Regulation speculation: An update from Professor David Sines

Following recent speculation on social media about what is happening with regards to the UK licensing scheme for non-surgical cosmetic procedures, Hamilton Fraser sat down with JCCP chair Professor David Sines to find out what’s going on.

Professor David Sines, the chair of the Joint Council for Cosmetic Procedures (JCCP) will give a regulation update and lead a Q&A at The Aesthetics Business Conference on Tuesday 8 October. However, with a new Labour government in place and social media speculation about whether or not the proposed Licensing scheme for non-surgical cosmetic procedures had been scrapped, Hamilton Fraser asked him for his insights into what’s really going on and where we currently stand.

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Hamilton Fraser: You may have seen people speculating on social media that now we've got a new government, and the consultation is showing as “closed” and “published under the 2022-2024 Sunak Conservative Government” that we weren’t going to progress any further in terms of UK regulation. What’s really happening?

Professor David Sines: My view is that it was a very serious attempt by some members of the aesthetic community to derail or at least to introduce a sense of disconnect and challenge in the sector.

Somebody had added a comment that read: "Rest in peace consultation." Now I saw that—of course, I did—but within four hours of the following day, it had quietened down. My email box didn't fill as I anticipated. I immediately emailed colleagues at the Department of Health and Social Care, sending them the screenshot, which I think is correct and proper because their own comms department needs to understand what is occurring in the media.

The bottom line is this: none of us have knowledge of when the Government will respond to that first consultation (which closed in October 2023). What was very clear in my mind was that, had the Government not announced the election by Rishi Sunak on that particular Thursday, some seven weeks ago now, there would have been an announcement by the Conservative Government, which would have resulted in the publication of their consultation response.

There were 11,800 responses to that consultation. That is powerful! So, with that in mind, I remain confident that the new Government will be in a strong place to validate whatever recommendations the previous administration was going to make.

It doesn't take a rocket scientist to understand or predict what the responses might have looked like. I think we know the mood music. It is about public protection and patient safety but recognising that people have a right to earn a living and celebrate excellence in their practice.

I am mindful that the consultation and the response that was available at that time had to be paused because no government department could release anything during a period of purdah. The election purdah period lasts for six weeks. The new government came into office one week ago, so let's be quite clear: we do not know today (Friday 12 July) who the responsible minister will be. So, things are organic; they're changing. My prediction is that we will receive a response to the first consultation, but we probably will not receive that response until after the summer recess. Just for colleagues to understand, a summer recess is a period when Parliament ceases its business and our MPs go back to their constituencies. That period will start on 25 July. So, with the Government's mountain of urgent challenges, it is most likely that we will not hear more until September. I am confident things will be on track but the timeline may not be fixed. I think we should just wait and treat the pause as nothing more than a natural break.

Hamilton Fraser: So, it's not all over?

Professor David Sines: Absolutely not. It is far from over and let me just say this: if anyone thinks it is or if anyone tries to make that happen, then this will flaunt the very real sense of opinion and consensus held amongst the majority of members of the public and stakeholders who are supportive of a new system of regulation for the sector.

So many people have worked on the design of the licensing programme. I have seen the sector unite around this over the past four years. But I will just remind you of one other important thing. I was asked this question some six months before the election: What if the Government were to change? Well, the answer is quite simple. We have had exceptional support from Labour Government colleagues in opposition. Labour MPs actually led the All-Party Parliamentary Group on Beauty, Aesthetics and Wellbeing. The Conservatives supported this too of course. The joint chairs were Carolyn Harris and Judith Cummings, who have both been re-elected to their constituencies as members of the Labour Party. There was also Kevin Jones, MP for North Durham, who has now been appointed to the House of Lords. We could name numerous MPs and members of the House of Lords from both parties. So, I remain confident this will be back on track.

Hamilton Fraser: You are going to be talking about regulation and leading a Q&A at Hamilton Fraser’s Aesthetics Business Conference in October. Can you give us a bit of an insight into what you hope the session is going to offer people attending?

