The Keogh Review: Botox and dermal fillers in the UK
Skin Beautiful Medical and Cosmetic Clinic provides expert advanced dermal filler treatments at clinics in Exeter Milton Keynes Bristol Coventry Swansea Warwick Daventry Evesham Carmarthen Llanelli and Neath.
The Keogh review, once concluded, will likely change the way in which non surgical cosmetic treatments such as Botox and dermal fillers are administered in the UK. Read this article to find out more.
At the request of the then health secretary Andrew Lansley MP the NHS medical director Prof. Sir Bruce Keogh is heading a review into the practices of both surgical and non surgical cosmetic procedures. A review was deemed necessary by Mr Lansley following the scandal of PIP breast implants. However, the review is to consider a much wider scope including all non surgical aesthetics procedures to include the prescribing and/or administration of all Botox (botulinum toxin) and dermal fillers products.
The review is currently at the consultation stage with both the medical profession and the wider public being encouraged to comment on and provide evidence of various aspects pertaining to (amongst other matters) cosmetic injectable treatments. It is set to conclude in March, 2013 soon after which many of my colleagues and I expect regulation to become a part of a largely unregulated industry.
As a qualified advanced medical aesthetics practitioner I give my full support to regulation within the industry. Not least as I consider patient safety to be fundamental in any cosmetic procedure (either surgical or non surgical), but also because I believe the cosmetic industry, and, in particular non surgical aesthetics must be better defined, allowing the public to be better protected and better informed.
Possible implications for Botox & dermal fillers in UK
There are several possible outcomes following the conclusion of the Keogh review. These range from a ban on beauticians administering prescribed, injectable Botox (botulinum toxin type A) and/or injectable dermal fillers such as Juvederm, Restylane, Radiesse and Teosyal to an outright ban on all but registered physicians from administering either Botox or dermal fillers. The latter is perhaps unlikely, and more in line with other EU member states where only doctors are permitted to administer injectable botulinum toxin type A.Between these two opposing states lies a whole conundrum of other possibilities for the aesthetics industry. For example, in the UK many nurses are permitted to prescribe, both as part of a team and also independently, drugs such as Botox. This is an exception within the EU where nurses do not have such roles.
There are further options, both along the lines of autonomous practice and regulation. One it has been decided who can and cannot administer cosmetic injectables such as Botox and dermal fillers then it must also be decided where the boundaries lie between 'practice' and 'autonomous practice.'
Botox - The current state of affairs
Currently, it is necessary only that all injections of botulinum toxin type A must be preceded by a face to face consultation with a qualified prescriber. That is to say there are no regulations governing who can and cannot administer the treatment so long as the prescription was obtained as described above.Needless to say, the UK is severely lacking in regulation. This has led to beauty salons across the country offering "Botox injections", "anti wrinkle injections", "skin rejuvenation" and "muscle relaxing injections" as part of their beauty portfolio. In light of the Keogh review questions must be asked as to whether a prescribed drug with potentially severe consequences should be administered by a person(s) who has no medical or health care training, and, therefore no knowledge of dealing with possible complications as a result of injecting.
Prior to the announcement of the Keogh review, and despite there being no current supporting regulations in place many organisations in the UK already have strict rules effectively excluding certain groups concerning the acquisition, and administration of Botox and dermal fillers and the insurance covering such interventions. For example, my own cosmetic insurance company sent letters to all members stating that it will not renew existing policies where the insured is not a qualified nurse, doctor or dentist. Similarly, none of the pharmacies or aesthetics manufacturers that I deal with will sell or market either Botox or dermal fillers to anyone other than a nurse, doctor or dentist.
Injectable Botox & dermal fillers - How should regulation be applied?
There is little doubt that the Keogh review will ultimately lead to regulation being implemented across the cosmetic industry, but how should this apply to non surgical aesthetics such as Botox & dermal fillers?In my own view as an experienced RGN and qualified advanced medical aesthetics practitioner any regulation must ultimately provide universal protection for the public seeking cosmetic treatments. It must also go further in addressing public awareness. When one considers a GP it is common knowledge in the UK that any such person is suitably qualified and knowledgeable to diagnose and treat illnesses. I believe it should also be common knowledge that any person administering Botox or dermal fillers is a qualified medical and/or health care professional with professional aesthetics training.
In summary, my own suggestions put forward to the Keogh review include the following
- Botox & dermal fillers should only be administered by a practicing qualified medical or healthcare professional.
- In addition to a medical, dentistry or nursing degree all practitioners should have suitable independent aesthetics training and qualifications and should only perform the treatments they have trained for.
- All practitioners must hold separate professional cosmetic insurance.
- All practice should be performed either by a qualified prescriber, or, at the very least by a qualified health care professional in connection with a prescriber.
Skin Beautiful Homepage
Helen Bowes RGN BSc (hons)
Botulinum Toxin Type A
Dermal Fillers
Botox & Dermal Fillers FAQ
There is an updated response on the Dept. of Health website which represents the conclusion of the 'Call for evidence.' A summary of comments and suggestions has been published today. Please note that the summary does not in any way reflect any likely changes in legislation at the present stage. Sir Bruce Keogh is due to present a final report to the Dept. of Health in March, 2013.
ReplyDeleteRead the article here:
http://www.dh.gov.uk/health/2012/12/responses-cosmetic-surgery/
Professor Sir Bruce Keogh has today concluded his report into the review of the regulation of cosmetic interventions in the UK. A key summary of recommendations are:
ReplyDelete1) Dermal fillers should become prescription only medical devices.
2) All practitioners should be accredited in their field of practice and listed on a national register.
3) Non health care professionals (i.e. not a doctor, dentist or nurse) can only be allowed to administer dermal fillers if they have an accredited beauty qualification and are working under the instruction of a qualified prescriber.
4) All procedures should be documented.
5) Suitable cosmetic insurance should be mandatory.
6) Better information regarding risks, side effects and outcomes should be given to patients.
7) Practitioners should be assessed and audited without advance notice being given.
8) Manufacturers should be audited on their products.
9) There should be a regulatory framework overseeing complaints and redress.
My personal feelings are that the report is both appropriate and fair. Many of the above points we already have in place. However, we do need better regulation so that when consulting with and treating patients we can point to a regulator to say that we are doing things properly. Otherwise how else can we reassure the discerning public that they are in safe hands?
Thank you to all for the dozens of comments received for this article.
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Helen Bowes
Skin Beautiful Medical & Cosmetic Clinic