Guidance for all doctors who offer
cosmetic interventions and advice for
patients considering these treatments
20th July 2016
John Davey - Regional Liaison Adviser
Functions of the GMC
Our Standards
The ugly history of cosmetic surgery
The Independent 10/06/16
Today?
Current regulation of cosmetic interventions “at a glance”
Session overview
! Background information on
how guidance been
developed
! Key highlights from the
guidance
! Information for patients
New guidance
! Effective from 1 June 2016
! Surgical and non-surgical procedures
! Keogh Review – highlighted the need for
this
! Complements work from others in this area
! Advice for patients also available from 1
June
Why we produced it
! Media attention - poor practice
! Support for doctors
! Vulnerable patients
! FtP evidence
How we developed it
! Evidence
! Early engagement
! Expert / stakeholder consultation
! Draft guidance
! Formal consultation - 142 responses
! Patient/public online survey – 57
responses
ProfessorTerenceStephenson,ChairoftheGMC,said
‘It is a challenging area of medicine which deals with patients who can be extremely vulnerable. Most doctors who practise in this area do so to a high standard but we do sometimes come across poor practice, and it is important that patients are protected from this and that doctors understand what is expected from them ‘‘Our new guidance is designed to help drive up standards in the cosmetic industry and make sure all patients, and especially those who are most vulnerable, are given the care, treatment and support they need.’
Scope of cosmetic interventions guidance
“ any intervention, procedure or
treatment carried out with the
primary objective of changing
an aspect of a patient’s
physical appearance”
Some highlights from the guidance
Yes
No
• Referring patients when a doctor cannot safely meet a patients needs
• Seeking and acting on feedback from patients and colleagues
• If carrying out a procedure for the first time doctors must make sure they can do so safely
• Annual appraisal must cover the whole of a doctor’s practice
Knowledge, skills and
experience
Some highlights from the guidance
Yes
No
• Share insights about outcomes with other people who offer similar interventions
• Tell patients how to report complications and adverse reactions
• Be satisfied that the environment for practice is safe, suitably equipped and staffed
• Carry out a physical examination of patient before prescribing injectable cosmetic medicines
Safety and quality
Some highlights from the guidance
Yes
No
• Doctor responsible for the procedure must personally seek consent from the patient
• Give patients time to reflect
• Consider patient vulnerabilities and psychological needs
• Make sure patients have written information about the medicines or implants used to ensure continuity of care
• Take care when considering carrying out procedures on children and young people
Communication, partnership and
teamwork
Some highlights from the guidance
Yes
No
• Detailed advice about what we consider to be responsible marketing
• Promotional tactics – think about the effect the promotional tactics might have on a patient
• Must not offer cosmetic procedures as a prize
• Not knowingly allow others to misrepresent their services
Maintaining trust
‘Must’ or ‘Should’
! ‘Must’ - overriding duty or principle
! ‘Should’ – providing an explanation of
meeting overriding duty or a
recognition that duty will not apply in
all circumstances.
Lets get you thinking!
‘Should’ or ‘Must’ exercise
1. Before carrying out an intervention for the first
time yourself you …… make sure you can do so
safely, eg by undergoing training or seeking
opportunities for supervised practice.
2. You …… carry out a physical examination of
patients before prescribing injectable cosmetic
medicines.
3. You …….. share insights and information about
outcomes with other people who offer similar
interventions, to improve outcomes and patient
safety.
Which doctors do cosmetic practice procedures?
! Cosmetic surgeons
! Surgeons
! General
! Other surgical sub-specialties
! Dermatologists
! GPs
! F2 doctors
! …any doctor with full registration!
Advice for patients
! A new leaflet for patients
! Explains what patients can expect from
cosmetic practice doctors
! Help patients understand:
! Risks & benefits
! Consent
! How and what to ask
Information for patients
! The doctor responsible for your
care must explain all you need to
know
! Must seek your consent
! Should consider psychological as
well as physical requirements
! Doctors must put patients before
commercial considerations
! Must give you appropriate time to
make decision
Find out more
! The guidance for doctors, effective from June 1 2016: www.gmc-uk.org/cosmetic
! Patient advice from the GMC: www.gmc-uk.org/cosmetic_leaflet
! Royal College of Surgeons (Eng.) – clinical guidance, forthcoming masterclass and accreditation details: www.rcseng.ac.uk/surgeons/surgical-standards/working-practices/cosmetic-surgery
! HSCIC Breast Implant Registry from April: www.hscic.gov.uk/bcir
! HEE qualifications for non-surgical procedures: www.hee.nhs.uk
John Davey
Regional Liaison Adviser, South West England
0161 250 8148
07586616767
@jdaveyGMC
Call Centre: 0161 9236 602
GMC Confidential Helpline 0161 9236 399