NEWS
New guidelines to curb remote prescribing of dermal fillers “Don’t go far enough”
New guidance from the Joint Council for Cosmetic Practitioners (JCCP) on the remote prescription of medication for non-surgical cosmetic treatments such as dermal fillers, has raised some concern from surgeons. Caroline Mills, British Association of Oral and Maxillofacial Surgeons (BAOMS) lead on aesthetic/cosmetic surgery and consultant maxillofacial surgeon at Great Ormond Street Hospital, welcomed the publication but said it did not go far enough.
“While BAOMS agrees with the introduction of guidelines for remote prescription of dermal fillers and other medications for high street beauty salon practitioners, we want to see regulation of the industry in line with European Union (EU) rules,” she said. “The new JCCP guidance to curb remote prescribing will provide some protection for patients, but it does not go far enough. In the
Caroline Mills, British Association of Oral and Maxillofacial Surgeons
EU practitioners have to have a medical licence to inject fillers, and we need similar regulation in the UK.
“Even with the new guidelines where the
prescriber will assess the patient’s suitability for treatment, there is still the risk of serious medical complications because the regulations allow non-medical staff to give non-surgical injectables.”
Caroline Mills explained that patients can suffer vascular occlusion, possibly leading to blindness, or severe allergic reactions both of which require emergency medical treatment: “It’s recognising and managing these problems that is so important and where patient safety maybe compromised.” The NHS faces increasing costs to treat the high street procedures that go wrong. But, without NHS coding for non-surgical treatment problems the scale of emergency treatment and corrective surgery remains unknown. “We need regulation in the UK to protect patients properly,” Caroline concluded.
NHS warned to take“urgent steps”todefend against hackers
A White Paper on NHS cyber security warns that the NHS remains vulnerable to cyber- attack, and must take urgent steps to defend against threats which could risk the safety of patients.
The report, written by researchers from Imperial College London’s Institute of Global Health Innovation, led by Professor the Lord Ara Darzi, suggests a combination of out-dated computer systems, lack of investment, and a deficit of skills and awareness in cyber security is placing NHS hospitals at risk. A cyber-attack on a hospital’s computer system can leave medical staff unable to access important patient details – such as blood test results or X-rays, meaning they are unable to offer appropriate and timely care. It can also prevent life-saving medical equipment or devices from working properly, and in some cases lead to patient data being stolen. The research team – who collated evidence for the report from NHS organisations and examples of previous attacks in the UK and across the globe – commend existing measures put in place across the health system, but say more investment is urgently needed. The report outlines a number of key measures for NHS Trusts to implement in order to increase cyber resilience. These initiatives include employing cyber security professionals in their IT teams, building ‘fire-breaks’ into their systems to allow certain segments to become isolated if infected with a computer virus, and having clear communication systems so staff know where to get help and advice on cyber security.
The authors also point to the number of new technologies being used in the health system, such as robotics, artificial intelligence, implantable medical devices and personalised
medicines based on a person’s genes, and say scientists must build security into the design of these technologies. Lord Darzi, co-director of the Institute of Global Health Innovation (IGHI), said: “We are in the midst of a technological revolution that is transforming the way we deliver and receive care. But as we become increasingly reliant on technology in healthcare, we must address the emerging challenges that arise in parallel. For the safety of patients, it is critical to ensure that the data, devices and systems that uphold our NHS and therefore our nation’s health are secure. “This report highlights weaknesses that compromise patient safety and the integrity of health systems, so we are calling for greater investment in research to learn how we can better mitigate against the looming threats of cyber-attacks.”
The authors of the report warn the
WannaCry attack was relatively crude and unsophisticated – and that the number and sophistication of attacks on the NHS is rising. Dr Saira Ghafur, lead author of the report from the IGHI, explained: “Since the WannaCry attack in 2017, awareness of cyber-attack risk has significantly increased. However we still need further initiatives and awareness, and improved cyber security ‘hygiene’ to counteract the clear and present danger these incidents represent. The effects of these attacks can be far-reaching – from doctors being unable to access patients test results or scans, as we saw in WannaCry, to hackers gaining access to personal information, or even tampering with a person’s medical record.”
The authors say the situation is not specific to the NHS and all healthcare systems around the world are vulnerable to cyber-attack, and
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highlight some UK initiatives to address the danger.
In October 2018 the Department of Health and Social Care announced a spend of £150 million over the next three years to protect key services from the threat of cyber-attacks. The department also recently announced the creation of a new unit overseeing digital transformation, called NHSX, and it is hoped that this organisation will help streamline cyber security accountabilities. However, further investment and awareness is required at all levels of the already stretched health system, explained Dr Ghafur: “Addressing the issue of cyber security will take time, as we need a shift in culture, awareness and infrastructure. Security needs to be factored into the design of digital tools and not be an afterthought. “NHS Trusts are already under financial pressure, so we need to ensure they have the funds available to ensure robust protection against potential threats.”
SEPTEMBER 2019
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