Licensing and further regulation of non-surgical procedures: business and regulatory impact assessment

Introduction

This document constitutes the final Business and Regulatory Impact Assessment (BRIA) for the proposed regulation and licensing of non-surgical procedures in Scotland. It provides a comprehensive assessment of the anticipated impacts of the full suite of policy proposals, with particular focus on the provisions set out in a proposed Bill. The Bill and associated regulatory framework aim to address gaps in oversight for the non-surgical procedures sector, which currently encompasses a wide range of cosmetic and lifestyle/wellbeing interventions delivered outside of regulated healthcare environments. The BRIA evaluates the potential effects on businesses, practitioners, service users and regulatory bodies of the proposals. The analysis draws on stakeholder evidence, public consultation responses, and the best available data to inform the Scottish Government’s approach and to support an effective transition to a newly regulated landscape.

Scottish Government proposals

The proposals considered in this impact assessment are those set out in the analysis and response to the further public consultation published in June 2025 (the consultation having been carried out between 20 December 2024 and 14 February 2025.) This proposes an approach where procedures are categorised into groups according to the most appropriate mitigation of their risks. In the consultation these groups are called Group 1, 2 and 3.

The Scottish Government proposes that Group 1 procedures should be included in a licensing scheme established using powers under the Civic Government (Scotland) Act 1982. This scheme would have a premises and practitioner element, and a procedure would have to be undertaken by a licensed practitioner working in a licensed premises.

The Scottish Government further proposes that Group 2 and 3 procedures should be undertaken in certain appropriate settings, and that Group 2 procedures should be undertaken by, or supervised by an appropriate healthcare professional, whereas a Group 3 procedure must only be undertaken by an appropriate healthcare professional – another practitioner should not be able to undertake these procedures even if supervised.

The appropriate professional for the purposes of these proposals is defined in the consultation response as being one of:

• A medical practitioner (doctor)
• Dentist
• Nurse who is an independent prescriber
• Pharmacist who is an independent prescriber

In response to feedback on those proposals the Scottish Government now intends that midwife independent prescribers should be added to this list, and this is reflected in the Bill.

An age restriction is also proposed, with procedures restricted to clients aged 18 or over. The Scottish Government proposes to ensure that Healthcare Improvement Scotland (HIS) and Local Authority environmental health officers have appropriate enforcement powers to support these restrictions and requirements. Fuller detail is included in the response.

On 8 October a Bill was introduced to the Scottish Parliament, in fulfilment of the commitment made in the 2025 Programme for Government published in May. This Bill includes provision relating in particular to the proposals that relate to Group 2 and 3 procedures. In respect of these procedures, which are known in the Bill as “non-surgical procedures”, and in this impact assessment will often be referred to as simply “procedures regulated by the Bill”, the Bill makes provision to restrict these to defined “permitted premises”, and to restrict procedures to people aged 18 and over, with related offences, enforcement powers and other provisions. More detail on the Bill can be found in the accompanying documents, and of particular relevance is the Financial Memorandum, which covers some ground in common with this impact assessment.

The Bill does not put into legislation all of the Scottish Government’s proposals in relation to those procedures that it regulates. In particular, it does not restrict procedures to particular healthcare professionals, put in place supervision requirements or set any training or qualification requirements for practitioners. The Bill does contain powers that will allow it to make further provision in relation to non-surgical procedures: these powers are discussed in more detail in the Delegated Powers Memorandum. The Bill does define a “permitted premises” as one from which an appropriate healthcare professional (including a midwife prescriber, as discussed above) provides services. This does not have the same effect as the full proposals which would restrict some procedures to appropriate healthcare professionals, set training and qualification standards and put in place a model for supervision but will nonetheless bring such settings into the scope of regulation where existing guidance which, amongst other things, may ensure that to some degree professional oversight or support is available to practitioners..

The Bill also contains provision relating to the certification of death, and amendments to be made to the Certification of Death (Scotland) Act 2011. This provision is unrelated to the policy or proposals on non-surgical procedures.

Terminology: Non-Surgical Procedures

This impact assessment follows the Bill in referring in most cases to “non-surgical procedures”. This is a change from the previous consultation, which referred to “non-surgical cosmetic procedures”, often abbreviated to “NSCPs”. In considering these procedures it was clear that the Scottish Government was also considering wider lifestyle or wellbeing purposes to which procedures are put. In preparing the Bill it was decided that the original term could be misleading, given the Bill will cover procedures without any intended cosmetic effect. This change in terminology does not, however, reflect any change in the scope of the Scottish Government’s intentions, in particular the intention to not make any provision that has an impact on the provision of healthcare remains.