In this episode, Vicky Eldridge is joined by Professor David Sines, Chair of the Joint Council for Cosmetic Practitioners (JCCP), to delve into one of the most pressing topics in the aesthetics industry: regulation and public safety. Together, they discuss the latest developments in the proposed licensing scheme for cosmetic procedures across the UK, the challenges of delayed governmental action, and the impact of recent tragedies on public perception and policy urgency.
Professor Sines sheds light on the ongoing efforts to improve safety, from defining surgical versus non-surgical procedures to advocating for national education and training standards. He highlights Scotland's proactive legislative approach and shares insights into collaboration with industry partners like Hamilton Fraser to improve governance and risk management.
The conversation also explores how practitioners can unite to support regulation, engage with the public, and prepare for the industry's future. Whether you're a seasoned professional or considering a career in aesthetics, this episode offers valuable guidance and a hopeful vision for advancing patient safety and professional standards.
Podcast transcript:
Vicky Eldridge
So, I'm joined on the podcast by Professor David Sines, he's the Chair of the JCCP. Now we're going to have a little bit of a chat about regulation. It's obviously always a big topic, has been for as long as I've been in aesthetics. Can you update us on where we are now in the UK in terms of regulations and the proposed licensing scheme?
David Sines
Well, thank you Vicky. It's been a bit frustrating to be honest. Because we are delayed. In the timeline that we expected from the UK Government. But I do also want just to mention in a moment, Scotland as well.
Vicky Eldridge
Yes. Okay.
David Sines
JCCP is a UK charity. So we have an interest in all four countries of the UK. So, what we expected in June of this year was the Government to publish its response to a very well publicised consultation, which received 11,800 responses. Now that consultation was long awaited for several reasons. One, it would've determined which procedures would go into a new licence for England. It should, we hope, have determined which procedures should be categorised as surgical. Now we're talking here Vicky, the very emotive topic of BBL. Breast augmentation.
David Sines
And that was actually covered in the consultation. And issues with supervision about who can provide which procedures. And also finally calling for a national mandated standard for education and training. Now we haven't received that response. Now we had a change of government, in fact the very week the Government called for a new election or the election, we understand the minister responsible at that time was ready to publish the Conservative Government's response.
David Sines
So there we go. We moved into a new government. We moved into a period of summer recess. And these things are very natural, to be fair. So we expected to see real movement around the beginning of September. That was our hope. So, we wrote to the Secretary of State in August and we wrote to a number of MPs and we were told that we just needed to be a little more patient. Well that's quite difficult. We're talking about public safety. And protection. But we thought, well we have to wait a little while longer. We were then told that there would be a formal briefing with the responsible minister in the Government. Now we're now talking about a Labour Government. I won't refer to that again. It's the UK Government.
David Sines
So we expect that briefing to have taken place now with the minister. And we are still anticipating the publication of the Government's response to that first consultation within the next four to six weeks. So a long time. We have been writing to MPs, we've had questions raised in the House of Commons, to keep the pressure on.
David Sines
But finally, I'll say on this, we've had such an appalling tragedy in the case of Alice Webb recently. And ironically, we wrote in our letter to the Secretary of State in August that the Brazilian butt lift the BBL issue was becoming of predominant importance. Therefore, we urge them to publish their response. Well we've now had a fatality, which is terribly tragic. But we think that might act as a little stimulus for the Government to now move this agenda forward … finally in Scotland. Scotland are really moving apace.
David Sines
They are producing some really interesting proposals with their MSPs, members of the Scottish Parliament who are really behind the civil service in Scotland. And we expect to see some real parallel changes in Scotland in terms of legislation within the next six months. It won't all enact by then, but at least we will know the direction of travel. And I speak regularly with my colleagues in Scotland
Vicky Eldridge
So things are moving. Because quite often people, you know, we'll see. Social media's a big place, isn't it? Where people speak about what's going on and often we don't know what's happening behind closed doors. We don’t know the letters that are being sent, the conversations that are being had. So it's, you know, there's a lot of assumptions sometimes on what might be happening, but you're confident that we're moving forward …
David Sines
Exactly Vicky. And one, one other thing I can assure you, there is no complacency here.
Vicky Eldridge
No.
David Sines
I mean, the last time when we spoke on our podcast, um, I remember making it very, very clear that we're not letting go on this at all. So there's, but we do have to maintain a sensible momentum with government. The minute we believe this is being drawn out beyond the level of an acceptable timescale we will of course move into an activation approach with our colleagues to say, we now need to move this.
Vicky Eldridge
And you mentioned there the tragedy with regarding Alice Webb and the liquid BBL that's happened. And I think that that's driven a lot of emotion, hasn't it, by people in the sector who really, really are saying we need some sort of regulation in light of these things. But in light of, this is something we've been talking about for many years.
David Sines
For many years, Vicky. And if you go back to the consultation document published last August by the Department of Health and Social Care there, it's a red category there. And that includes BBL, breast augmentation, et cetera. And that was for a reason. And we made it very clear our position at the JCCP is that these procedures are not non-surgical.
David Sines
They are surgical procedures and can and should only be performed by appropriately qualified surgeons. And that does not include by the definition nurses or any other practitioner. So, we're not just saying this is about beauty therapists. Of course it's unacceptable in our view.
