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  Draft guidance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

jdavey@gmc-uk.org

@jdaveyGMC

Call Centre: 0161 9236 602

GMC Confidential Helpline 0161 9236 399