Why We are Consulting
There is evidence from social and traditional media of individuals who are not regulated healthcare professionals providing unregulated lip enhancing injections, or dermal fillers or injections for facial wrinkles. Similarly, there is anecdotal evidence from healthcare professionals and media coverage that there is an increase in such procedures going wrong: causing discomfort, harm, or permanent damage in severe cases.
There is also growing potential for risk posed by an increase in unregulated premises carrying out non-surgical cosmetic procedures that pierce/penetrate the skin. The Scottish Government's commitment to patient safety must be maintained with the same level of assurance for people who choose to have procedures carried out by individuals who are not healthcare professionals in non-healthcare premises.
In addition, a number of pharmacists have now entered the cosmetics procedure field and are providing injectable procedures within premises which are not currently classified as independent clinics under the 1978 Act. This means that they do not need to be registered with HIS.
SCIEG recommended that regulation should be extended to ensure that non-surgical procedures (including dermal fillers) which pierce/penetrate the skin should only be provided by or on behalf of regulated healthcare professionals by individuals who have an appropriate level of expertise. When these procedures are provided on behalf of a regulated healthcare professional, that professional should have overall responsibility for the quality of care delivered.
We are not averse to this SCIEG recommendation in principle and recognise that the safety of everyone that chooses to have a cosmetic intervention carried out is of paramount importance, regardless of provider or location. However, there is currently a lack of evidence of harm from all activities and therefore we do not want to cause undue financial difficulties for reputable small businesses, if this can be avoided by the introduction of other appropriate regulation. We consider that a blanket ban on non-medical professionals carrying out non-surgical cosmetic procedures could be difficult to enforce and might drive unregulated providers underground.
We therefore offer, in this consultation, a way forward that ensures the visibility of all services and licensing backed with rigorous implementation guides (specific conditions) to ensure best practice in all circumstances. Conditions could include that services are provided in a clean and safe environment; individuals would be 18 years of age or older; cooling off periods would be offered and sharps etc. would be disposed of appropriately.
The National Health Service (Scotland) Act 1978 provides HIS with powers to regulate independent clinics. At present only clinics in, or from which, services are provided by specified healthcare professionals (including doctor, nurse, dentist, dental nurse, midwife or dental care professional) are captured within the definition of an independent clinic in section 10F of the 1978 Act (as amended). Where services are provided by a person who is not a healthcare professional and they operate from premises which do not fall within the definition of "independent clinic" then they are currently unregulated.
Further statutory, as opposed to voluntary, regulation would ensure that providers of non-surgical cosmetic procedures that pierce/penetrate the skin and who are not qualified healthcare professionals are regulated with the aim of ensuring that both they and their premises meet required standards.
Fundamentally, we want to ensure that anyone providing non-surgical cosmetic procedures that pierce/penetrate the skin is competent and appropriately trained to do so. We are therefore seeking views on the need for further statutory regulation to ensure the safety of end users.
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