the licensing scheme is announced.
- How much will a licence cost, and will this be a one-off or annual cost? The cost and frequency of the licence have not yet been decided.
- Will practitioners have to be inspected to obtain (and renew) a licence? Yes. The intention is that practitioners and premises will have to be inspected and checked against certain nationally agreed and enforceable standards prior to obtaining a licence.
- Can I be prevented from working/operating if I fail a licence inspection? Yes. As with existing licensing schemes, failure to meet the requirements of the licence can lead to practitioners and premises being prevented from operating. The exact details of the sanctions that will be applied to those practitioners who fail to meet the required standards set down for the new licence have yet to be legally determined.
- Can I be prevented from practising if I do not possess the correct qualifications or training? Yes, in the future when the new licence is enforced in England. While the exact level and content of the nationally mandated standard are yet to be determined, the intention is that only practitioners who meet an agreed standard will be able to carry out those procedures that are defined as being within the scope of the new licence.
- What qualifications will practitioners need to possess to perform non-surgical cosmetic procedures? See the response to point 9. This will be determined following extensive consultation between the Government and stakeholders.
- How do I know that the products and equipment that I am buying are safe and licensed for use in the UK? You should always ensure that the medicines, products, devices and equipment that you are intending to use as part of your procedure are ethically sourced and carry a Conformitè Europëenne (CE) or UK Conformity Assessed (UKCA) mark and/or meet MHRA quality approval standards. If a prescription-only medicine is being used as part of a procedure, ensure that nationally agreed guidelines on prescribing practice and the legal requirements for the supply of medicines are followed. Additionally, always ensure that a face-to-face assessment has been undertaken between the prescriber and the person for whom the prescription is intended prior to the prescription being issued. If you have any queries regarding the product, device or substance that is intended for use as part of a procedure then advice can be sought from the manufacturer or pharmaceutical company that produces it, the pharmacy supplier or the MHRA.
- What procedures will be licensed? In the wording of the Health and Care Act law passed in April 2022, a cosmetic procedure is defined as a procedure, other than a surgical or dental procedure, that is carried out for cosmetic purposes. This includes:
- The injection of a substance
- The application of a substance that is capable of penetrating into or through the epidermis
- The insertion of needles into the skin
- The placing of threads under the skin
- The application of light, electricity, cold or heat.
- However, the exact procedures within this definition will be defined as the licensing law is drafted. The Government intends to consult on exactly which procedures will be included in the scope of the new licence.
- What else will be included in the licence? Again, details of what will be included within the licence are still to be decided. However, the JCCP expects that practitioners will be expected to show proof of certain qualifications and insurance and that the premises where procedures take place meet hygiene and safety standards.
- Do I have to have this licence if I already have a special treatments or other licence? Yes. All practitioners and premises wishing to offer procedures included within the scope of the future licence will have to have a specific licence to do so.
- If I am CQC regulated, will I still have to be licensed? Yes. The intention is that all practitioners, including registered healthcare professionals, will have to have a specific licence to carry out any of the procedures included within the future legislation. Wherever possible, the JCCP expects that the Government will seek to remove the duplication of inspection regimes. However, what is clear is that the new national licensing standard for aesthetic practice will be applied to all providers and practitioners, regardless of their professional background. In addition, all registered healthcare professionals who perform procedures that are defined for inclusion within the scope of the new licence will also need to continue to satisfy all requirements set down by their professional statutory regulator.
- How do I know if the product/equipment is safe and licenced for use in the UK?
Patients should always ask their practitioner about the products and equipment that they use as part of their procedure. If they are receiving an injectable product or medicine, they should ask to see the container in which the substance is sealed within and check that it has a CE or UKCA mark to confirm that it is safe and appropriately produced. If there are any queries regarding the product, device or substance that is intended for use as part of a procedure, then advice can be sought from the MHRA.
These answers are supported by:
- The British Association of Beauty Therapy and Cosmetology (BABTAC)
- The British Beauty Council (BBC)
- The British Institute and Association of Electrolysis (BIAE)
- The Chartered Institute of Environmental Health (CIEH)
- The Federation of Holistic Therapists (FHT)
- The Federation of Nail Professionals (FNP)
- The Hairdressing and Beauty Industry Authority (HABIA)
- The Joint Council for Cosmetic Practitioners (JCCP)
- The National Hair and Beauty Federation (NHBF)
- UK Spa Association (UKSA).