Professor David Sines: The Q&A element is very important. I have found that over the last six months, the Q&As at conferences have become very lively, engaging, and helpful. So that is what this is going to be about at our business conference this year. We want questions and we want ideas.

Hopefully, we will receive the Government consultation by October. I cannot predict what will be included in the Government’s response document but as I have said earlier, I think I have a good idea of where common sense should take us.

I will be talking about the implications of the consultation outcome and will make reference to the potential re-categorisation of certain surgical procedures. Those are the invasive procedures such as Brazilian Butt Lift (BBL) procedures, breast augmentation, and lipolysis. We are very clear that in the ‘red’ category that was consulted upon in the last government consultation paper, clear lines will be drawn. I want to talk about that and what it means for practitioners, governance, and restrictions on who can do what and under what conditions and, of course, with the right qualifications and regulated experience.

I will encourage debate with colleagues about what it means for the application of supervision for procedures such as injectable toxins, some of our lasers, and, of course, dermal fillers. These are big topics. Supervision needs to be proportionate to the risks. We need a year to think about these issues -  we need to get this right.

I think the very big question would be, what will education and training standards look like? Who will award them? What about people who don’t have a qualification? It will be a requirement of the new practitioner license that all eligible practitioners will need to evidence the same level of knowledge, competence, and practice proficiency that the Government will set as its new expected standard when it is determined. Evidence of meeting the new standard in the form of qualifications will normally be required. In addition, suitably experienced and trained regulated healthcare professionals may be able to evidence compliance with the new DHSC standard through a potential credentialing route.

Hamilton Fraser: That's what people really want to know, isn’t it? That is the main sticking point for everybody – who can do what? Particularly when it comes to botulinum toxin and dermal fillers.

Professor David Sines: Absolutely right. It is a big issue. We are looking at a licence—that is a starting point. It will take time for that licence to be fully designed. Even when we have an implementation date, which we were talking about being at the end of 2026 at the earliest, I want to see a two-year period thereafter to give people a chance to meet the new standards. Practitioners can then have a licence, which they can put above the door, and they don't need any other authority, they can say, "Here's my licence to practise. I am providing you with the confidence that I am a legitimate practitioner, and I am accountable for my practice." So, for me, we are not saying there should be restrictions beyond proportionate governance, but it will assist people to be very clear about what they are competent to do. I am also advocating that there will be some procedures that only doctors, for example, should undertake. I would wish to see such procedures re-designated as surgical with CQC oversight.

Hamilton Fraser: Anything else you think it's important for us to say at this stage when we're in this no man's land, so to speak?

Professor David Sines: I think there are a couple of other things that are important. Firstly, don't rush off to buy qualifications or find a quick fix because you may regret that in the absence of knowing what will be acceptable in the future. We have recommended to the Government that only persons who are in possession of benchmarked and standardised qualifications awarded by UK Universities or by JCCP approved Ofqual regulated Awarding Organisations, and which are provided by their associated JCCP approved Training Centres (i.e., those who have been proven to meet all of the HEE and JCCP/CPSA standards) should be regarded as meeting current standards for Level 7 aesthetic practice.

Secondly, I do not think people should be panicking. Moral panic is completely unnecessary. Talk to people who are having the conversations. The JCCP is one of those organisations.  

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Make sure you have full malpractice insurance. I have seen some of the insurance certificates and the indemnities; watch out. There will be a wake-up call for some of those.

The other thing is to remember your complaints procedures and your redress. Inform members of the public of what you can do and what you can't do. Being honest is important, but much more importantly, value yourself and your own credibility and be proud of what you do. We are all on a journey to enhance the quality of our practice and our accountability.

Hamilton Fraser is proud to be a partner of the JCCP and looks forward to welcoming Professor Sines to The Aesthetic Business Conference on Tuesday 8 October. Book your tickets today.

You can read our article on The Health & Care Act 2022 for more about the proposed licensing scheme.

The JCCP has also produced a detailed licensing in aesthetics FAQ fact sheet, which provides more information for both patients and practitioners and should answer most of the questions you will have about what is to come as well as an article on myth busting.

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