Aesthetic (non-surgical cosmetic) procedures

We don’t know yet is the simple answer. The specific regulations that will underpin the licensing scheme will be subject to extensive engagement with stakeholders and further public consultation, the current consultation is the first stage.

The purpose of the licencing scheme is to ensure that consumers who choose to undergo an aesthetic (non-surgical cosmetic) procedure can be confident that the procedure they receive is safe and of a high standard.

The licensing scheme will ensure that those who offer these procedures are suitably knowledgeable, trained, and qualified, hold appropriate indemnity cover and operate from premises which meet the necessary standards of hygiene and cleanliness.

The Government advises that their intention is that the licensing scheme will be administered by Local Authorities in England, who will work with a range of partners to operate and enforce the scheme, such as Environmental Health Officers, Trading Standards Officers and the Health and Safety Executive.

The licensing scheme will consist of two interlinked components:

a. practitioner licence

practitioners who offer procedures must be:

- suitably trained and qualified

- hold appropriate indemnity cover

b. premises licence

a practitioner will operate from premises which meet the licencing scheme’s standards of hygiene and cleanliness.

In the wording of the Health and Care Act, 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. It includes:

(a) the injection of a substance

(b) the application of a substance that is capable of penetrating into or through the epidermis

(c) the insertion of needles into the skin

(d) the placing of threads under the skin

(e) 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 current Government consultation seeks to inform and answer this question and will determine exactly which procedures will be included in the scope of the new licence.

At this time, it is not possible to confirm which procedures will be included within the scope of the new licensing regime but the current Government consultation on this subject sets out the Government’s current proposals for the scope of the new practitioner license.

The Government has advised that it considers that there are ‘certain aesthetic (non-surgical cosmetic) procedures that are of sufficient complexity and invasiveness that they should only be performed by healthcare professionals overseen by the CQC.

Yes, we anticipate that the license will detail each of the procedures that a practitioner is licenced to perform.

Yes, questions are included in the consultation document to enable you to  highlight any procedures you think should or should not be included within the license.

This is still to be determined and a matter for ongoing consultation.

The intention is that all practitioners, including registered health care professionals, will have to have a specific licence to carry out any of the procedures included within the future legislation.

There is currently no suggestion that a national public register system will be mandated or  implemented.

What will be included within the licence is still to be decided. However, it is intended that both practitioners and the premises from which they work will be expected to show proof of certain qualifications and insurance and provide evidence that the premises where procedures take place meet hygiene and safety standards.

We expect there to be one practitioner license. We expect the license will state and specify which procedures it has been issued for.

Both the premises and personal licenses will specify the procedures that are included in the scope of the license.

Yes, we expect this to be the case although each ‘site’ will need to have its own individually assigned premises license.

Yes, if the home business meets the standards set down in the anticipated new premises license. Home based businesses will also have to be inspected by local authority Environmental Health Officers in just the same way as they inspect salons and clinics.

This is yet to be determined. However, we anticipate that it will not be acceptable to provide the procedure in the client’s home or from a mobile vehicle.

This will depend on the procedures being offered and remains subject to review and approval.

We recognise the potential risks associated with any delay to requiring all practitioners to meet all of the conditions set down and prescribed in the new license. We expect however that there will be ‘grace’ period of up to two years to enable practitioners to evidence that they meet and satisfy all of the conditions set down in the license. It will be for enforcers such as Environmental Health Officers to apply their judgement to risk assess and (if necessary) apply conditions/ sanctions at any time if they consider that there is a real risk of harm to members of the public.

The legislation has been designed to ‘future proof’ as far as possible. New procedures may be assessed as they arise.

This is expected to be the case.

Yes. The intention is that all practitioners and the premises from which they work will have to be inspected and checked against certain standards prior to receiving a licence. The requirements for a practitioner and a premise licence will be set out in regulations.

As with existing licensing schemes, it is anticipated that EHOs will have the power to implement immediate or emergency enforcements notices.