David Sines
But it will include nurses and others because the NMC have stated it's out of their scope of practice. So we are publishing in the next week a series of guidelines, Vicky, which will have the support of all of our medical colleagues. And the guidelines are currently being reviewed by the Royal College of Surgeons. So those guidelines should make it clear to our environmental health officers in the four countries of the United Kingdom, that any person who performs such procedures who does not possess a licence to practise for surgery could well be the subject of a legal enforcement notice and criminal prosecution.
Vicky Eldridge
What would you like to see happen then in the future? So we've got your, obviously we're going to have hopefully a response soon. What's your sort of ideal situation? What would you like to see happen?
David Sines
Well, certainly for the red procedures, which I think are really the ones we are feeling much more emotive about but also with every reason from evidence-based practice. I feel we should have emergency legislation brought in as soon as possible to actually restrict those procedures to appropriately qualified medical practitioners. So emergency legislation.
We shouldn't be waiting two years for the new licence. So we will be calling for that. So that's our immediate position. That'll be for the United Kingdom, because the Royal College of Surgeons, they are an intercollegiate group, which means there's a Royal College of Surgeons for each of the four countries of the UK.
They work together very closely, Vicky. So I would hope we would see a mandate of support. Including of course the CQC, Health Improvement Scotland, Wales, Northern Ireland, et cetera. The RQAA. So that could all really move together, I think, on this.
Vicky Eldridge
How can practitioners come together and be proactive in supporting, you know, in the absence, whilst we're still waiting for a licensing scheme? Because I think, you know, my view is that we see that people feel really passionate about this. They feel very emotional about this and they're very vocal about it on social media. How can we come together and be proactive in the way that we're letting the public know?
David Sines
Well, this is a really big question. I believe my faith in our practitioner community is very high, Vicky. We have recently worked together across the community to look at non-medical prescribing or independent prescribing and to avoid remote prescribing. And the nursing and midwifery council has launched an incredibly helpful consultation. We had a big meeting, an online meeting last Wednesday. And I was absolutely enthralled, and I use that term wisely, by the number of people - there were over 80 on the call, who through breakout groups were highly supportive of the need to avoid remote prescribing. In other words, many other thoughts came out during those conversations, Vicky, which showed us that we have a community of interest. In the public interest.
David Sines
How do we though communicate that to members of the public?
Vicky Eldridge
That's a challenge, isn't it,
David Sines
It's the challenge. And I don't have the real answer to that. But for example, I'm now working with my colleagues at Consulting Rooms.
They're doing some amazing work. And they, their suggestion is, why don't we work together to start to build some public facing media competence messaging, I use that word, media competence, using the right language code, getting the right questions. But we've absolutely agreed that we'll use our JCCP and me public website with Consulting Rooms and others to get those messages out to members of the public.
Vicky Eldridge
Yeah, absolutely. And you've mentioned partnering there with other industry organisations and associations. Hamilton Fraser have long been involved with the JCCP and have been supportive of that. Why have it been important for you to partner with a company like Hamilton Fraser? And I know Eddie's been very, um, instrumental, hasn't he?
David Sines
Well, Eddie has been, but Eddie was instrumental Eddie Hooker, our chief executive, long before we entered into a formal partnership. I can remember Eddie coming to meet me back in 2015 at the King's Fund, at a meeting where he said, I really need support to close the gap here. We're not sure whether we are able to, well the methods that we use to screen for insurance with our clients, leaves us to some extent exposed from a risk perspective, how can we really protect the public, members of the public. And then work backwards. So that's what did it for me, Vicky. It was the commitment of Hamilton Fraser, which I've never doubted, to public protection, patient safety and constantly trying to improve the quality of the insurance market. Putting public safety ahead of just commercial insurance interest. So it wasn't at all difficult for us to see that one of the gateways to public safety was through insurance.
because if you insure effectively using the correct risk assessment, risk analysis and risk metrics, you automatically have a public protection system. So in my view, due diligence and governance of public protection is via the insurance market as much as anywhere else. So it was a natural partnership that formed. Hamilton, Fraser now host our registers for our education, approved education and training providers. But we also work constantly with them to develop best practise in insurance. So we've just developed together, along with a number of underwriters and others, a good practice guide to inform the department of health and social care of what insurance should look like, including indemnity, allow, sorry, thresholds, et cetera. So it's been a natural, I think, synergy of ethical and moral alignment.
Vicky Eldridge
Amazing. My final question is just what advice would you give to anyone getting started in aesthetics now? So medical professionals who are thinking about moving into aesthetics. It's a growing market, isn't it? What advice would you have for them?
David Sines
Well, I would say it's a very positive future. The bottom line here is that medical aesthetics should not just be treated as a soft option.
David Sines
It is a specialty in its own right. Therefore it should be treated with the same due regard as if you were pursuing or seeking to pursue a specialist career in cardiology. Or in plastic surgery. So critically important will be the need to consider the next step beyond initial training and education. So, seeking out a postgraduate programme in medical aesthetics at one of our medical schools, our universities, one of the JCCPs own approved providers would put you in a very good place, when licensing comes into effect in England and elsewhere.
Vicky Eldridge
Amazing. David, thank you so much. A pleasure to talk to you as always.
David Sines
Lovely. Thank you very much too.
Vicky Eldridge
Thank you.
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