Licensing of non-surgical cosmetic procedures in England

On Saturday 2 September 2023, the much-anticipated government consultation into a new licencing scheme for non-surgical cosmetic procedures was launched and can be found here. In what has been described as ‘the biggest shake up in a generation’ by the JCCP, the proposed new licensing scheme will make it an offence for anybody to carry out non-surgical cosmetic treatments without a practitioner and a premises licence in England. Senior Associate, Alaw Krishan-Gray, provides an overview of the latest position.

What brought us here?

An amendment to the Health and Care Act 2022 gave the Secretary of State the power to introduce a licensing regime for non-surgical cosmetic procedures such as Botox and fillers (Health and Care Act 2022 (legislation.gov.uk)).

In July 2022, the Health and Social Care Committee published a report titled ‘The impact of body image on mental and physical health’  (The impact of body image on mental and physical health - Health and Social Care Committee (parliament.uk). It made a number of recommendations to the government in order to ensure a safe and consistent standard of care in the aesthetic industry, including (in respect of non surgical cosmetic procedures):

• A two-part consent process for anyone considering a non-surgical cosmetic procedure.
• A mandatory 48-hour cooling off period between the consent process and undergoing the procedure.
• A minimum standard of education and training of all practitioners to be a ‘central pillar’ of the licensing regime.
• A specific premises standard for all beauty salons and non-CQC registered premises.  Local authorities should be given the powers to enforce compliance with a nationally agreed set of premises standards.   

The Government’s Consultation

The scope of this consultation is to gather feedback on 3 points:

(a) types of procedures that should fall within the scope of the licensing scheme.

(b) restrictions on which practitioners should be permitted to perform certain procedures.

(c) Age restrictions on those undergoing such procedures.

Looking at these in further detail, the scope of cosmetic procedure is defined in the Health and Care Act 2022 and includes e.g. the injection of a substance and insertion of needles or threads under the skin.  The new consultation introduces a three-tier system using green, amber and red to categorise procedures depending on the risks and potential complications as follows:

1. Green is deemed the lowest risk of complications e.g. microneedling and IPL. All practitioners will be eligible to perform these procedures where they meet agreed standards (which are yet to be defined).
2. Amber is medium risks e.g.  injections and semi-permanent dermal fillers into the face. Non-healthcare professionals must be licensed and have relevant oversight by a named regulated healthcare professional (who will have an accredited qualification). Qualified and regulated healthcare professionals can perform these without oversight where they meet agreed standards.
3. Red is the highest risk category, e.g. any procedure aimed at augmenting the body like the breasts or buttocks using dermal fillers. It is recommended that high-risk procedures be brought under CQC regulation and so would fall outside the scope of the licensing scheme. These procedures are to be restricted to specified healthcare professionals only.It is recommended that any procedure requiring a prescription-only medicine must (at least) be overseen by a qualified and regulated healthcare professional.

Finally, the licensing scheme proposes prohibiting practitioners from performing any procedures included within the scheme to under 18s unless it has been approved by a GMC registered doctor and is carried out by a specified healthcare professional.  This will be in line with the Botulinium Toxin and Cosmetic Fillers (Children) Act 2021 and the law in respect of botox injections, cosmetic fillers, tattoos, teeth whitening and sunbed use.

Next steps:

Key stakeholders e.g. those working in the aesthetic industry and members of the public, are invited to engage and provide feedback to the government which closes at 2359 hours on 28 October 2023. Further, targeted consultations are expected in 2024 which will include considerations including what the standard of education and training should be and to consider any economic impact of the proposed regime. 

The government will then consider the feedback provided and this will inform the scope and shape of the proposed regulations which will underpin the licensing scheme. Then, following a period of legislative scrutiny the regulations are expected to become law in approximately 2-3 years’ time.

Hill Dickinson LLP has a team of specialists in the aesthetic field including managing associated claims and advising on the regulatory frameworks in place.  If you would like to discuss any matters arising in respect of this (or future) consultations and changes to your practice, please contact Alaw Krishan-Gray and Emma Galland.

For further detail, Alaw presented on the topic within days of the consultation being launched. Click here to watch the full video.