All practitioners will be legally required to hold indemnity insurance to protect members of the public if something goes wrong with their procedure. The level of insurance for practitioners is still to be decided. This will be a key condition for the granting of a practitioner license.

As with existing licensing schemes, failure to meet the requirements of the licence can lead to practitioners and premises being prevented from operating.

License costs have yet to be determined, although it is probable that the fee will reflect recovery costs associated with review and inspection. We expect that practitioner and premises licenses will be charged separately, as is currently the case for hair and beauty licences  in some local authorities. This will permit a practitioner with a personal license to seek work at one or more establishments with the appropriate premises license.

The cost and frequency of the licence has not yet been decided.

No. The intention is that all practitioners, including registered all health care professionals, will have to have a specific licence to carry out any of the procedures included within the future legislation.

We do not yet know what qualifications will be required. The Government intends to consult on a new enforceable education and training standard.

We anticipate that there will be a transition period between the law being passed and when it comes into force.

At this time, we are unable to confirm the level or qualification requirement, these will be set down by the DHSC as part of its mandated licensing standards.

If the courses are for the purposes of obtaining a license, and if the government sets a mandate for approved qualifications (in the form of a new ‘industry standard’), then the training organisation must comply with the requirements set by an Ofqual approved awarding body or those approval standards set by a UK University or by an approved Apprenticeship provider organisation.

At this time, we are unable to confirm which level or qualification requirement will be set down by the DHSC as part of its mandated licensing standards.

We advise caution before taking any qualification which may or may not meet future DHSC mandated requirements.

Whilst the exact level and content of the national mandated standard is 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.

We have recommended that qualifications should be regulated, by Ofqual or provided by a university. We also consider that a new aesthetics Apprenticeship Pathway should be developed and included in the portfolio of qualification options.

Yes, trainers will be required to demonstrate that they have appropriate teaching and assessment experience and qualifications. The requirements for teaching and other qualifications will be set out by the awarding body as part of Ofqual conditions or by  local university education providers.

The wording of the Health and Care Act law passed in April defines an aesthetic (non-surgical cosmetic)procedure under the term “cosmetic procedure” as a procedure, other than a surgical or dental procedure, that is carried out for cosmetic purposes; and includes—

(a) the injection of a substance.

(b) the application of a substance that is capable of penetrating into or through the epidermis.

(c) the insertion of needles into the skin.

(d) the placing of threads under the skin; (e) 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.

No. Medically trained and non-medically trained professionals can currently offer aesthetic (non-surgical cosmetic)procedures. However, we consider that all practitioners offering such procedures should be trained to an agreed national standard. We know however, 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 aesthetic (non-surgical cosmetic)procedures to provide evidence that they meet a new (and yet to be defined) minimum standard of training, education, and skill competence.

If you have any concerns about a medical or aesthetic practice, salon, clinic, or individual practitioner you should contact your Environmental Health Department at your local Council. If your practitioner is a registered health care professional (such as a nurse, doctor or dentist) then you can also seek advice from their professional regulator (i.e., the General Medical Council etc).

Contact the practitioner who performed the procedure immediately and seek their advice. If this is unsatisfactory, contact your GP or in an emergency attend your Urgent Care Centre at your local hospital.

Currently there is no central place to find qualified aesthetic practitioners because there are many different types of qualification and training available, which many argue vary in quality and competency. This is why a licensing scheme that ensures a minimum standard of practice to include premises and practitioner competence is needed.

You should always ask your practitioner about the products and equipment that they use as part of your procedure. If you are receiving an injectable product or medicine, then you should ask to see the container in which the substance is sealed within and check that it has a UK quality ‘CE’  mark to check that it is safe and appropriately produced. If you have any queries regarding the product, device or substance that is intended for use as part of your procedure then you can seek advice from the Medicines and Healthcare products Regulatory Agency (MHRA).