COSMETIC SURGERY
accurate records of consultations, using systems to identify and act on any patient safety concerns, and contributing to programmes to monitor quality and outcomes, including registers for devices such as breast implants.
Professor Terence Stephenson, chair of the GMC, said: “Cosmetic interventions should not be entered into lightly or without serious considerations. Above all, patients considering whether to have such a procedure need honest and straightforward advice which allows them to understand the risks as well as the possible benefits. “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.” Health Minister Ben Gummer said:
“Anyone who chooses to have a cosmetic procedure should expect to have high quality and safe clinical care. This guidance for doctors is an important step forward in improving standards and ending the lottery of poor practice in parts of the cosmetic industry.” Professor Sir Bruce Keogh, National Medical Director, NHS England, said: “The GMC’s guidance will play a pivotal role in raising standards and protecting people who choose to have a cosmetic procedure. The independent review I chaired, following the PIP breast implant scandal, highlighted major problems with unsafe practices in the
CQC ratings of cosmetic surgery clinics
The Department of Health has announced proposals to expand the Care Quality Commission’s (CQC’s) public ratings system to providers of cosmetic surgery. Up to 100 cosmetic surgery clinics will be given ratings of: outstanding, good, requires improvement or inadequate, to enable the public to gain an insight into the quality of clinics providing procedures such as face lifts, breast implants, liposuction, removal of bags under the eyes, brow lifts and buttock implants. The Royal College of Surgeons welcomed the proposal, saying it will complement plans for a new system of certification. Commenting on the proposal, Mr Stephen Cannon, chair of the Cosmetic Surgery Interspecialty Committee and vice president of the Royal College of Surgeons, said: “Deciding to undergo cosmetic surgery is a big decision and choosing the right provider can often be confusing and overwhelming for prospective patients. It is excellent news that the Department of Health is proposing to expand the CQC’s public ratings system to cosmetic surgery providers. The easier
it is for patients considering cosmetic surgery to identify providers that meet the high standards required for safe surgery, the better. “The RCS has worked with the regulators the GMC and the CQC to produce new professional standards for cosmetic surgery. If these proposals go ahead, the CQC will refer to the new standards when carrying out their inspections and before they rate private hospitals or clinics. “We will also launch a system of certification for surgeons later this year which will help patients to find a certified
surgeon, with the appropriate training, experience and insurance to carry out a procedure. If the CQC’s rating programme is extended to providers of cosmetic surgery, patients will be able to review how a hospital has been rated by the CQC and whether the surgeon has been certified by the Royal College of Surgeons, before making their decision on where to have treatment. This will improve patient safety and tighten regulation of the industry.”
According to consultant plastic surgeon and former president of BAAPS, Douglas McGeorge; “At the British Association of Aesthetic Plastic Surgeons we welcome – and indeed, have been calling for during the last decade – as much Government scrutiny as is possible of the cosmetic sector. This is an arena where regulation has historically been lax and many practitioners can engage in procedures they are not trained or even qualified to perform.
“However, it is important to stress that the Care Quality Commission (CQC) regulates facilities – that is, clinics rather than clinicians. Their remit entails a facility or practice’s aspects such as equipment, record-keeping and administrative areas, so we still call for the public to remain extremely vigilant of; and query; their surgeon’s experience and accreditations. At BAAPS we have always stressed not to be swayed by flashy adverts or offers and to ‘choose a surgeon, not a clinic’. Members of our organisation must undergo strict criteria to join such as a number of substantive consultant posts and thus represent the vast majority; if not all; NHS-trained plastic surgeons specifically trained in aesthetic or cosmetic practise.”
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cosmetic sector, including poor follow-up care and record keeping, and misleading and inappropriate advertising and marketing techniques. “This addresses these issues and will drive safer care, more ethical practice and, overall, a better experience for people undergoing cosmetic procedures. It will also help ensure doctors are seen to be open and honest, that they work within their competence and seek appropriate training and advice where necessary. This marks an important step forward for patient protection across a wide range of cosmetic and lifestyle procedures, including areas such as laser eye surgery.”
Details of all UK doctors, including any specialisms they have, are published on the GMC’s online List of Registered Medical Practitioners. The GMC is continuing to explore how additional information about doctors and their qualifications, in areas such as cosmetic practice, can be made available to patients via the register. This may require legislative change, and was the subject of a public consultation by the GMC in 2015. In addition, the GMC has recently developed a guide for patients considering cosmetic procedures, which gives advice and information on things to consider and the questions they should ask their doctor. Plastic surgeon and former president of the British Association of Aesthetic Plastic Surgeons (BAAPS), Douglas McGeorge, commented: “The British Association of Aesthetic Plastic Surgeons welcome these guidelines for cosmetic surgery from the General Medical Council and the Royal College of Surgeons as a step forward to establishing basic care standards for aesthetic procedures. This initiative, for greater patient safety, has been one that the Association has been driving for over a decade. We look forward to advancing the process of enforcement of these guidelines, so that all patients will be properly counselled and treated: able to make informed decisions about their healthcare - without being pressurised by unscrupulous practitioners and financial inducements.” British Association of Plastic
Reconstructive and Aesthetic Surgeons (BAPRAS) deputy president, David Ward, a consultant surgeon, who also sits as deputy chair of the RCS Cosmetic Surgery Interspecialty Committee (CSIC), commented: “We welcome the call for better regulation of cosmetic surgery and believe a robust framework that includes pre-operative consultation, the opportunity for a second consultation and time for reflection is required to protect every patient. “BAPRAS fully supports regulation of cosmetic surgery and better protection of cosmetic surgery patients. BAPRAS continues to emphasise that cosmetic surgery should only be performed when it’s the right thing for the patient and done only by surgeons fully trained in cosmetic surgery.”
CSJ OCTOBER 2016
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